INBDE Pharmacology Study Guide
Questions with Detailed Answers 2026-
2027 Updated.
List the Amide local anesthetics - Answer 1. Lidocaine
2. Bupivacaine
3. Articaine (septocaine)
4. Mepivacaine
5. Prilocaine
Where are amides metabolized? - Answer liver
Where are esters metabolized? - Answer plasma
List all the ester local anesthetics - Answer 1. Bupivacaine
2. Cocaine
3. Pilocaine
4. Tetracaine
Which is the longest acting local anesthetic (amide) - Answer Bupivacaine
Which is the shortest acting local anesthetic (amide) and why? - Answer Articaine - it has an
ester group and is metabolized by both liver and plasma
Are esters or amides more toxic and more allergic? - Answer Esters because of methylparaben
- a food preservative and antifungal
Local anesthetic safest in children? - Answer Lidocaine
Local anesthetic not safe in children? - Answer Bupivacaine
Which local anesthetic can cause methemglobimenia? - Answer Prilocaine
Methemoglobinemia - blood disorder where too little oxygen delivered to tissues bc of
abnormal methemoglobin.
, Which local anesthetic is a vasoconstrictor? - Answer cocaine
Pharmakodynamics of local anesthetics - Answer 1. LA are SODIUM CHANNEL BLOCKERS
2. Non-ionized form of drug passes through the hydrophobic barrier of the neuron. Inflamed
tissue has low pH (decreases amount of non-ionized forms of LA), so it is harder to penetrate
the neuron.
3. Critical length = complete anesthesia achieved when THREE consecutive nodes of rangier are
blocked.
Pharmacokinetics of local anesthesia - Answer Increase blood flow = shorter duration of action
Increased lipid solubility = more potent & longer duration of action
Increase protein binding = longer duration of action
Low pKa = stronger acid, more likely to give up its proton (non-ionized crossed neuron
membrane) --> faster onset of action
pKA of mepivacaine, lidocaine prilocaine, articaine, and bupivacine - Answer 7.6 =
Mepivacaine
7.8 = lidocaine, articaine, prilocaine
8.1 = Bupivacaine
Vasoconstrictor in local anesthetic role - Answer 1. Prolong numbness
2. Reduce toxicity = constrict BV, less blood flow, less opportunity for LA to enter bloodstream
3. Promote hemostasis
Max Epi for ASA 1 patient? - Answer 0.2 mg
Max Epi for cardiac patient? - Answer 0.04mg
Max lidocaine with vasoconstrictor? - Answer 7mg/kg
(vasoconstrictor reduces blood flow and possible toxicity of local anesthetic)
Max lidocaine without vasoconstrictor - Answer 4.4mg/gk
Define Bacteriostatic - Answer prevent bacterial growth
T/F: bacteriostatic and bactericidal cancel each other out and should never be used together -
Answer T
Questions with Detailed Answers 2026-
2027 Updated.
List the Amide local anesthetics - Answer 1. Lidocaine
2. Bupivacaine
3. Articaine (septocaine)
4. Mepivacaine
5. Prilocaine
Where are amides metabolized? - Answer liver
Where are esters metabolized? - Answer plasma
List all the ester local anesthetics - Answer 1. Bupivacaine
2. Cocaine
3. Pilocaine
4. Tetracaine
Which is the longest acting local anesthetic (amide) - Answer Bupivacaine
Which is the shortest acting local anesthetic (amide) and why? - Answer Articaine - it has an
ester group and is metabolized by both liver and plasma
Are esters or amides more toxic and more allergic? - Answer Esters because of methylparaben
- a food preservative and antifungal
Local anesthetic safest in children? - Answer Lidocaine
Local anesthetic not safe in children? - Answer Bupivacaine
Which local anesthetic can cause methemglobimenia? - Answer Prilocaine
Methemoglobinemia - blood disorder where too little oxygen delivered to tissues bc of
abnormal methemoglobin.
, Which local anesthetic is a vasoconstrictor? - Answer cocaine
Pharmakodynamics of local anesthetics - Answer 1. LA are SODIUM CHANNEL BLOCKERS
2. Non-ionized form of drug passes through the hydrophobic barrier of the neuron. Inflamed
tissue has low pH (decreases amount of non-ionized forms of LA), so it is harder to penetrate
the neuron.
3. Critical length = complete anesthesia achieved when THREE consecutive nodes of rangier are
blocked.
Pharmacokinetics of local anesthesia - Answer Increase blood flow = shorter duration of action
Increased lipid solubility = more potent & longer duration of action
Increase protein binding = longer duration of action
Low pKa = stronger acid, more likely to give up its proton (non-ionized crossed neuron
membrane) --> faster onset of action
pKA of mepivacaine, lidocaine prilocaine, articaine, and bupivacine - Answer 7.6 =
Mepivacaine
7.8 = lidocaine, articaine, prilocaine
8.1 = Bupivacaine
Vasoconstrictor in local anesthetic role - Answer 1. Prolong numbness
2. Reduce toxicity = constrict BV, less blood flow, less opportunity for LA to enter bloodstream
3. Promote hemostasis
Max Epi for ASA 1 patient? - Answer 0.2 mg
Max Epi for cardiac patient? - Answer 0.04mg
Max lidocaine with vasoconstrictor? - Answer 7mg/kg
(vasoconstrictor reduces blood flow and possible toxicity of local anesthetic)
Max lidocaine without vasoconstrictor - Answer 4.4mg/gk
Define Bacteriostatic - Answer prevent bacterial growth
T/F: bacteriostatic and bactericidal cancel each other out and should never be used together -
Answer T
