Pharm Exam 3

Front 1

what was the first local anesthetic?

Back 1

Cocaine

Front 2

who isolated cocaine out of the coca plant?

Back 2

Niemann

Front 3

what is trephining

Back 3

was to release evil spirits thought to be caused by mental illness or epilepsy.

Front 4

the oldest surgery was ___

Back 4

trephining

Front 5

who noted cocaine placed in eyes resulted in complete anesthesia?

Back 5

Ophthalmologist, Karl Koller

Front 6

Who invented Coco-Cola in 1888?

Back 6

John S Pemberton

Front 7

what was the first synthetic local anesthetic developed in 1905?

Back 7

Procaine (used cocaine as a building block)

Front 8

lidocaine (xylocaine) was synthesized in what year?

Back 8

1952

Front 9

what local anesthetic was synthesized in 1960?

Back 9

mepivacaine (carbocaine)

Front 10

know ideal properties of local anesthetic

Back 10

potent, reversible, absence of local and systemic reactions, absence of allergic reactions,

Front 11

what are the two major chemical groups of local anesthetics?

Back 11

esters and amides

Front 12

cross-hypersensitivity between amides and esters in local anesthetics is _________?

Back 12

unlikely

Front 13

what three parts make up the structure of local anesthetics?

Back 13

aromatic nucleur (R)
Linkage
Amino group

Front 14

the aromatic nucleus (R) is _______
the amino group is __________

Back 14

lipophilic, hydrophilic

Front 15

all the LAs end in the suffix?

Back 15

caine

Front 16

all amide type LAs have the letter __ in the part of the generic name before the suffix. esters do not follow this rule.

Back 16

i

Front 17

for the following decide whether the LA is an amide or an ester.
cocaine, mepivacaine, ropivacaine, propoxycaine, tetracaine, bupivacaine

Back 17

ester, amide, amide, ester, ester, amide

Front 18

what is the main clinical effect of LAs

Back 18

reversible blockage of peripheral nerve conduction

Front 19

what is the site of action of LAs?

Back 19

nerve membrane

Front 20

local anesthetics act as

Back 20

sodium channel blockers

Front 21

if sodium cannot flow out of the neuron in a action potential then __________ cannot flow out thus inhibiting the depolarization of the nerve

Back 21

potassium

Front 22

the active ingredient of local anesthetic is called the __________ which is a weak base

Back 22

anesthetic base

Front 23

lipid soluble free base is the carrier which ________ the nerve membrane
water-soluble hydrochloride salt binds to the receptors causing the ______ action

Back 23

penetrates
blocking

Front 24

pH is equal to pKa of LA
pKa is related to _____ __ ______

Back 24

onset of action

Front 25

out healthy tissue pH is usually about __________
the la carpule solution has an acidic pH of __________. it penetrates well in to the tissue and changes rapidly to the tissue pH

Back 25

7.4
4.5

Front 26

the _______ the pKa the longer the onset of action

Back 26

higher

Front 27

what has the longest onset of action for local anesthetics

Back 27

bupivacaine

Front 28

Inflamed tissue (hot red swollen and painful) tends to be acidic in nature. does this make local anesthesia work easier or harder?

Back 28

harder because the asethesia is pH sensitive. it is harder for it to diffuse into the fibers of the tissue so you use a lot more anesthesia to have the same effect as healthy tissue

Front 29

rate of these factors depends on tissue vascularity and amount of free base in LA (nonionized)

Back 29

absorption

Front 30

a ________ is added to the local anesthetic to reduce absorption (epinephrine most common)

Back 30

vasoconstrictor

Front 31

bupivacaine in 0.5% solution is about ______ more lipid soluble than2% lidocaine

Back 31

10 times

Front 32

pseudo means

Back 32

false

Front 33

what is the only amide that is primarily metabolized in the plasma and not the liver

Back 33

articaine

Front 34

amides are metabolized in the ________

Back 34

liver

Front 35

esters are metabolized in the _______

Back 35

plasma

Front 36

articaine is an amide or a ester? it is metabolized where?

Back 36

amide metabolized in the plasma

Front 37

LAs are excreted from the

Back 37

kidneys

Front 38

The unconscious perception of movement and spatial orientation arising from stimuli within the body itself.

