CDC Pharmacology & Medication Management 2 — Questions and Answers
Question 1: A patient taking warfarin requires dental extractions. Which analgesic is MOST appropriate to prescribe for post-operative pain?
- Ibuprofen 600mg
- Aspirin 650mg
- Acetaminophen 500mg (Correct answer)
- Naproxen 500mg
Correct answer: Acetaminophen 500mg
Acetaminophen does not affect platelet function or INR, making it the safest analgesic choice for patients on warfarin.
Question 2: Which opioid analgesic is contraindicated in patients taking monoamine oxidase inhibitors (MAOIs)?
- Hydrocodone
- Oxycodone
- Meperidine (Correct answer)
- Codeine
Correct answer: Meperidine
Meperidine combined with MAOIs can cause a life-threatening serotonin syndrome characterized by hyperthermia, seizures, and cardiovascular collapse.
Question 3: A dental patient reports allergy to penicillin with a history of anaphylaxis. Which antibiotic is the BEST alternative for prophylaxis?
- Amoxicillin
- Clindamycin (Correct answer)
- Cephalexin
- Ampicillin
Correct answer: Clindamycin
Clindamycin is recommended for patients with a history of anaphylaxis to penicillin because cephalosporins carry cross-reactivity risk in such cases.
Question 4: Which local anesthetic agent has the LONGEST duration of action for dental nerve blocks?
- Lidocaine 2%
- Mepivacaine 3%
- Prilocaine 4%
- Bupivacaine 0.5% (Correct answer)
Correct answer: Bupivacaine 0.5%
Bupivacaine has the longest duration of action among dental local anesthetics, providing 4–9 hours of pulpal anesthesia.
Question 5: What is the maximum recommended dose of epinephrine in a local anesthetic for a patient with significant cardiovascular disease?
- 0.04 mg (Correct answer)
- 0.2 mg
- 0.5 mg
- 1.0 mg
Correct answer: 0.04 mg
The AHA/ADA guidelines recommend limiting epinephrine to 0.04 mg (2 cartridges of 1:100,000) in patients with significant cardiovascular disease.
Question 6: A patient is prescribed azithromycin for a dental infection. Which drug interaction is MOST clinically significant?
- Acetaminophen
- Ibuprofen
- Warfarin (Correct answer)
- Lidocaine
Correct answer: Warfarin
Azithromycin inhibits CYP enzymes and can increase warfarin levels, raising the risk of bleeding complications.
Question 7: Which benzodiazepine is MOST commonly used for oral conscious sedation in dentistry due to its intermediate half-life?
- Triazolam (Correct answer)
- Diazepam
- Lorazepam
- Midazolam
Correct answer: Triazolam
Triazolam is widely used for oral sedation in dentistry because of its rapid onset, intermediate duration, and amnesic properties.
CDC Pharmacology & Medication Management 2
A patient taking warfarin requires dental extractions.
Which analgesic is MOST appropriate to prescribe for post-operative pain?