Local Anesthesia in Dentistry | QUESTIONS AND
CORRECT ANSWERS | 2025/2026 VERSION
Sodium Bisulfite - SOLUTION -Prevents oxidation of vasoconstrictors in LA
Vasoconstrictors - SOLUTION -Compounds found in LA cartridges to constrict blood vessels
Plain - SOLUTION -Type of LA recommended for patients with Sodium Bisulfite allergy
Sulfa Drug Precautions - SOLUTION -No precautions needed for sulfites in LA if patient has sulfa
antibiotic allergy
Patient Position for LA - SOLUTION -Semi-supine position for all patients receiving LA
Malignant Hyperthermia - SOLUTION -Genetic condition affecting O2, temp regulation, and CO2
removal
Methemoglobinemia - SOLUTION -Abnormal methemoglobin levels causing cyanosis, respiratory
depression, and syncope
Relative Contraindication for Methemoglobinemia - SOLUTION -Prilocaine, also avoid benzocaine
Amide Drug Less Affected by Liver Dysfunction - SOLUTION -Articaine
Renal Dysfunction in Pregnant Women - SOLUTION -Increases LA levels in blood, impairs excretion
Placenta - SOLUTION -Barrier allowing drug transfer to fetus
Category B Drugs - SOLUTION -Lidocaine, Prilocaine
Category C Drugs - SOLUTION -Mepivacaine, Septocaine
Bleeding Disorder Injection - SOLUTION -Gow Gates injection
Mild Hypersensitivity Reaction Treatment - SOLUTION -Chlorpheniramine in addition to
diphenhydramine
Cyanotic Patient with Wheezing - SOLUTION -Experiencing asthma
Angina Attack Drug - SOLUTION -Nitroglycerine, administered every 5 minutes up to 3 doses in 15
minutes
Trendelenburg Position - SOLUTION -Position with feet higher than the head
Ester vs. Amide Drugs - SOLUTION -Esters have one 'I', amides have two 'I's
Ester Biotransformation - SOLUTION -In the blood plasma
Amide Biotransformation - SOLUTION -In the liver
Mepivacaine Brand Names - SOLUTION -Carbocaine, Polocaine
Vasoconstrictor-Contradicted LA Drug - SOLUTION -Mepivacaine (Polocaine, Carbocaine)
Methylparaben - SOLUTION -Bacteriostatic agent no longer used in cartridges
, Paresthesia-Causing Drugs - SOLUTION -4% Prilocaine and Articaine
Ester Allergy Avoidance - SOLUTION -Avoid topical anesthetics containing esters
Anaphylaxis Management - SOLUTION -Administer oxygen and 0.3mg epinephrine
Absolute Contraindication - SOLUTION -Medical treatment should never be given
Vasoconstrictor Use in Uncontrolled Diabetes - SOLUTION -Not recommended
Relative Contraindication of Vasoconstrictors - SOLUTION -Evaluate benefits and risks
Relative Contraindications of Vasoconstrictors - SOLUTION -Significant renal and liver dysfunction,
atypical pseudocholinesterase, methemoglobinemia
Methemoglobinemia-Avoided Drugs - SOLUTION -Benzocaine and Prilocaine
Elavil as a Contraindication - SOLUTION -Relative contraindication
Adverse Reaction Timing - SOLUTION -Most reactions within 5-10 minutes of injection
Most Common Adverse Reaction - SOLUTION -Overdose
Allergic Reaction Severity - SOLUTION -Not related to the amount or dose given
Unpredictable Reaction Type - SOLUTION -Idiosyncratic reactions
Local Anesthetic Overdose Sequence - SOLUTION -CNS excited, then depressed
Early Overdose Signs - SOLUTION -Dizziness, confusion, numbness, twitching, slowed speech,
tremors, talkativeness
Severe Overdose Signs - SOLUTION -Loss of consciousness, metallic taste, drowsiness
Dental Injection Administration - SOLUTION -Subcutaneously
Blood-Brain Barrier Crossing - SOLUTION -All local anesthetics cross the blood-brain barrier
Ester Biotransformation Location - SOLUTION -In the blood plasma
Amide Biotransformation Location - SOLUTION -In the liver
Primary LA Excretory Organ - SOLUTION -Kidneys
CNS Components - SOLUTION -Brain and spinal cord
Blood-Brain Barrier - SOLUTION -Semipermeable membrane
CNS Response at Any Toxicity Level - SOLUTION -Excites
Drug Biotransformation Speed Factors - SOLUTION -Cirrhosis, hypotension, CHF
Ester Drug 'I' Count - SOLUTION -One
LA Effect on CVS - SOLUTION -Relaxes smooth muscles of the blood vessels
Paresthesia-Affected Nerves - SOLUTION -Lingual and IA nerves
Atropine - SOLUTION -Depressant to prevent syncope
Mandible Density - SOLUTION -More dense, less porous than maxillary