Back 38

proprioception

Front 39

LAs can cause vasodilation so a __________ is added to stop that and also to keep it localized

Back 39

vasoconstriction

Front 40

what portion of the population is more susceptible to adverse reactions of LA

Back 40

children and elderly

Front 41

what are the two main systems affected by toxicity of LAs?

Back 41

Central nervous system
cardiovascular system

Front 42

inherited disease characterized by often fatal hyperthermia with rigidity of the muscles occurring in affected people exposed to certain anesthetic agents

Back 42

malignant hyperthermia

Front 43

what two anesthetic agents are most connected with malignant hyperthermia

Back 43

halothane and succinylcholine

Front 44

LAs esters or amides have the highest allergic potential

Back 44

esters are higher allergic potential

Front 45

composition of LA solutions. this is added to LA to retard absorption reduce systemic toxicity and prolong its duration of action

Back 45

vasoconstrictor (usually epinephrine)

Front 46

the most commonly used dental administered drugs for relaxation of an anxious patient is _____ adminestered drugs

Back 46

orally

Front 47

nitrous oxide used in dentistry as an antianxiety agent is classified as what

Back 47

a general anesthetic

Front 48

true or false
intravenous is used often as an antiaxiety in the dental office

Back 48

false

Front 49

sedative-hypnotic agents depress

Back 49

CNS

Front 50

what is the range of sedative hypnotics effects with increasing doses from lowest to highest

Back 50

selhad
sedative/anxiety, euphoric, lethargic, hypnosis, anesthetic/coma, death

Front 51

the absence of all sensation

Back 51

anesthesia

Front 52

what are the three groups of drugs classified as sedative-hypnotics

Back 52

benzodiazepines-most common
barbiturates
nonbenzodiazepines-nonbarbiturates

Front 53

which benzodiazepine was synthesized in 1955 (first one)

Back 53

chlordiazepoxide (Librium

Front 54

valium (diazepam) is a _________

Back 54

benzodiazepine (antianxiety agent)

Front 55

usual suffix for benzodiazepines

Back 55

azepam or azolam

Front 56

benzodiazepines controlled substance rating

Back 56

IV

Front 57

most benzodiazepines are rated what for pregnancy

Back 57

D some X and C

Front 58

Benzodiazepines are well absorbed when administered by the ______ route

Back 58

oral

Front 59

Lorazepam oxazepam, temazepam are metabolized by phase II (glucoronidation) only so they may be better tolerated in the _______ patient

Back 59

elderly and liver impaired

Front 60

phase I metabolism in benzodiazepines is ______ metabolism
phase II is ________ metabolism

Back 60

hard - effected by external factors such as other drugs and hepatic disease
easy - unaffected by factors such as age other disease or hepatic disease

Front 61

what mineral is affected by benzodiazepines

Back 61

chlorine

Front 62

what minerals do local anesthetics effect

Back 62

sodium, potassium

Front 63

where are benzodiazepines excreted

Back 63

kidneys

Front 64

long half-lives = _________ side effects

Back 64

more

Front 65

the most common side effect of benzodiazepines is

Back 65

depression of CNS manifested as fatigue drowsiness muscle weakness and ataxia

Front 66

this is common with benzodiazepines causes muscle spasms

Back 66

pitosis

Front 67

date rape drug

Back 67

flunitrazepam (rohypnol)

Front 68

Halcion (triazeolam) in oral form greater likelihood of what

Back 68

anterograde amnesia

Front 69

single object viewed as two ( double vision)

Back 69

diplopia

Front 70

rhythmic oscillation of the eyeballs (rapid eye movement)

Back 70

nystagmus

Front 71

benzodiazepines can have what dental effects

Back 71

xerostomia, increased salivation, swollen toungue, and a bitter or metallic taste

Front 72

imflammation of the venous vessels

Back 72

thrombophlebitis

Front 73

benzodiazepines antagonist that is used for overdose (IV administration)

Back 73

flumazenil (romazicon)

Front 74

dopamine deficiency may have parkinsons may take levodopa benzodiazepines may ____ the effects of levodopa

Back 74

reduce

Front 75

what are uses for benzodiazepines

Back 75

anxiety control, insomnia management, treatment of epilepsy (seizures), treatment of alcoholism, control of muscle spasms

