NBDHE Pharmacology in Dental Hygiene 3

Question 1

What is the mechanism of action of metronidazole, and why is it effective against periodontal pathogens?

Accepted Answer

It is a prodrug activated in anaerobic organisms to form nitro radical anions that disrupt DNA, making it bactericidal against anaerobes including Porphyromonas gingivalis

Answer

It inhibits bacterial cell wall synthesis like beta-lactam antibiotics

Answer

It inhibits protein synthesis at the 30S ribosomal subunit

Answer

It disrupts fungal cell membrane ergosterol

Question 2

Which locally delivered controlled-release antibiotic device is FDA-approved for adjunctive use in periodontal pockets ≥5 mm?

Accepted Answer

Doxycycline hyclate 10% polymer gel (Atridox) and minocycline microspheres (Arestin)

Answer

Tetracycline fibers (removed from market)

Answer

Chlorhexidine chip (Perio Chip) alone

Answer

Systemic doxycycline only

Question 3

A patient reports severe anxiety about dental treatment and requests 'something to calm them down.' The drug diazepam (Valium) belongs to which drug class, and what is its mechanism of action?

Accepted Answer

Benzodiazepine — positive allosteric modulator of GABA-A receptors, increasing chloride ion conductance and producing CNS depression

Answer

Opioid — binds mu receptors to produce sedation

Answer

Barbiturate — directly opens chloride channels

Answer

Antihistamine — blocks H1 receptors causing sedation

Question 4

Which drug interaction is MOST critical for a dental hygienist to recognize when a patient is taking monoamine oxidase inhibitors (MAOIs) for depression?

Accepted Answer

MAOIs can cause hypertensive crisis if combined with indirectly-acting sympathomimetic agents, and dangerous serotonin syndrome if combined with meperidine

Answer

MAOIs reduce the efficacy of local anesthetics

Answer

MAOIs cause increased bleeding with NSAIDs

Answer

MAOIs cause gingival enlargement

Question 5

Fluoride works to prevent dental caries through which primary mechanism at the tooth surface?

Accepted Answer

Incorporation into hydroxyapatite to form fluorapatite, which is more acid-resistant, and promotion of remineralization during pH cycling

Answer

Directly killing all cariogenic bacteria in the oral cavity

Answer

Increasing salivary flow to dilute acids

Answer

Blocking plaque adhesion to enamel through surface coating

Question 6

What is the drug of choice for managing dental pain in a patient who is pregnant (second trimester)?

Accepted Answer

Acetaminophen (paracetamol) at recommended doses

Answer

Ibuprofen 600 mg

Answer

Aspirin 325 mg

Answer

Codeine 30 mg with acetaminophen