DDS Dental Pharmacology and Anesthesia 2

Question 1

Nitrous oxide (N₂O) produces analgesia and sedation primarily by:

Accepted Answer

GABA receptor potentiation and NMDA receptor antagonism

Answer

N₂O exerts its effects via potentiation of GABA-A inhibitory neurotransmission and antagonism of NMDA (glutamate) receptors, reducing pain transmission and producing anxiolysis.

Question 2

A patient taking warfarin requires tooth extraction. Which INR threshold is generally accepted as safe for routine dental extractions without altering anticoagulation therapy?

Accepted Answer

INR ≤ 3.5

Answer

Current evidence supports performing routine dental extractions when the INR is ≤ 3.5 without altering warfarin, using local hemostatic measures rather than risking thromboembolic events from stopping anticoagulation.

Question 3

Which antibiotic is the first-line choice for prophylaxis against infective endocarditis before dental procedures in eligible patients?

Accepted Answer

Amoxicillin 2 g orally 30–60 minutes before the procedure

Answer

Current AHA guidelines recommend amoxicillin 2 g (adults) orally 30–60 minutes before procedures as first-line IE prophylaxis for eligible high-risk patients.

Question 4

NSAIDs reduce dental pain primarily by inhibiting which enzyme?

Accepted Answer

Cyclooxygenase (COX), reducing prostaglandin E2 synthesis

Answer

NSAIDs inhibit cyclooxygenase-1 and -2 (COX-1/COX-2), blocking the conversion of arachidonic acid to prostaglandins, reducing peripheral sensitization and inflammation.

Question 5

Bisphosphonate-related osteonecrosis of the jaw (BRONJ/MRONJ) most commonly occurs after which dental procedure?

Accepted Answer

Tooth extraction (dentoalveolar surgery)

Answer

Tooth extraction and other dentoalveolar surgeries that disrupt the oral mucosa and bone are the most common triggers for MRONJ in patients on bisphosphonate therapy.

DDS - Doctor of Dental Surgery Practice Test

DDS - Doctor of Dental Surgery Practice Test

DDS Dental Pharmacology and Anesthesia 2