Deck 5: Local Anesthetic Agents

Question 1

What is the solution that is added to the cartridge of local anesthetic to prevent oxidation of the vasoconstrictor called?

A) Vasoconstrictor preservative
B) Sodium hydroxide
C) Sodium chloride
D) Methylparaben

Answer 1

Vasoconstrictor preservative

Question 2

Name the local amide anesthetic agent that has the highest dissociation constant,and explain what this high dissociation constant means.

Answer 2

Bupivacaine has the highest pKa,which means that it has the slowest onset of action but has a duration that almost doubles the duration of lidocaine.

Question 3

Which two local anesthetic agents have the least vasodilating properties?

Answer 3

Mepivacaine and prilocaine

Question 4

What is the solution that is added to the cartridge of local anesthetic that can trigger bronchospasms?

A) Vasoconstrictor preservative
B) Sodium hydroxide
C) Sodium chloride
D) Methylparaben

Question 5

Name the local anesthetic that produces an intermediate duration when administered as a block injection.

Question 6

An anesthetic solution of 1:100,000 epinephrine is twice as effective in controlling pain as a solution of 1:50,000 epinephrine.

Question 7

Currently,no anesthetic cartridges contain methylparaben.

Question 8

What is the solution that was added to the cartridge of local anesthetic to prevent bacterial growth?

A) Vasoconstrictor preservative
B) Sodium hydroxide
C) Sodium chloride
D) Methylparaben

Question 9

Sodium chloride is a buffer creating an injectable solution that is isotonic.

Question 10

What local anesthetic agents would be a good choice to use when a vasoconstrictor is contraindicated?

Question 11

Name the local anesthetic that has the shortest half-life and the lowest risk for systemic toxicity.

Question 12

Articaine local anesthetic cartridges are labeled that they contain 1.7 mL of solution.

Question 13

What is the difference between generic names and proprietary names of local anesthetics?

Question 14

Which of the following local anesthetics,without vasoconstrictors,is/are useful in dentistry?

A) Prilocaine
B) Mepivacaine
C) All options listed
D) None of the options listed

Question 15

Which of the following should the dental hygienist consider prior to administering local anesthetic to a patient?

A) Need for posttreatment pain control
B) Length of the procedure
C) Patient's current health assessment
D) Need for hemostasis
E) All options listed

Question 16

Inflamed tissue experiences an increase in vascularity,slowing the onset of anesthetic action and decreasing the duration of anesthetic action;however,in healthy tissues the onset of action and the duration of action are more predictable.

Question 17

Among local anesthetics procaine has the highest percentage of protein binding and is the most lipid soluble.

Question 18

Intermediate-action anesthetics are most commonly used for regular restorative dentistry and nonsurgical periodontal therapy.

Question 19

Name the only long-lasting local anesthetic available for use in dentistry.

Question 20

Epinephrine is the most commonly used anesthetic in the United States.

Question 21

What is the name of the only topical amide anesthetic currently on the dental market in the United States?

A) Levonordefrin
B) Lidocaine
C) Benzocaine
D) Butacaine

Question 22

Which anesthetic solution,no longer used in dentistry,is still available in multidose vials and is used in medicine as an antiarrhythmic agent?

A) Mepivacaine
B) Bupivacaine
C) Carbocaine
D) Procaine

Question 23

There are two main classifications of local anesthetic agents: esters and amides.Esters are metabolized in the liver,and most amides are metabolized in the plasma.

A) Both statements are true.
B) Both statements are false.
C) The first statement is true;the second statement is false.
D) The first statement is false;the second statement is true.

Question 24

What is the term used to describe the persistent anesthesia or the altered sensation of tingling or itching beyond the expected duration of local anesthetic?

A) Paresthesia
B) Paralysis
C) All options listed
D) None of the options listed

Question 25

Which of the following statements best describes levonordefrin?

A) Levonordefrin is a vasoconstrictor added to mepivacaine.
B) Levonordefrin is a vasodilator added to mepivacaine.
C) Levonordefrin is an amide local anesthetic.
D) Levonordefrin is an ester local anesthetic that is not used in dentistry today.

Question 26

What duration category best describes mepivacaine 3%?

A) Short-acting
B) Intermediate-acting
C) Long-acting
D) None of the above

Question 27

Which of the following statements is (are)true regarding local anesthetics and allergic reactions?

A) Sulfite sensitivities have been well documented and may rule out anesthetic formulations that contain vasoconstrictors.
B) Only 1% of reactions associated with administration of local anesthetics are true allergies.
C) A documented drug allergy would indicate the need for an alternative drug selection and may represent an absolute contraindication to the offending drug.
D) All options listed

Question 28

Prilocaine is the generic name for which of the following?

A) Citanest
B) Marcaine
C) Carbocaine
D) Xylocaine,Alphacaine,Octocaine

Question 29

Local anesthetic agents with vasoconstrictors are generally more acidic than plain formations because of the presence of sodium bisulfite.

A) Both the statement and reason are correct and related.
B) Both the statement and reason are correct but NOT related.
C) The statement is correct,but the reason is NOT.
D) The statement is NOT correct,but the reason is correct.
E) NEITHER the statement NOR the reason is correct.

Question 30

Which of the following factors influence(s)duration of anesthesia?

A) Individual response
B) Accuracy of administration
C) Vascularity of tissue
D) All options listed

Question 31

All of the following local anesthetic agents would be considered safer for cardiovascular patients EXCEPT one.Which one is the EXCEPTION?

A) 4% prilocaine 1:200,000 epinephrine
B) 4% articaine 1:200,000 epinephrine
C) 2% lidocaine 1:100,000 epinephrine
D) 4% prilocaine,plain

Question 32

What is the lipid solubility and the protein-binding ability of the local anesthetic related to?

A) Anesthetic dissociation constant
B) Anesthetic duration of action
C) Distribution of cations and anions
D) All options listed

Question 33

Increasing the pH of local anesthetic agents toward physiologic prior to injection is referred to as which of the following?

A) Propagation
B) Onset
C) Biotransformation
D) Anesthetic buffering

Question 34

Marcaine is the proprietary name for which of the following?

A) Mepivacaine
B) Bupivacaine
C) Carbocaine
D) Xylocaine,alphacaine,octocaine

Question 35

A relative contraindication means that the offending drug may be administered judiciously.An absolute contraindication means that the offending drug should not be administered to the individual under any circumstances.

A) Both statements are true.
B) Both statements are false.
C) The first statement is true;the second statement is false.
D) The first statement is false;the second statement is true.

Question 36

What is the advantage of the thiophene ring found in articaine?

A) It stimulates bone penetration properties.
B) It allows a slower metabolism,thus decreasing the risk of systemic toxicity.
C) It gives the molecule better diffusion properties compared with lidocaine.
D) All options listed.

Question 37

Which ingredient added to the dental cartridge alkalinizes,or adjusts the pH,of the solution between 6 and 7?

A) Vasoconstrictor preservative
B) Sodium chloride
C) Sodium hydroxide
D) Methylparaben

Question 38

Septocaine,Zorcaine,and Articadent are the proprietary names for which of the following?

A) Lidocaine
B) Prilocaine
C) Articaine
D) Bupivacaine

Question 39

Which amide anesthetic agent is metabolized in both the plasma and the liver?

A) Lidocaine
B) Mepivacaine
C) Prilocaine
D) Articaine

Question 40

Which amide anesthetic agent is metabolized by the lungs before it reaches the liver?

A) Lidocaine
B) Mepivacaine
C) Prilocaine
D) Articaine