Front 76

what neurotransmitter does benzodiazepines enhance or facilitate

Back 76

GABA (y-aminobutyric acid)

Front 77

drug of choice for marilyn monroe

Back 77

barbiturates

Front 78

benzodiazepines replaced _________ in treating anxiety, insomnia, and panic because it is safer

Back 78

barbiturates

Front 79

________- are still used to treat seizure disorders and induce general anesthesia

Back 79

barbiturates

Front 80

absorption of barbiturates are pretty good except for with _--

Back 80

intramuscular

Front 81

barbiturates work with which neurotransmittor

Back 81

GABA receptor binding

Front 82

what is main effect of barbiturates

Back 82

CNS depression

Front 83

there is an absolute contraindication of barbiturates if a patient has

Back 83

porphyria- a group of disorders involving heme biosynthesis.

Front 84

use of barbiturates can stimulate and increase the synthesis of ______which is already in excess in what disease

Back 84

porphyrins, porphyria

Front 85

nonbenzodiazepine-nonbarbiturate sedative hypnotics are mostly used with

Back 85

children

Front 86

________ ________ is not useful alone as a general anesthetic

Back 86

nitrous oxide

Front 87

which drug was the first general anesthetic used in 1846 by William Morton at the Massachussetts general hospital

Back 87

ethyl ether

Front 88

blocking the conscious sensation of pain

Back 88

analgesia

Front 89

producing unconsciousness

Back 89

hypnosis

Front 90

preventing memory formation

Back 90

amnesia

Front 91

preventing unwanted movement or muscle tone

Back 91

paralysis

Front 92

preventing exaggerated autonomic reflexes

Back 92

obtundation of reflexes

Front 93

who created a system of stages and planes to describe the effects of anesthesia in 1920

Back 93

Guedel

Front 94

what are the four stages of Guedel's stages and planes of anesthesia

Back 94

stage 1 analgesia
stage II delirium or excitement
stage III surgical anesthesia ( divided into four planes based upon eye movement, depth of respiration, and muscle relaxation)
stage IV respiratory or medullary paralysis

Front 95

which stage of Guedel's stages and planes of anesthesia is the stage where general surgery is performed?

Back 95

stage III surgical anesthesia

Front 96

what are the current levels of anesthesia

Back 96

Induction
Maintenance
Recovery

Front 97

term in the current levels of anesthesia that is used to refer to the quick cahnge in the patient's state of consciousness from stage I to III

Back 97

Induction

Front 98

this level of the current levels of anesthesia beginswhen the patient has achieved a depth of anesthesia sufficient for surgery to begin and ends upon the completion of the surgical procedure

Back 98

maintenance

Front 99

this is the level of the current levels of anesthesia at the termination of the surgical procedure and continues throughout the postoperative recovery period until the patient is fully responsive to his/her environment

Back 99

recovery

Front 100

inhalation volatile liquids (liquids that easily evaporate) in general anesthesia end in the suffix

Back 100

rane

Front 101

what is MAC

Back 101

minimal alveolar concentration

Front 102

is a way of measuring and comparing the potency of inhalational anesthetics (the inspired concentration of the inhaled anesthesia required to induce surgical anes. in 50% of patients)

Back 102

MAC minimal alveolar concentration

Front 103

agents with ____MACs are less potent than agents with ______MACs

Back 103

high, low

Front 104

who discovered nitrous oxide,
who was the first dentist to use nitrous oxide

Back 104

Joseph Priestly in 1700
Dr Horace Wells

Front 105

a colorless, tasteless gas with little or no odor, administered with oxygen

Back 105

Nitrous oxide

Front 106

what colour tank is Nitrous Oxide

Back 106

blue

Front 107

what colour tank is oxygen

Back 107

green

Front 108

very good for conscious sedation (used in dental offices for anxiety and slight analgesia)

Back 108

Nirtous oxide

Front 109

after nitrous oxide is discontinued what should the patient be placed on for five minutes

Back 109

oxygen

Front 110

vomiting and nausea have been reported with nitrous oxide how long do they recommend you don't eat before an appointment

