EXOS EXAM PRACTICE QUESTIONS
WITH CORRECT ANSWERS!!
If giving IV adrenaline, what is the dose? (Anaphylaxis, asthma etc)
1-5mL of 1:10,000
Treatment for hypoglycaemic shock
If their conscious - glucose drink
Unconscious - IV 20mL 50% glucose (3-5mins) or 1mg glucagon IM
Check BSL
What LA would you use in a patient on Atenolol?
3% Prilocaine with Octapressin
What is the only type of anti-hypertensive drug contraindicated with lignocaine
w/ adrenaline?
β-blockers - atenolol, metoprolol, propranolol
What LA would you use in a patient on Salbutamol?
3% Prilocaine with Octapressin OR 3% plain mepivacaine
What LA would you use in a patient on tricylic antidepressants?
3% Prilocaine with Octapressin OR 3% plain mepivacaine
What LA would you use in a patient on MAOIs for depression?
3% Prilocaine with Octapressin OR 3% plain mepivacaine
What are the possible side effects in giving lignocaine with adrenaline to a patient on
MAOIs?
Potentiation of adrenaline may lead to elevated BP
Why is adrenaline contraindicated in patients using tricyclic antidepressants?
, They inhibit removal/reuptake of noradrenaline and may cause prolonged adrenergic effects.
What antipsychotic is plain lignocaine contraindicated for?
Phenothiazines
Generally, would lignocaine be okay to use in patients on antipsychotic medication?
Yes, phenothiazines may be contraindicated for plain ligno however.
New patient presents for a restoration and is on Digoxin for heart failure. What LA would
you use? Why?
3% Prilocaine with Octapressin OR 3% plain mepivacaine. Adrenaline may potentiate cardiac
arrythmias.
How do opioid analgesics affect LA choice?
They require higher dosages of LA between treatments or during withdrawal. This could mean
that increased LA dose may lead to hypertensive, cardiovascular effects or risk OD. Best to
defer dental treatment until when no opioids taken, if needed use articaine 4% infiltration.
Why is lignocaine contraindicated in patients taking H2 agonists? What is the alternative?
May decrease metabolism in the liver, leading to lignocaine toxicity. Use 4% articaine
for infiltration and 3% prilocaine with octapressin for blocks.
Is lignocaine contraindicated when using statins?
No
Is lignocaine contraindicated when using cyclosporin? What is cyclosporin?
Cyclosporin is an immune suppressant. It is contraindicated as adrenaline may increase BP.
3% Prilocaine with octapressin instead.
What is phenytoin used for? Is lignocaine contraindicated?
Anticonvulsant used for treatin epilepsy. Lignocaine plain is contraindicated as it has
additive cardiodepressive effects. Can use lignocaine WITH adrenaline, otherwise 3%
Prilocaine with Octapressin
WITH CORRECT ANSWERS!!
If giving IV adrenaline, what is the dose? (Anaphylaxis, asthma etc)
1-5mL of 1:10,000
Treatment for hypoglycaemic shock
If their conscious - glucose drink
Unconscious - IV 20mL 50% glucose (3-5mins) or 1mg glucagon IM
Check BSL
What LA would you use in a patient on Atenolol?
3% Prilocaine with Octapressin
What is the only type of anti-hypertensive drug contraindicated with lignocaine
w/ adrenaline?
β-blockers - atenolol, metoprolol, propranolol
What LA would you use in a patient on Salbutamol?
3% Prilocaine with Octapressin OR 3% plain mepivacaine
What LA would you use in a patient on tricylic antidepressants?
3% Prilocaine with Octapressin OR 3% plain mepivacaine
What LA would you use in a patient on MAOIs for depression?
3% Prilocaine with Octapressin OR 3% plain mepivacaine
What are the possible side effects in giving lignocaine with adrenaline to a patient on
MAOIs?
Potentiation of adrenaline may lead to elevated BP
Why is adrenaline contraindicated in patients using tricyclic antidepressants?
, They inhibit removal/reuptake of noradrenaline and may cause prolonged adrenergic effects.
What antipsychotic is plain lignocaine contraindicated for?
Phenothiazines
Generally, would lignocaine be okay to use in patients on antipsychotic medication?
Yes, phenothiazines may be contraindicated for plain ligno however.
New patient presents for a restoration and is on Digoxin for heart failure. What LA would
you use? Why?
3% Prilocaine with Octapressin OR 3% plain mepivacaine. Adrenaline may potentiate cardiac
arrythmias.
How do opioid analgesics affect LA choice?
They require higher dosages of LA between treatments or during withdrawal. This could mean
that increased LA dose may lead to hypertensive, cardiovascular effects or risk OD. Best to
defer dental treatment until when no opioids taken, if needed use articaine 4% infiltration.
Why is lignocaine contraindicated in patients taking H2 agonists? What is the alternative?
May decrease metabolism in the liver, leading to lignocaine toxicity. Use 4% articaine
for infiltration and 3% prilocaine with octapressin for blocks.
Is lignocaine contraindicated when using statins?
No
Is lignocaine contraindicated when using cyclosporin? What is cyclosporin?
Cyclosporin is an immune suppressant. It is contraindicated as adrenaline may increase BP.
3% Prilocaine with octapressin instead.
What is phenytoin used for? Is lignocaine contraindicated?
Anticonvulsant used for treatin epilepsy. Lignocaine plain is contraindicated as it has
additive cardiodepressive effects. Can use lignocaine WITH adrenaline, otherwise 3%
Prilocaine with Octapressin