CORRECT ANSWERS | 2025/2026 VERSION
Sodium Bisulfite - SOLUTION -Prevents oxidation of vasoconstrictors in LA
Vasoconstrictors - SOLUTION -Compounds found in LA cartridges to constrict blood vessels
Plain - SOLUTION -Type of LA recommended for patients with Sodium Bisulfite allergy
Sulfa Drug Precautions - SOLUTION -No precautions needed for sulfites in LA if patient has sulfa
antibiotic allergy
Patient Position for LA - SOLUTION -Semi-supine position for all patients receiving LA
Malignant Hyperthermia - SOLUTION -Genetic condition affecting O2, temp regulation, and CO2
removal
Methemoglobinemia - SOLUTION -Abnormal methemoglobin levels causing cyanosis, respiratory
depression, and syncope
Relative Contraindication for Methemoglobinemia - SOLUTION -Prilocaine, also avoid benzocaine
Amide Drug Less Affected by Liver Dysfunction - SOLUTION -Articaine
Renal Dysfunction in Pregnant Women - SOLUTION -Increases LA levels in blood, impairs excretion
Placenta - SOLUTION -Barrier allowing drug transfer to fetus
Category B Drugs - SOLUTION -Lidocaine, Prilocaine
Category C Drugs - SOLUTION -Mepivacaine, Septocaine
Bleeding Disorder Injection - SOLUTION -Gow Gates injection
Mild Hypersensitivity Reaction Treatment - SOLUTION -Chlorpheniramine in addition to
diphenhydramine
Cyanotic Patient with Wheezing - SOLUTION -Experiencing asthma
Angina Attack Drug - SOLUTION -Nitroglycerine, administered every 5 minutes up to 3 doses in 15
minutes
Trendelenburg Position - SOLUTION -Position with feet higher than the head
Ester vs. Amide Drugs - SOLUTION -Esters have one 'I', amides have two 'I's
Ester Biotransformation - SOLUTION -In the blood plasma
Amide Biotransformation - SOLUTION -In the liver
Mepivacaine Brand Names - SOLUTION -Carbocaine, Polocaine
Vasoconstrictor-Contradicted LA Drug - SOLUTION -Mepivacaine (Polocaine, Carbocaine)
Methylparaben - SOLUTION -Bacteriostatic agent no longer used in cartridges
, Paresthesia-Causing Drugs - SOLUTION -4% Prilocaine and Articaine
Ester Allergy Avoidance - SOLUTION -Avoid topical anesthetics containing esters
Anaphylaxis Management - SOLUTION -Administer oxygen and 0.3mg epinephrine
Absolute Contraindication - SOLUTION -Medical treatment should never be given
Vasoconstrictor Use in Uncontrolled Diabetes - SOLUTION -Not recommended
Relative Contraindication of Vasoconstrictors - SOLUTION -Evaluate benefits and risks
Relative Contraindications of Vasoconstrictors - SOLUTION -Significant renal and liver dysfunction,
atypical pseudocholinesterase, methemoglobinemia
Methemoglobinemia-Avoided Drugs - SOLUTION -Benzocaine and Prilocaine
Elavil as a Contraindication - SOLUTION -Relative contraindication
Adverse Reaction Timing - SOLUTION -Most reactions within 5-10 minutes of injection
Most Common Adverse Reaction - SOLUTION -Overdose
Allergic Reaction Severity - SOLUTION -Not related to the amount or dose given
Unpredictable Reaction Type - SOLUTION -Idiosyncratic reactions
Local Anesthetic Overdose Sequence - SOLUTION -CNS excited, then depressed
Early Overdose Signs - SOLUTION -Dizziness, confusion, numbness, twitching, slowed speech,
tremors, talkativeness
Severe Overdose Signs - SOLUTION -Loss of consciousness, metallic taste, drowsiness
Dental Injection Administration - SOLUTION -Subcutaneously
Blood-Brain Barrier Crossing - SOLUTION -All local anesthetics cross the blood-brain barrier
Ester Biotransformation Location - SOLUTION -In the blood plasma
Amide Biotransformation Location - SOLUTION -In the liver
Primary LA Excretory Organ - SOLUTION -Kidneys
CNS Components - SOLUTION -Brain and spinal cord
Blood-Brain Barrier - SOLUTION -Semipermeable membrane
CNS Response at Any Toxicity Level - SOLUTION -Excites
Drug Biotransformation Speed Factors - SOLUTION -Cirrhosis, hypotension, CHF
Ester Drug 'I' Count - SOLUTION -One
LA Effect on CVS - SOLUTION -Relaxes smooth muscles of the blood vessels
Paresthesia-Affected Nerves - SOLUTION -Lingual and IA nerves
Atropine - SOLUTION -Depressant to prevent syncope
Mandible Density - SOLUTION -More dense, less porous than maxillary