Back 110

3 hours

Front 111

what is the average concentration of nitrous oxide for analgesia to occur

Back 111

35%

Front 112

chronic use of nitrous oxide interferes with bs12 in the body and can cause b12 deficiency which can mimic

Back 112

pernicious anemia

Front 113

Thiopental (Pentothal)
Methohexital (Brevital)
Thiamylal (Surital)
are examples of what

Back 113

Ultrashort-acting barbiturates (general anesthetics)

Front 114

what general anesthetic did Michael Jackson die of

Back 114

Propofol (Diprivan)

Front 115

ketamine is also known as what

Back 115

angel dust

Front 116

what two local anesthetics have been linked or associated with causing malignant hyperthermia

Back 116

none trick question

Front 117

recurrent herpes appears intraorally on __________ tissue

Back 117

keratinized

Front 118

Other names for candidiasis

Back 118

moniliasis, thrush

Front 119

cyclosporine treats

Back 119

antirejection drug for transplants

Front 120

defined as the use of drugs for nonmedical purposes, usually with the intent of altering consciousness

Back 120

drug abuse

Front 121

a state of mind in which a person believes that he or she is unable to function without a specific drug

Back 121

psychological dependance

Front 122

the altered physiologic state that results from constantly increasing drug concentrations

Back 122

physical dependance

Front 123

tobacco cessation drugs

Back 123

varenicline,blocks nicotine receptor busPIROne non benzodiazepine (antianxiety agent)not for tobacco cessation , buPROPion antidepressant used in an anti tobacco regiment

Front 124

which of the following is a tobacco cessation drug bupropion, buspirone

Back 124

bupropion

Front 125

when is physical dependence determined to exist?

Back 125

when the person experiences withdrawal symptoms

Front 126

the need for dose increases in order to achieve the desired effect or if the same dose produces a diminished effect

Back 126

tolerance

Front 127

characterized by a desire to continue to use a drug for its effect

Back 127

habituation and addiction

Front 128

what is a better term to replace habituation and addiction

Back 128

dependence

Front 129

a state of psychological or physical desire to use a drug

Back 129

dependence

Front 130

time required to produce physical dependence, when comparing drugs, is ______---- with a rapidly metabolized drug and ________ with a slowly metabolized drug

Back 130

shortest
longest

Front 131

the ______ the half life of a drug the quicker the withdrawal reaction

Back 131

shorter

Front 132

in an addiction to ______ (opiod) other opioids can prevent withdrawal

Back 132

heroin

Front 133

___________ cannot be substituted for an opioid and vice versa

Back 133

barbiturates

Front 134

what are the most commonly abused drugs in the U.S

Back 134

alcohol, tobacco and caffeine

Front 135

t or f 1 in 10 people abuse alcohol

Back 135

true-

Front 136

aspirin and NSAID use may need to be avoided because of the increased risk of GI adverse effects in whom

Back 136

drug abuse pt's

Front 137

______ is the primary organ of drug metabolism so it must be considered when prescribing drugs

Back 137

liver

Front 138

Delirium temens (DTs) is what

Back 138

withdrawal from alcohol

Front 139

which drug produces significant bad side effects if alcohol is ingested

Back 139

disulfiram (antabuse)
metronidazole also causes a disulfiram reaction

Front 140

which drug (oral opioid antagonist) is used to reduce alcohol cravings

Back 140

naltrexone

Front 141

how many cases of alcohol are reported each year in the united states? how many people die each week from alcohol poisoning

Back 141

50000
1

Front 142

what is considered binge drinking

Back 142

five or more drinks at one sitting

Front 143

what do these signs point to
mental confusion stupor coma or person can't be roused
vomiting
seizures
slow breathing (fewer then 8 a minute)
irregular breathing (10 sec or more between breaths)
hypothermia, bluish skin color, paleness

Back 143

alcohol poisoning

Front 144

permanent dilation of the capillaries and small blood vessels

Back 144

telangiectasia

Front 145

synonym for squamous cell carcinoma

Back 145

epidermoid carcinoma

Front 146

FAS patients have no ______

Back 146

philtrum

Front 147

what is the most commonly abused illicit drug

Back 147

marijuana

Front 148

major psychoactive ingredient in marijuana

Back 148

THC delta-9-tetrahydrocannabinol

Front 149

how long can THC be detected in urine after being stored in body fat

Back 149

60 days

Front 150

what is dronabinol (marinol)

Back 150

a synthetic THC approved by FDA schedule III drug prescription drug

Front 151

what is the triad of narcotic (opioid analgesics heroin methatdone etc) overdose that is treated with nalaxone

Back 151

respiratory depression
pinpoint pupils
coma

Front 152

GHB (gamma hydroxybutyrate) is also known as?
Can be used for treatment of

Back 152

liquid ecstasy
narcolepsy

Front 153

what is the most widely used social drug?

