Pharmacology and Pain Control Flashcards
7 cards from real NBDE practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Pharmacology and Pain Control flashcards as text
Which local anesthetic has the longest duration of action and is commonly used for procedures requiring prolonged anesthesia?
Answer: Bupivacaine
Bupivacaine has the highest lipid solubility and protein binding, producing durations of 4–9 hours and making it suitable for lengthy surgical procedures.
Nitrous oxide produces analgesia primarily by:
Answer: Stimulating opioid receptors in the central nervous system
Nitrous oxide activates endogenous opioid receptors in the brainstem and spinal cord, contributing to its analgesic and anxiolytic effects.
A child requires sedation for dental treatment. Which oral sedative is FDA-approved and commonly used in pediatric dentistry?
Answer: Midazolam
Oral midazolam is widely used for pediatric dental sedation due to its rapid onset, effective sedation, and amnestic properties with a manageable safety profile.
COX-2 selective inhibitors like celecoxib are preferred over non-selective NSAIDs primarily because they:
Answer: Have lower risk of gastrointestinal ulceration
COX-2 inhibitors spare gastric prostaglandin synthesis (COX-1 mediated), reducing the risk of gastrointestinal mucosal damage compared to non-selective NSAIDs.
Which opioid is a partial mu-receptor agonist and can precipitate withdrawal in opioid-dependent patients?
Answer: Buprenorphine
Buprenorphine is a partial agonist with very high mu-receptor affinity; it displaces full agonists and precipitates acute withdrawal in opioid-dependent individuals.
The maximum safe dose of lidocaine WITH epinephrine in a healthy adult is approximately:
Answer: 7 mg/kg (not to exceed 500 mg)
Epinephrine's vasoconstrictive effect slows absorption and allows a higher maximum dose of lidocaine—7 mg/kg up to 500 mg—compared to 4.4 mg/kg without epinephrine.
Codeine's analgesic effect depends on its hepatic conversion to morphine by which enzyme?
Answer: CYP2D6
CYP2D6 O-demethylates codeine to morphine; poor metabolizers receive minimal analgesia while ultra-rapid metabolizers risk toxic morphine levels.