NBDE Pharmacology and Pain Control 4

Question 1

A patient taking MAO inhibitors presents for dental treatment requiring pain control. Which drug combination poses the greatest risk?

Accepted Answer

Meperidine + phenelzine

Answer

Meperidine combined with MAO inhibitors can cause a life-threatening serotonin syndrome, manifesting as hyperthermia, seizures, and cardiovascular collapse.

Question 2

Which reversal agent is used to treat severe benzodiazepine sedation during dental procedures?

Accepted Answer

Flumazenil

Answer

Flumazenil is a competitive benzodiazepine receptor antagonist that rapidly reverses CNS depression caused by benzodiazepine overdose.

Question 3

Articaine differs from other amide local anesthetics in that it contains:

Accepted Answer

A thiophene ring instead of a benzene ring

Answer

Articaine uniquely contains a thiophene ring (instead of a benzene ring) and an additional ester group, allowing rapid plasma hydrolysis and a shorter systemic half-life.

Question 4

In dentistry, the vasoconstrictive concentration of epinephrine most commonly used is:

Accepted Answer

1:100,000

Answer

A 1:100,000 epinephrine concentration (10 mcg/mL) provides adequate vasoconstriction to prolong anesthesia and limit bleeding without significant cardiovascular risk in most patients.

Question 5

Which analgesic mechanism best describes the action of NSAIDs?

Accepted Answer

Inhibiting cyclooxygenase enzymes and prostaglandin synthesis

Answer

NSAIDs inhibit cyclooxygenase (COX-1 and COX-2) enzymes, reducing prostaglandin synthesis and thereby decreasing peripheral sensitization and inflammation-mediated pain.

NBDE - National Board Dental Examination Practice Test

NBDE - National Board Dental Examination Practice Test

NBDE Pharmacology and Pain Control 4