Back 153

caffeine

Front 154

methamphetamine is a medicine to do what?

Back 154

curb appetite

Front 155

methamphetamine may be synthesized from what
they are adronergic agonists

Back 155

pseudoephedrine or ephedrine

Front 156

methamphetamine abusers get xerostomia with ____ saliva

Back 156

ropey

Front 157

methamphetamine has been described as teh

Back 157

mother of all dopamine releases

Front 158

basometabolic rate (BMR) is increased by

Back 158

methamphetamine

Front 159

what is the most potent hallucinogen

Back 159

LSD

Front 160

this is a spreading ulcer that has both bacteriologic (spirochetes) and environmental factors

Back 160

ANUG acute necrotizing ulcerative gingivitis

Front 161

what drugs should be used for pain and fever associated with anug

Back 161

acetaminophen or other nonopioid pain relievers

Front 162

what are cold sores or feverblisters caused by?

Back 162

herpes symplex type 1 virus

Front 163

what type of tissue does recurrent herpes appear on intraorally

Back 163

keratinized

Front 164

what would be used to treat pain associated with cold sores

Back 164

aspirin ibuprofen or acetaminophen

Front 165

what topical antiviral drugs would be used to treat herpes simplex type 1 virus?

Back 165

penciclovir and docosanol 10?

Front 166

what would be used to treat cold sores if the pt. was immunocompromised

Back 166

acyclovir

Front 167

oral candidiasis, or thrush is the result of what fungus?

Back 167

candida albicans

Front 168

what antifungal drug is used to treat candidiasis?

Back 168

nystatin

Front 169

what oral disease is characterized by redness, fissures, erosions, and ulcers at the corners of the mouth?

Back 169

angular cheilitis, or Cheilosis

Front 170

what causes angular cheilitis

Back 170

can be candida albicans, bacteria, drugs, and a vitamin B deficiency

Front 171

what oral disease is the result of a loss of necrosis or blood clot after an extraction that exposes bone

Back 171

alveolar osteitis or dry socket

Front 172

treatment for what oral disease includes packing the socket, analgesics, antibiotics if necessary, supportive therapy, and debridment and the disease is characterized by pain fever lymphadenopathy and malodor

Back 172

alveolar osteitis

Front 173

dry socket also known as

Back 173

alveolar osteitis

Front 174

proper name for canker sore

Back 174

aphthous stomatitis

Front 175

aphthous stomatitis is found in __________ areas of the mouth

Back 175

nonkeratinized

Front 176

what is the last resort treatment of canker sores?

Back 176

immunosuppressants

Front 177

what is a new topical antiinflammatory that is used to decrease duration of healing and ulcer pain in aphthous stomatitis

Back 177

aphthasol (amlexanox)

Front 178

a skin lesion that often involves lesions on the oral mucous membranes

Back 178

lichen planus

Front 179

which classic lesion appears bilaterally on buccal mucosa as white lacy lines?aka wickhams striae

Back 179

lichen planus

Front 180

oral cavity appears normal but pt describes pain that increases through the day

Back 180

burning mouth or tongue syndrome

Front 181

inflammation of the tissue around the crown of the tooth

Back 181

pericoronitis

Front 182

where does pericoronitis most often occur?

Back 182

around the partially erupted third molars as a possible response to food or bacteria that has becom trapped between the operculum and the tooth

Front 183

actinic lip changes are caused by constant exposure to the sun what is long term irreversible changes knows as?

Back 183

actinic cheilitis or solar keratosis

Front 184

what topical is recommended keratotic changes have occured to the lips?

Back 184

topical 5-fluorouracil is indicated

Front 185

what drug is used to treat xerostomia?

