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

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

Answer 2

4.4 cartridges,
The actual number of cartridges is limited by the maximum recommended dose of the anesthetic agent.

Question 3

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

Answer 3

22.2 cartridges.
The actual number of cartridges is limited by the maximum recommended dose of the anesthetic agent.

Question 4

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

Question 5

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

Question 6

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

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

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 options listed

Question 9

Why are vasoconstrictors important additives to the local anesthetic solution?

A) They provide hemostasis at the injection site.
B) They reduce the possibility of systemic toxicity.
C) They prolong the duration of the anesthetic's effect.
D) All options listed

Question 10

Levarterenol is no longer available in the United States.

Question 11

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

Question 12

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 options listed

Question 13

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.

Question 14

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 options listed

Question 15

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 16

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 17

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 options listed

Question 18

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

Question 19

Which of the following is true regarding norepinephrine?

A) Its use in dentistry is not recommended
B) Has the same action as levonordefrin on alpha receptors
C) Exhibits intense vasoconstriction
D) All options listed
E) None of the options listed

Question 20

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

Question 21

A 1:100,000 dilution of epinephrine for obtaining pulpal anesthesia may be used in combination with a relatively small infiltrated dose of 1:50,000 to decrease bleeding.This is a particularly important strategy for dental hygienists to use during provision of nonsurgical periodontal therapy.

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 22

The undesirable effects of epinephrine are short lived because of the rapid inactivation of epinephrine by the reuptake of adrenergic nerves.

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 23

The absorption of epinephrine is retarded because of the drug's vasoconstricting properties.It may take several hours for absorption to be completed.

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 inactivates epinephrine once it is in the bloodstream?

A) Adrenergic nerves
B) Liver enzymes
C) Its excretion into the urine
D) All options listed

Question 25

Which local anesthetic would be appropriate for a patient with a history of true bisulfite allergy?

A) 2% mepivacaine,1:20,000 levonordefrin
B) 4% prilocaine
C) 4% articaine,1:200,000 epinephrine
D) All options listed

Question 26

The addition of sodium bisulfite preservative can reduce the efficiency of the quaternary amine to dissociate into the uncharged tertiary amine base necessary to penetrate the lipid rich membrane of nerve because the preservative can increase the pH of the anesthetic solution.

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 27

For all of the following conditions the risks of using a local anesthetic with a vasoconstrictor might outweigh the benefits EXCEPT one.Which one is the EXCEPTION?

A) Unstable angina
B) Recent knee replacement
C) Uncontrolled diabetes
D) Uncontrolled hypertension

Question 28

Which of the following vasoconstrictors are NOT added to dental local anesthetic drugs in the United States?

A) Phenylephrine
B) Felypressin
C) Norepinephrine
D) All options listed
E) None of the above

Question 29

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.

Question 30

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 31

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 32

Patients with a relative contraindication for vasoconstrictors can receive epinephrine containing local anesthetic agents in the lowest possible dose,not to exceed the MRD of 0.04 mg per appointment,using the best technique.In general,there are only a few absolute contraindications to the use of vasoconstrictor,and in most situations limiting the amount of vasoconstrictor a patient can receive produces the benefits of vasoconstrictor use in local anesthesia without compromising the patient.

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 33

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 options listed

Question 34

Which vasoconstrictor is the most widely used in dentistry and the most potent?

A) Epinephrine
B) Levonordefrin
C) Felypressin
D) All options listed

Question 35

Which of the following anesthetics are combined with levonordefrin?

A) 2% lidocaine
B) 2% mepivacaine
C) 3% mepivacaine
D) 4% prilocaine

Question 36

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 options listed

Question 37

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 options listed

Question 38

What is the name of the vasoconstrictor,commonly combined with 3% prilocaine,that may be safely administered to patients with uncontrolled hyperthyroidism?

A) Phenylephrine
B) Felypressin
C) All options listed
D) None of the options listed