Deck 4: Pharmacology of Vasoconstrictors

Question 1

Which receptors relax bronchial smooth muscles,causing the bronchi of the lungs to dilate?

A) Alpha receptors
B) Beta receptors
C) Alpha and beta receptors are equal
D) Adrenergic receptors

Answer 1

Beta receptors

Question 2

What is the name of the vasoconstrictor that can produce tissue necrosis?

A) Phenylephrine
B) Felypressin
C) Norepinephrine
D) Levonordefrin

Answer 2

Norepinephrine

Question 3

Neleen indicates on her health history that she is allergic to novocaine and sulfa drugs.What patient education might you provide to Neleen?

A) Explain that novocaine is in the ester family of drugs and you will be using a local anesthetic from the amide family.
B) Explain that, because she is allergic to novocaine and to sulfa drugs, you will be using a local anesthetic without a preservative.
C) Explain that, because she is allergic to sulfa drugs, you will be using a local anesthetic with a vasoconstrictor.
D) Explain why you are choosing not to administer any local anesthesia.

Answer 3

Explain that novocaine is in the ester family of drugs and you will be using a local anesthetic from the amide family.

Question 4

Adrenalin comes in concentrations of 1:50,000,1:100,000,and 1:200,000.

Question 5

Undesirable side effects of incorporating sympathomimetic agents such as epinephrine into local anesthetic solutions include:

A) Increased force of air exchange
B) Increased bronchi dilation
C) Increased rate and force of heart contractions
D) All of the above

Question 6

Which of the following statement(s)is/are true regarding the vasculature effects of epinephrine?

A) The effects of epinephrine on the blood vessels of the skeletal muscles are dose dependent due to the predominance of beta 2 receptors.
B) Smaller doses of epinephrine affect the beta 2 receptors of the blood vessels of the skeletal muscles and produce vasodilation.
C) Larger doses of epinephrine affect the alpha receptors of the blood vessels of the skeletal muscles and produce vasoconstriction.
D) All of the above

Question 7

Why is there such a difference in the number of epinephrine-anesthesia cartridges that a healthy patient may have per dental appointment and that a patient with cardiovascular disease may have per dental appointment?

Question 8

The number of 1:50,000 epinephrine-anesthesia cartridges that a patient with cardiovascular disease may have per dental appointment is ______.

Question 9

You have administered 2% lidocaine,1:50,000 mg/ml epinephrine to a healthy patient.The patient experiences restlessness,nausea,and begins to hyperventilate.What should you suspect?

A) Central nervous system stimulation
B) Overdose of epinephrine
C) Metabolic rise in blood sugar
D) All of the above

Question 10

The number of 1:200,000 epinephrine-anesthesia cartridges that a patient with cardiovascular disease may have per dental appointment is ______.

Question 11

The number of 1:200,000 epinephrine-anesthesia cartridges that a healthy patient may have per dental appointment is______.

Question 12

A comparison of levonordefrin and epinephrine reveals that hemostasis is less effective with the vasoconstrictor epinephrine.

Question 13

Vasodilation of the blood vessels at the site of the administration of a local anesthetic will cause what?

A) An increased rate of anesthetic absorption
B) A decrease in the duration of the anesthetic
C) Increased risk of toxicity
D) All of the above

Question 14

Which receptors are the most sensitive to epinephrine?

A) Alpha receptors
B) Beta receptors
C) Alpha and beta receptors are equal
D) Adrenergic receptors

Question 15

A comparison of levonordefrin and epinephrine reveals that levonordefrin offers better pain control than epinephrine.

Question 16

The heart rate is increased when the beta 1 and beta 2 receptors are affected by the systemic effects of adrenergic amines.

Question 17

Levarterenol is no longer available in the United States.

Question 18

Which receptors have inhibitory actions from adrenergic drugs on smooth muscle?

A) Alpha receptors
B) Beta receptors
C) Alpha and beta receptors are equal
D) Adrenergic receptors

Question 19

The number of 1:50,000 epinephrine-anesthesia cartridges that a healthy patient may have per dental appointment is ______.

Question 20

Why are vasoconstrictors important additives to the local anesthetic solution?
1) They provides hemostasis at the injection site.
2) They reduces the possibility of systemic toxicity.
3) They prolongs the duration of the anesthetic's effect.
4) They increases the blood flow to the area.

A) Some other combination
B) 2, 3
C) 1, 2, 3
D) All of the above

Question 21

What factors might contribute to an accidental overdose of vasoconstrictors?

A) Poor technique
B) Selection of an inappropriate type of vasoconstrictor
C) Too much vasoconstrictor administered
D) All of the above

Question 22

What is the name of the vasoconstrictor that exerts its action predominately on alpha receptors with few beta effects,yet its side effects are nine times higher than epinephrine?

A) Phenylephrine
B) Felypressin
C) Norepinephrine
D) Levonordefrin

Question 23

Which of the following may cause an endogenous release of epinephrine?

A) An injection of epinephrine
B) Anxiety related to a divorce
C) Apprehension about a dental appointment
D) All of the above

Question 24

What inactivates epinephrine once it is in the blood stream?

A) Adrenergic nerves
B) Liver enzymes
C) Its excretion into the urine
D) All of the above

Question 25

Under what conditions might the risks of using a local anesthetic with a vasoconstrictor outweigh the benefits?
1) A medically compromised patient
2) A patient with unstable angina or uncontrolled hypertension
3) A patient with a recent knee replacement
4) A patient with severe gingivitis and perio
5) A patient with uncontrolled diabetes

A) Some other combination
B) 2, 4
C) 1, 2, 5
D) 1, 4, 5
E) All of the above

Question 26

How long do adverse effects of vasoconstrictors last in the body?

A) 1 to 3 minutes
B) 5 to 10 minutes
C) 5 to 10 hours
D) Up to 48 hours

Question 27

What is the name of the weak vasoconstrictor that exerts its action predominately on alpha receptors with very few beta effects on the heart?

A) Phenylephrine
B) Felypressin
C) Norepinephrine
D) Levonordefrin

Question 28

Why are vasoconstrictors added to local anesthetics?

A) To increase the potency of the local anesthetic
B) To inhibit the oxidation of the local anesthetic
C) To counteract the vasodilating properties of the local anesthetic
D) All of the above

Question 29

Which local anesthesia would be appropriate for a patient with a history of cardiovascular disease?

A) 3% Mepivacaine
B) 4% Prilocaine
C) 2% Lidocaine, 1:100,000 epinephrine
D) Some combination of the above

Question 30

What effect does the endogenous release of epinephrine have on exogenous administration of epinephrine?

A) It may compound the effects.
B) It may counteract the effects.
C) It should have no effect.
D) Its effects are unknown.

Question 31

Once epinephrine is absorbed,what happens to the action of the epinephrine?

A) It is activated in order to provide vasoconstriction.
B) It is deactivated in order to provide hemostasis.
C) It is altered due to the presence of enzymes.
D) It is terminated by reuptake by adrenergic nerves.

Question 32

Why might it not be safe to administer epinephrine to a patient taking MAO inhibitors?

A) Because epinephrine creates a hemostasis environment
B) Because the action of epinephrine is terminated by monoamine oxidase concentrated in the liver
C) Because epinephrine is a synthetic sympathomimetic amine that exerts its action predominately on alpha receptors
D) Because patients taking MAO inhibitors should have a physician consult before local anesthetic is administered

Question 33

More concentrated formulations of epinephrine are safer for patients who are cardiovascularly compromised.More diluted formulations of epinephrine provide the greatest bleeding control.

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.