INBDE Booster Pharmacology UPDATED
Exam Questions and CORRECT Answers
Local Anesthetics
[Amides vs Esters] - CORRECT ANSWER - LA Amides: Metabolized in liver [Lidocaine,
Bupivicaine, Mepivicaine, Articaine, Prilocaine]
LA Esters: Metabolized in plasma [Procaine, Cocaine, Tetracaine, Benzocaine]
*Only memorized one column and remember that all LAs end in -aine
Amide Local Anesthetics: Lidocaine, Bupivicaine, Mepivicaine, Articaine, Prilocaine -
CORRECT ANSWER - Lidocaine: Safest in children
Bupivicaine: not safe in children, Longest duration
Mepivicaine: Least vasodilation
Articaine: One ester chain
Prilocaine: Linked to metheglobinemia
Pharmacodynamics of Local Anesthetics
[Function on a Cellular Level] - CORRECT ANSWER - -Sodium Channel Blockers:
Prevents depolarization of neurons
-Drug's unionized form can penetrate the hydrophobic membrane to work [inflamed tissues are
acidic and cause the ionized form which reduces function]
Pharmacokinetics of Local Anesthetics [Blood Flow, Lipid Solubility, Protein Binding, and pKa]
- CORRECT ANSWER - High Blood Flow: Shorter duration of action
High Lipid Solubility/Hydrophobicity: more potent, longer duration of action
High Protein Binding: Longer duration of action
Lower pKa: faster onset of action [lower pKa then stronger acid so donates H faster to create
nonionized form]
, Calculating Local Anesthetic Concentrations - CORRECT ANSWER - -1mL of liquid
weights 1g
-Carpule/Cartridge of anesthetic contains 1.8mL
EX: For 1% LA Cartridge then amount of anesthetic is 1800mg * 0.01 = 18mg
Maximums: 7mg/kg Lidocaine Adults, 4.4mg/kg Lidocaine Children, 7mg/kg Articaine,
4.4mg/kg Mepivacaine, 1.4mg/kg Bupivicaine
Maximum mL: max dose mg/kg * weight (kg)/10 * 1/concentration %
1 lb = 0.45kg
Vasoconstrictor Purposes (3) - CORRECT ANSWER - 1) Prolongs numbness
2) Reduces toxicity
3) Promote hemostasis
Toxicity of Epinephrine for ASA, Epinephrine for Cardiac Patient, Lidocaine without
Vasoconstrictor, and Max Lidocaine with Vasoconstrictor - CORRECT ANSWER - Epi
ASA: 0.2mg
Ep Cardiac: 0.04mg
Lido without Vaso: 4.4mg/kg
Lido with Vaso: 7mg/kg
IAN Block, Buccal Nerve Block, Mental Nerve Block, Incisive Nerve Block - CORRECT
ANSWER - IAN: Numbs all mandibular teeth in that quadrant
-Lingual nerve block numbs relative half of tongue
Buccal: Terminal to IAN to block tissue buccal to molars
Mental: Anterior to mandibular second premolar & numbs soft tissue buccal to premolars and
lateral/central incisor on that side
Incisive: Same as mental but hold pressure for 2 minutes after injection to force into mental
foramen
Exam Questions and CORRECT Answers
Local Anesthetics
[Amides vs Esters] - CORRECT ANSWER - LA Amides: Metabolized in liver [Lidocaine,
Bupivicaine, Mepivicaine, Articaine, Prilocaine]
LA Esters: Metabolized in plasma [Procaine, Cocaine, Tetracaine, Benzocaine]
*Only memorized one column and remember that all LAs end in -aine
Amide Local Anesthetics: Lidocaine, Bupivicaine, Mepivicaine, Articaine, Prilocaine -
CORRECT ANSWER - Lidocaine: Safest in children
Bupivicaine: not safe in children, Longest duration
Mepivicaine: Least vasodilation
Articaine: One ester chain
Prilocaine: Linked to metheglobinemia
Pharmacodynamics of Local Anesthetics
[Function on a Cellular Level] - CORRECT ANSWER - -Sodium Channel Blockers:
Prevents depolarization of neurons
-Drug's unionized form can penetrate the hydrophobic membrane to work [inflamed tissues are
acidic and cause the ionized form which reduces function]
Pharmacokinetics of Local Anesthetics [Blood Flow, Lipid Solubility, Protein Binding, and pKa]
- CORRECT ANSWER - High Blood Flow: Shorter duration of action
High Lipid Solubility/Hydrophobicity: more potent, longer duration of action
High Protein Binding: Longer duration of action
Lower pKa: faster onset of action [lower pKa then stronger acid so donates H faster to create
nonionized form]
, Calculating Local Anesthetic Concentrations - CORRECT ANSWER - -1mL of liquid
weights 1g
-Carpule/Cartridge of anesthetic contains 1.8mL
EX: For 1% LA Cartridge then amount of anesthetic is 1800mg * 0.01 = 18mg
Maximums: 7mg/kg Lidocaine Adults, 4.4mg/kg Lidocaine Children, 7mg/kg Articaine,
4.4mg/kg Mepivacaine, 1.4mg/kg Bupivicaine
Maximum mL: max dose mg/kg * weight (kg)/10 * 1/concentration %
1 lb = 0.45kg
Vasoconstrictor Purposes (3) - CORRECT ANSWER - 1) Prolongs numbness
2) Reduces toxicity
3) Promote hemostasis
Toxicity of Epinephrine for ASA, Epinephrine for Cardiac Patient, Lidocaine without
Vasoconstrictor, and Max Lidocaine with Vasoconstrictor - CORRECT ANSWER - Epi
ASA: 0.2mg
Ep Cardiac: 0.04mg
Lido without Vaso: 4.4mg/kg
Lido with Vaso: 7mg/kg
IAN Block, Buccal Nerve Block, Mental Nerve Block, Incisive Nerve Block - CORRECT
ANSWER - IAN: Numbs all mandibular teeth in that quadrant
-Lingual nerve block numbs relative half of tongue
Buccal: Terminal to IAN to block tissue buccal to molars
Mental: Anterior to mandibular second premolar & numbs soft tissue buccal to premolars and
lateral/central incisor on that side
Incisive: Same as mental but hold pressure for 2 minutes after injection to force into mental
foramen
