NBDE Pharmacology and Therapeutics 3

Question 1

A dentist prescribes amoxicillin-clavulanate (Augmentin). What advantage does clavulanate provide?

Accepted Answer

It inhibits beta-lactamase enzymes produced by resistant bacteria

Answer

Clavulanate is a beta-lactamase inhibitor that protects amoxicillin from enzymatic degradation by resistant organisms such as Staphylococcus aureus.

Question 2

Which opioid analgesic is MOST appropriate for moderate-to-severe dental pain in a patient with renal impairment?

Accepted Answer

Hydromorphone

Answer

Hydromorphone has fewer active metabolite accumulations in renal impairment compared to morphine or codeine, which accumulate toxic metabolites.

Question 3

Corticosteroids are sometimes used after oral surgery. Which adverse effect is MOST concerning with systemic use?

Accepted Answer

Adrenal suppression

Answer

Exogenous corticosteroids suppress the hypothalamic-pituitary-adrenal axis, potentially causing adrenal insufficiency upon sudden withdrawal.

Question 4

A patient is prescribed tetracycline for periodontal disease. What should the dentist counsel regarding administration?

Accepted Answer

Avoid dairy, antacids, and iron supplements within 2 hours

Answer

Divalent and trivalent cations (Ca²⁺, Mg²⁺, Al³⁺, Fe²⁺) chelate tetracycline in the GI tract, significantly reducing oral bioavailability.

Question 5

Which mechanism explains why aspirin is avoided in children with viral infections?

Accepted Answer

Association with Reye syndrome causing hepatic and cerebral damage

Answer

Aspirin use in children with viral illnesses (influenza, varicella) is linked to Reye syndrome, a potentially fatal hepatoencephalopathy.

NBDE - National Board Dental Examination Practice Test