DMD Pharmacology and Therapeutics 2

Question 1

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

Accepted Answer

7 mg/kg, not exceeding 500 mg

Answer

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

Question 2

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

Accepted Answer

An ester side chain hydrolyzed by plasma esterases

Answer

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

Question 3

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

Accepted Answer

Prilocaine

Answer

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

Question 4

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

Accepted Answer

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

Answer

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

Question 5

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

Accepted Answer

Reversible inhibition of COX-1 and COX-2

Answer

Ibuprofen reversibly blocks both cyclooxygenase isoforms, reducing prostaglandin synthesis.

DMD - Doctor of Medicine in Dentistry Practice Test