Back 185

pilocarpine (for pt's with fuctioning parotid glands)

Front 186

what should be avoided from a pt who has xerostomia

Back 186

alcohol, caffeine beverages

Front 187

what three terms mean an increase of production of saliva

Back 187

sialosis, sialism, sialorrhea

Front 188

what cholinergic agent causes sialorrhea?

Back 188

pilocarpine

Front 189

what is the most common drug that is associated with eruptions that resemble lichen planus

Back 189

hydrochlorothiazide (HCTZ)

Front 190

what color are minocyclines thought to produce in the bone in adult teeth

Back 190

blue-gray

Front 191

chlorhexidine rinse and liquid iron preperations can cause

Back 191

extrinsic staining

Front 192

phenytoin, cyclosporine, calcium channel blockers, carbamazepine, and valproic acid can cause what

Back 192

gingival enlargement

Front 193

what enzyme primarily metabolizes esters in which portion of the body

Back 193

pseudocholinesterase in the bloodstream (plasma)

Front 194

what is the process of metabolizing esters known as?

Back 194

ester hydrolysis

Front 195

what is the most rapidly hydrolyzed and least toxic LA ester

Back 195

chloroprocaine

Front 196

how many times slower is tetracaine then chloroprocaine

Back 196

16 times

Front 197

what is the most toxic ester

Back 197

tetracaine

Front 198

what is the most common cause of allergic reactions in esters

Back 198

PABA para-aminobenzoic acid

Front 199

what is the by-product of ester metabolism that is the most common cause of allergic reactions

Back 199

PABA para-aminobenzoic acid

Front 200

what are the only type of LAs used parenterally (injections)

Back 200

amides

Front 201

what is the most commonly used LA in dental office

Back 201

lidocaine (xylocaine, octocaine)

Front 202

lidocaine is used in an IV to treat what?

Back 202

cardiac arrhythmias

Front 203

mepivicaine is not effective by which route of entrance?

Back 203

TOPICALLY

Front 204

Mepivicaine is used with what vasoconstrictor

Back 204

levonordefrin

Front 205

t or f mepivacaine can be used plain because it produces less vasodilation than lidocaine

Back 205

true

Front 206

blood cells that carry oxygen to the blood

Back 206

methhemoglobin

Front 207

what disease is associated with prilocaine?

Back 207

methhemoglobinemia

Front 208

prilocaine should not be administered to patients with problems of what

Back 208

oxygenation

Front 209

prilocaine plain is faster then what
prilocaine with epinephrine has a duration slightly longer than what?

Back 209

mepivacaine
lidocaine

Front 210

how much shorter is bupivicaine then lidocaine

Back 210

trick question
bupivicaine has twice the prolonged duration than lidocaine

Front 211

prilocaine should not be administered to patients with problems of what

Back 211

oxygenation

Front 212

bupivicaine (marcaine) has what effect after sensation occurs

Back 212

analgesic

Front 213

prilocaine plain is faster then what
prilocaine with epinephrine has a duration slightly longer than what?

Back 213

mepivacaine
lidocaine

Front 214

articaine like prilocaine may cause what if administered in very high doses

Back 214

methhemoglobinemia

Front 215

how much shorter is bupivicaine then lidocaine

Back 215

trick question
bupivicaine has twice the prolonged duration than lidocaine

Front 216

bupivicaine (marcaine) has what effect after sensation occurs

Back 216

analgesic

Front 217

articaine like prilocaine may cause what if administered in very high doses

Back 217

methhemoglobinemia

Front 218

articaine has an extra what?

Back 218

ester linkage

Front 219

articaine is metabolized where?

Back 219

5-10% in liver 90-95 in blood

Front 220

what is articaine derived from?

Back 220

thiophene

Front 221

what is the slowest LA

Back 221

mepivicaine

Front 222

what is the longest duration LA

Back 222

bupivacaine

Front 223

are amides or esters more likely to cause an allergic reaction

Back 223

esters

Front 224

what is the most commonly used topical ester LA

Back 224

benzocaine

Front 225

epinephrine is an

Back 225

vasoconstrictor

Front 226

how long must one wait to use epinephrine to make sure not to increase the risk of hypertension and cardiac arrhythmias after the use of cocaine

Back 226

twenty four hours

Front 227

what ester produces the greatest vasodialtion of all LA

Back 227

procaine

Front 228

why is procaine not often used in dentistry today?

