NBDE Pharmacology and Therapeutics 4

Question 1

Which drug used for conscious sedation in dentistry works by antagonizing histamine H1 receptors AND producing anticholinergic effects?

Accepted Answer

Hydroxyzine

Answer

Hydroxyzine is an antihistamine with anticholinergic and sedative properties commonly used for preoperative anxiolysis in dental settings.

Question 2

Nitrous oxide produces analgesia primarily by which mechanism?

Accepted Answer

Endogenous opioid peptide release and NMDA receptor antagonism

Answer

Nitrous oxide activates endogenous opioid pathways and inhibits NMDA receptors, contributing to its analgesic and anxiolytic properties.

Question 3

A diabetic patient on metformin requires oral surgery under general anesthesia. What is the primary concern regarding metformin perioperatively?

Accepted Answer

Risk of lactic acidosis if renal perfusion is compromised

Answer

Metformin is associated with lactic acidosis when renal function is compromised, a risk that increases during surgery due to hemodynamic changes and contrast use.

Question 4

Which drug is the treatment of choice for acute anaphylaxis occurring in the dental office?

Accepted Answer

Epinephrine 0.3 mg IM (1:1,000)

Answer

Intramuscular epinephrine into the anterolateral thigh is the first-line treatment for anaphylaxis due to its rapid reversal of vasodilation and bronchoconstriction.

Question 5

Which antifungal drug used for oral candidiasis inhibits ergosterol synthesis by blocking lanosterol 14-alpha-demethylase?

Accepted Answer

Fluconazole

Answer

Fluconazole inhibits fungal CYP450 enzyme lanosterol 14-alpha-demethylase, blocking ergosterol synthesis and disrupting fungal cell membrane integrity.

NBDE - National Board Dental Examination Practice Test

NBDE - National Board Dental Examination Practice Test

NBDE Pharmacology and Therapeutics 4