Pharmacology and Pain Management Flashcards

Which local anesthetic has the longest duration of action and is most appropriate for lengthy dental hygiene procedures?

Answer: Bupivacaine 0.5%

Bupivacaine has the longest duration of pulpal anesthesia (up to 90 minutes) among commonly used dental local anesthetics due to its high protein binding.

A patient reports an allergy to sulfa drugs. Which local anesthetic should be avoided due to its ester linkage and potential cross-reactivity with PABA metabolites?

Answer: Procaine

Ester anesthetics like procaine are metabolized to para-aminobenzoic acid (PABA), which can cause allergic reactions in patients sensitive to sulfonamides.

What is the maximum recommended dose of lidocaine with epinephrine for a healthy adult patient in dental procedures?

Answer: 4.4 mg/kg up to 300 mg

The maximum recommended dose of lidocaine with vasoconstrictor is 4.4 mg/kg with an absolute maximum of 300 mg to prevent systemic toxicity.

Which vasoconstrictor concentration is most commonly found in dental local anesthetic cartridges in the United States?

Answer: 1:100,000 epinephrine

1:100,000 epinephrine is the standard concentration in most dental cartridges, providing adequate vasoconstriction with minimal cardiovascular risk.

Which block technique anesthetizes the lingual nerve, inferior alveolar nerve, and long buccal nerve with a single injection?

Answer: Gow-Gates mandibular block

The Gow-Gates block targets the mandibular nerve trunk at the condylar neck, anesthetizing all three nerves supplying the mandibular arch with one injection.

Paresthesia following an inferior alveolar nerve block is most often associated with which local anesthetic?

Answer: Articaine 4%

Articaine 4% has been associated with a higher incidence of paresthesia compared to other anesthetics, particularly when used for inferior alveolar nerve blocks.