NBDHE Pharmacology in Dental Hygiene 2

Question 1

Which analgesic should be avoided in a patient with aspirin-exacerbated respiratory disease (AERD/Samter's triad)?

Accepted Answer

Ibuprofen and all NSAIDs (including aspirin)

Answer

Patients with AERD (Samter's triad: asthma, nasal polyps, aspirin sensitivity) experience bronchospasm with all NSAIDs that inhibit COX-1, including ibuprofen; acetaminophen is generally safe.

Question 2

The opioid analgesic codeine exerts its analgesic effect by being converted to:

Accepted Answer

Morphine via hepatic CYP2D6 enzyme

Answer

Codeine is a prodrug that undergoes O-demethylation by hepatic CYP2D6 to morphine (about 10% conversion), which provides most of its analgesic effect.

Question 3

A patient is taking warfarin (Coumadin) for atrial fibrillation. If the dental hygienist recommends ibuprofen for post-procedural pain, what is the primary drug interaction concern?

Accepted Answer

NSAIDs inhibit platelet aggregation and may displace warfarin from plasma proteins, increasing bleeding risk

Answer

NSAIDs inhibit platelet function (GI mucosal protection) and may compete with warfarin for protein binding sites, potentially raising free warfarin levels and increasing hemorrhagic risk.

Question 4

Which antihypertensive drug class is MOST likely to cause gingival enlargement?

Accepted Answer

Calcium channel blockers (particularly nifedipine)

Answer

Calcium channel blockers, especially nifedipine (and to a lesser extent amlodipine and diltiazem), are well-known causes of drug-influenced gingival enlargement.

Question 5

Nitrous oxide-oxygen sedation (N2O/O2) used in dental hygiene is classified as which level of sedation?

Accepted Answer

Minimal sedation (anxiolysis) — patient fully conscious and responsive

Answer

At the concentrations used in dentistry (up to 50% N2O), nitrous oxide provides minimal sedation (anxiolysis) only — the patient remains fully conscious, maintains their own airway, and responds normally to verbal communication.

NBDHE Test Practice Test

NBDHE Test Practice Test

NBDHE Pharmacology in Dental Hygiene 2