Back 228

high rate of allergic reactions

Front 229

what are people usually allergic to in procaine?

Back 229

PABA

Front 230

how much more potent and toxic is tetracaine compared to procaine

Back 230

ten times

Front 231

what is a topical anesthetic that is neither an ester nor an amide?

Back 231

dyclonine

Front 232

which LA has antitussive properties?

Back 232

benzonatate

Front 233

why are vasoconstricting agents included in LAs

Back 233

prolongs action of LAs, increases depth of anesthesia to local area, makes toxicity less likely, produces hemostasis

Front 234

what is the most common concentration of vasoconstrictors

Back 234

1:100000

Front 235

what concentration of vasoconstrictor would most likely be used if patient was bleeding profusely

Back 235

1:50000

Front 236

what is the safe dose for cardiac patients of epinephrine

Back 236

0.04mg

Front 237

what is the max. safe dose of epinephrine for healthy patient

Back 237

0.2mg

Front 238

which two anesthetic solutions are sold with or without vasoconstrictor because they have less vasodilating properties than other LAs

Back 238

mepivocaine and prilocaine

Front 239

what are the two most important drug interactions with epinephrine

Back 239

tricyclic antidepressants
nonselective B-blockers

Front 240

what reaction may happen with combining epinephrine and nonselective B-blockers

Back 240

may result in hypertension and reflex bradycardia

Front 241

what reaction may happen with combining epinephrine and tricyclic antidepressants

Back 241

may result in increase in blood pressure

Front 242

what is slowness of the heart rate usually fewer than 60 beats per minute known as

Back 242

bradycardia

Front 243

duration of action of LA is usually related to what

Back 243

its protein binding capacity not its half life

Front 244

what determines the potency of a local anesthetic agent

Back 244

lipid solubility

Front 245

what two general factors will determine choice of anesthetic in a patient

Back 245

duration of procedure and patient-specific information

Front 246

mepivacaine and prilocaine can be used without a what

Back 246

vasoconstrictor

Front 247

which has the highest vasodilating effect lidocaine mepivacaine or prilocaine

Back 247

lidocaine

Front 248

lidocaine and bupivacaine produce too much vasodioation to be used without a what

Back 248

vasoconstrictor

Front 249

what is the reversal agent for residual soft-tissue anesthesia?

Back 249

OraVerse- phentolamine mesylate

Front 250

what is the downside to oraverse

Back 250

cost

Front 251

how much faster is recovery from anesthesia with oravers

Back 251

cuts time in half

Front 252

what kind of drug is oraverse

Back 252

an adrenergic alpha-blocking drug and its vasodilating

Front 253

what drug would be used in a cocaine overdose (MAOI crises)

Back 253

Regitine (phentolamine)

Front 254

what is the most commonly used topical anesthetic

Back 254

benzocaine

Front 255

what is the second most commonly used topical anesthetic

Back 255

lidocaine

Front 256

which LA is neither an ester nor an amide

Back 256

Dyclonine

Front 257

what is the topical needle free anesthetic placed in gingival sulcus

Back 257

Oraqix half lidocaine half prilocaine (2.5%/2.5%)

Front 258

what are some OD reactions to local anesthetics

Back 258

decreased BP heart rate and respiratory rate, generalized CNS depression, and tonic-clonic seizures

Front 259

the term used in general anesthesia to describe the quick change in the pt's state of consciousness from stage I to stage III

Back 259

induction

Front 260

the term in general anesthesia used to describe when the pt has achieved a depth of anesthesia sufficient to allow the surger to begin and ends upon completion of surgical procedure

Back 260

maintenance

Front 261

a term used in general anesthesia used when termination of surgical procedure and continues thorughout the postoperartive recovery period until pt is fully responsive to his or her environment

Back 261

recovery

Front 262

liquids that easily evaporate

Back 262

volatile anesthetics

Front 263

what are the most popular volatile liquids in use

Back 263

enflurane and isoflurane

Front 264

what ultrashort-acting barbiturate is also known as truth serum

Back 264

thiopental (pentothal)

Front 265

what are some serious adverse effects to Ultrashort-acting barbiturates?

