NBDE Pharmacology and Therapeutics 2

Question 1

A patient on warfarin requires dental extractions. Which analgesic is SAFEST to prescribe postoperatively?

Accepted Answer

Acetaminophen 500 mg

Answer

Acetaminophen does not inhibit platelet function or significantly affect INR, making it the safest analgesic for patients on warfarin.

Question 2

Which local anesthetic has the LONGEST duration of action for dental nerve blocks?

Accepted Answer

Bupivacaine 0.5%

Answer

Bupivacaine has the longest duration of action among dental local anesthetics, providing 4–12 hours of pulpal anesthesia with a vasoconstrictor.

Question 3

Methemoglobinemia is a known adverse effect of which local anesthetic at high doses?

Accepted Answer

Prilocaine

Answer

Prilocaine is metabolized to o-toluidine, which oxidizes hemoglobin to methemoglobin, causing methemoglobinemia at high doses.

Question 4

A patient taking a monoamine oxidase inhibitor (MAOI) requires local anesthesia. Which vasoconstrictor is CONTRAINDICATED?

Accepted Answer

Levonordefrin

Answer

Levonordefrin (neo-cobefrin) is a sympathomimetic whose pressor effects are dangerously potentiated by MAOIs, risking hypertensive crisis.

Question 5

Which antibiotic is the FIRST-LINE prophylaxis for infective endocarditis in dental patients who are allergic to penicillin but can take oral medications?

Accepted Answer

Azithromycin 500 mg

Answer

Current AHA/ADA guidelines recommend azithromycin or clarithromycin 500 mg orally for penicillin-allergic patients requiring IE prophylaxis.

NBDE - National Board Dental Examination Practice Test

NBDE - National Board Dental Examination Practice Test

NBDE Pharmacology and Therapeutics 2