CDC Pharmacology & Medication Management 2

Question 1

A patient taking warfarin requires dental extractions. Which analgesic is MOST appropriate to prescribe for post-operative pain?

Accepted Answer

Acetaminophen 500mg

Answer

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)?

Accepted Answer

Meperidine

Answer

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?

Accepted Answer

Clindamycin

Answer

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?

Accepted Answer

Bupivacaine 0.5%

Answer

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?

Accepted Answer

0.04 mg

Answer

The AHA/ADA guidelines recommend limiting epinephrine to 0.04 mg (2 cartridges of 1:100,000) in patients with significant cardiovascular disease.

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