NBDE Pharmacology and Pain Control 5

Question 1

Which local anesthetic is MOST appropriate for a patient with documented allergy to amide-type local anesthetics?

Accepted Answer

Procaine

Answer

Procaine is an ester-type local anesthetic with a different chemical structure than amides, making it an alternative when true amide allergy is confirmed.

Question 2

The phenomenon of tachyphylaxis with local anesthetics refers to:

Accepted Answer

Decreased effectiveness with repeated injections in short succession

Answer

Tachyphylaxis is a progressive decrease in local anesthetic effect with repeated injections, partly due to local tissue acidosis reducing the free base available to cross nerve membranes.

Question 3

Which drug is the opioid antagonist of choice for reversing respiratory depression caused by opioid overdose?

Accepted Answer

Naloxone

Answer

Naloxone is the first-line agent for acute opioid-induced respiratory depression due to its rapid onset and competitive antagonism at mu-opioid receptors.

Question 4

Ketorolac is preferred over other NSAIDs for short-term postoperative pain because it:

Accepted Answer

Can be administered parenterally for potent analgesia

Answer

Ketorolac is unique among NSAIDs in having an injectable formulation that provides opioid-comparable analgesia for acute postoperative pain without opioid side effects.

Question 5

In a patient with poorly controlled hypertension, the maximum recommended epinephrine dose per dental appointment is:

Accepted Answer

0.018 mg (2 cartridges of 1:100,000)

Answer

The AHA recommends limiting epinephrine to 0.04 mg (approximately two cartridges of 1:100,000) per appointment in patients with significant cardiovascular disease or uncontrolled hypertension.

NBDE - National Board Dental Examination Practice Test

NBDE - National Board Dental Examination Practice Test

NBDE Pharmacology and Pain Control 5