Pharmacology and Therapeutics Flashcards

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

Answer: 7 mg/kg, not exceeding 500 mg

Lidocaine with epinephrine is generally limited to 7 mg/kg with an absolute maximum of 500 mg in healthy adults.

Articaine has a short plasma half-life mainly because it contains which structural feature?

Answer: An ester side chain hydrolyzed by plasma esterases

Although classed as an amide, articaine has an ester group that plasma esterases rapidly hydrolyze.

Which local anesthetic is most associated with methemoglobinemia because of its o-toluidine metabolite?

Answer: Prilocaine

Prilocaine is metabolized to o-toluidine, which oxidizes hemoglobin to methemoglobin.

Why are local anesthetics less effective when injected into an area of acute infection?

Answer: The acidic tissue pH increases the ionized fraction that cannot cross nerve membranes

Low pH shifts the equilibrium toward the charged cation, reducing the lipid-soluble base available to penetrate the nerve.

Ibuprofen produces its analgesic and anti-inflammatory effects primarily by which mechanism?

Answer: Reversible inhibition of COX-1 and COX-2

Ibuprofen reversibly blocks both cyclooxygenase isoforms, reducing prostaglandin synthesis.

What is the generally cited maximum daily dose of acetaminophen for a healthy adult without liver disease?

Answer: 4 g

A ceiling of 4 g per day is the standard limit, with lower limits advised for alcohol use or hepatic disease.

A patient becomes unresponsive with pinpoint pupils and slow breathing after taking hydrocodone. Which drug should be given?

Answer: Naloxone

Naloxone is a competitive mu-opioid antagonist that reverses opioid-induced respiratory depression.