Local Anesthesia in Dentistry exam questions and answers fully solved
Sodium Bisulfite - AnswersPrevents oxidation of vasoconstrictors in LA
Vasoconstrictors - AnswersCompounds found in LA cartridges to constrict blood vessels
Plain - AnswersType of LA recommended for patients with Sodium Bisulfite allergy
Sulfa Drug Precautions - AnswersNo precautions needed for sulfites in LA if patient has sulfa
antibiotic allergy
Patient Position for LA - AnswersSemi-supine position for all patients receiving LA
Malignant Hyperthermia - AnswersGenetic condition affecting O2, temp regulation, and CO2
removal
Methemoglobinemia - AnswersAbnormal methemoglobin levels causing cyanosis, respiratory
depression, and syncope
Relative Contraindication for Methemoglobinemia - AnswersPrilocaine, also avoid benzocaine
Amide Drug Less Affected by Liver Dysfunction - AnswersArticaine
Renal Dysfunction in Pregnant Women - AnswersIncreases LA levels in blood, impairs excretion
Placenta - AnswersBarrier allowing drug transfer to fetus
Category B Drugs - AnswersLidocaine, Prilocaine
Category C Drugs - AnswersMepivacaine, Septocaine
Bleeding Disorder Injection - AnswersGow Gates injection
Mild Hypersensitivity Reaction Treatment - AnswersChlorpheniramine in addition to
diphenhydramine
Cyanotic Patient with Wheezing - AnswersExperiencing asthma
Angina Attack Drug - AnswersNitroglycerine, administered every 5 minutes up to 3 doses in 15
minutes
Trendelenburg Position - AnswersPosition with feet higher than the head
Ester vs. Amide Drugs - AnswersEsters have one 'I', amides have two 'I's
, Ester Biotransformation - AnswersIn the blood plasma
Amide Biotransformation - AnswersIn the liver
Mepivacaine Brand Names - AnswersCarbocaine, Polocaine
Vasoconstrictor-Contradicted LA Drug - AnswersMepivacaine (Polocaine, Carbocaine)
Methylparaben - AnswersBacteriostatic agent no longer used in cartridges
Paresthesia-Causing Drugs - Answers4% Prilocaine and Articaine
Ester Allergy Avoidance - AnswersAvoid topical anesthetics containing esters
Anaphylaxis Management - AnswersAdminister oxygen and 0.3mg epinephrine
Absolute Contraindication - AnswersMedical treatment should never be given
Vasoconstrictor Use in Uncontrolled Diabetes - AnswersNot recommended
Relative Contraindication of Vasoconstrictors - AnswersEvaluate benefits and risks
Relative Contraindications of Vasoconstrictors - AnswersSignificant renal and liver dysfunction,
atypical pseudocholinesterase, methemoglobinemia
Methemoglobinemia-Avoided Drugs - AnswersBenzocaine and Prilocaine
Elavil as a Contraindication - AnswersRelative contraindication
Adverse Reaction Timing - AnswersMost reactions within 5-10 minutes of injection
Most Common Adverse Reaction - AnswersOverdose
Allergic Reaction Severity - AnswersNot related to the amount or dose given
Unpredictable Reaction Type - AnswersIdiosyncratic reactions
Local Anesthetic Overdose Sequence - AnswersCNS excited, then depressed
Early Overdose Signs - AnswersDizziness, confusion, numbness, twitching, slowed speech,
tremors, talkativeness
Severe Overdose Signs - AnswersLoss of consciousness, metallic taste, drowsiness
Dental Injection Administration - AnswersSubcutaneously
Blood-Brain Barrier Crossing - AnswersAll local anesthetics cross the blood-brain barrier
Ester Biotransformation Location - AnswersIn the blood plasma
Amide Biotransformation Location - AnswersIn the liver
Sodium Bisulfite - AnswersPrevents oxidation of vasoconstrictors in LA
Vasoconstrictors - AnswersCompounds found in LA cartridges to constrict blood vessels
Plain - AnswersType of LA recommended for patients with Sodium Bisulfite allergy
Sulfa Drug Precautions - AnswersNo precautions needed for sulfites in LA if patient has sulfa
antibiotic allergy
Patient Position for LA - AnswersSemi-supine position for all patients receiving LA
Malignant Hyperthermia - AnswersGenetic condition affecting O2, temp regulation, and CO2
removal
Methemoglobinemia - AnswersAbnormal methemoglobin levels causing cyanosis, respiratory
depression, and syncope
Relative Contraindication for Methemoglobinemia - AnswersPrilocaine, also avoid benzocaine
Amide Drug Less Affected by Liver Dysfunction - AnswersArticaine
Renal Dysfunction in Pregnant Women - AnswersIncreases LA levels in blood, impairs excretion
Placenta - AnswersBarrier allowing drug transfer to fetus
Category B Drugs - AnswersLidocaine, Prilocaine
Category C Drugs - AnswersMepivacaine, Septocaine
Bleeding Disorder Injection - AnswersGow Gates injection
Mild Hypersensitivity Reaction Treatment - AnswersChlorpheniramine in addition to
diphenhydramine
Cyanotic Patient with Wheezing - AnswersExperiencing asthma
Angina Attack Drug - AnswersNitroglycerine, administered every 5 minutes up to 3 doses in 15
minutes
Trendelenburg Position - AnswersPosition with feet higher than the head
Ester vs. Amide Drugs - AnswersEsters have one 'I', amides have two 'I's
, Ester Biotransformation - AnswersIn the blood plasma
Amide Biotransformation - AnswersIn the liver
Mepivacaine Brand Names - AnswersCarbocaine, Polocaine
Vasoconstrictor-Contradicted LA Drug - AnswersMepivacaine (Polocaine, Carbocaine)
Methylparaben - AnswersBacteriostatic agent no longer used in cartridges
Paresthesia-Causing Drugs - Answers4% Prilocaine and Articaine
Ester Allergy Avoidance - AnswersAvoid topical anesthetics containing esters
Anaphylaxis Management - AnswersAdminister oxygen and 0.3mg epinephrine
Absolute Contraindication - AnswersMedical treatment should never be given
Vasoconstrictor Use in Uncontrolled Diabetes - AnswersNot recommended
Relative Contraindication of Vasoconstrictors - AnswersEvaluate benefits and risks
Relative Contraindications of Vasoconstrictors - AnswersSignificant renal and liver dysfunction,
atypical pseudocholinesterase, methemoglobinemia
Methemoglobinemia-Avoided Drugs - AnswersBenzocaine and Prilocaine
Elavil as a Contraindication - AnswersRelative contraindication
Adverse Reaction Timing - AnswersMost reactions within 5-10 minutes of injection
Most Common Adverse Reaction - AnswersOverdose
Allergic Reaction Severity - AnswersNot related to the amount or dose given
Unpredictable Reaction Type - AnswersIdiosyncratic reactions
Local Anesthetic Overdose Sequence - AnswersCNS excited, then depressed
Early Overdose Signs - AnswersDizziness, confusion, numbness, twitching, slowed speech,
tremors, talkativeness
Severe Overdose Signs - AnswersLoss of consciousness, metallic taste, drowsiness
Dental Injection Administration - AnswersSubcutaneously
Blood-Brain Barrier Crossing - AnswersAll local anesthetics cross the blood-brain barrier
Ester Biotransformation Location - AnswersIn the blood plasma
Amide Biotransformation Location - AnswersIn the liver
