INBDE Pharmacology and Pain Management

Question 1

Which local anesthetic has the longest duration of action?

Accepted Answer

Bupivacaine

Answer

Bupivacaine (Marcaine) has the longest duration of pulpal and soft tissue anesthesia among common dental local anesthetics due to its high protein-binding affinity.

Question 2

Epinephrine is added to local anesthetic solutions primarily to:

Accepted Answer

Prolong the duration of anesthesia by causing vasoconstriction

Answer

Epinephrine causes local vasoconstriction, reducing the rate of systemic absorption of the local anesthetic and thereby prolonging its duration and reducing toxicity.

Question 3

A patient taking warfarin requires a dental extraction. The INR is 2.5. The most appropriate management is to:

Accepted Answer

Proceed with extraction using local hemostatic measures

Answer

For patients on warfarin with an INR ≤3.5, routine dental extractions can proceed safely with local hemostatic measures such as pressure and sutures.

Question 4

Which analgesic is contraindicated in patients with aspirin-exacerbated respiratory disease (AERD)?

Accepted Answer

Ibuprofen

Answer

NSAIDs like ibuprofen inhibit COX-1, shunting arachidonic acid toward leukotriene production, which triggers bronchoconstriction in patients with AERD.

Question 5

Tetracyclines are contraindicated in children under 8 years of age because they:

Accepted Answer

Cause permanent tooth discoloration and enamel hypoplasia

Answer

Tetracyclines chelate calcium and incorporate into developing teeth and bone, causing permanent yellow-gray discoloration and enamel hypoplasia in children under 8.

INBDE - Integrated National Board Dental Exam Practice Test

INBDE - Integrated National Board Dental Exam Practice Test

INBDE Pharmacology and Pain Management