Back 265

bronchospasm and laryngospasm

Front 266

when are Ultrashort-acting barbiturates contraindicated

Back 266

in prphyria and status asthmaticus

Front 267

what is it called when you abruptly discontinue nitrous oxide?

Back 267

diffusion hypoxia

Front 268

what can nitrous oxide cause in the pregnant patient?

Back 268

spontaneous miscarriage

Front 269

suffix for ultrashort-acting barbiturates

Back 269

tal or lal

Front 270

if repeagted dose of ultrashort-acting barbiturates are given where does the drug accumulate? Causing what?

Back 270

in the body tissues resulting in prolonged recovery

Front 271

what is the inspired concentration of the inhaled anesthetic required to induce surgical anesthesia in 50% of people known as ?

Back 271

minimal alveolar concentration or MAC

Front 272

MAC (minimal alveolar concentration) is used to compare the potency of

Back 272

inhalational anesthetics

Front 273

what is the primary part of dental office conscio0us sedation

Back 273

nitrous oxide

Front 274

what is the best indicator of sedation with nitrous oxide?

Back 274

pt's response to questions

Front 275

why is nitrous oxide contraindicated for the pregnant women (particulary in first trimester)

Back 275

high incidence of spontaneous miscarriage

Front 276

why is nitrous oxide contraindicated for the COPD pt

Back 276

COPD depends on low O2 concentrations as primary stimulant for respirations. use of hgh oxygen dose cances out this system and can cause respiration to cease

Front 277

what are the main contraindicators for nitrous oxide

Back 277

COPD, Pregnancy, treatment with bleomycin sulfate

Front 278

what vitamin does chronic use of nitrouss oxid interfere with and what does it cause

Back 278

b12 and pernicious enemia

Front 279

what is the most commonly used halogenated agent

Back 279

isoflurane

Front 280

suffix for halogenated hydrocarbons

Back 280

ane

Front 281

three examples of ultrashort-acting barbiturates

Back 281

thiopental, methohexital, thiamylal

Front 282

what is the drug unrelated to other general anesthetics used for day surgery that has a very high rapid onset makes pt feel better faster

Back 282

propofol

Front 283

what is the drug chemically related to phencyclidine also known as angel dust

Back 283

ketamine

Front 284

what drugs are related to general anesthetics and are given during induction phase and surgery to provide analgesia

Back 284

opioid analgesics

Front 285

what combination of drugs produces neuroleptoanalgesia which is a wakeful anesthetic state

Back 285

droperidol plus fentanyl

Front 286

which type of drugs are used as an integral pard of conscious sedation in general anesthetics

Back 286

benzodiazepines

Front 287

what are two muscle relaxants used with general anesthetics

Back 287

succinylcholine and pipecuronium

Front 288

what is mortality rate of malignant hyperthermia

Back 288

fifty percent

Front 289

what is malignant hyperthermia treated with

Back 289

dantrolen sodium and a quick trip to intensive care.

Front 290

nitrous oxide is used in dentistry as a what?

Back 290

antianxiety agent

Front 291

sedative hypnotic agents - depress _____

Back 291

cns

Front 292

what are the three groups of drugs classified as sedative-hypnotics

Back 292

benzodiazepines, barbiturates, nonbenzodiazepines-nonbarbiturates

Front 293

what is the most commonly used group of drugs classifed as sedative-hypnotics

Back 293

BENZODIAZEPINES

Front 294

benzodiazepines are named according to there what

Back 294

structure

Front 295

benzodiazepines are the most commonly used drugs to treat what

Back 295

anxiety

Front 296

what are the suffixes of benzodiazepines

Back 296

azepam or azolam

Front 297

which route is best for benzodiazepines

Back 297

oral

Front 298

which three benzodiazepines are metabolized by phase II glucuronidation only?

Back 298

lorazepam, oxazepam, temazepam

Front 299

this type of benzodiazepine metabolism involves oxidation, reduction, hydrolysis and is considered hard metabolism because it is affected by external factors

Back 299

phase 1 metabolism

Front 300

benzodiazepines bind to benzodiazepine receptors in the CNS and act as what

Back 300

agonists

Front 301

what inhibitory neurotransmittor does benzodiazepines act upon

Back 301

GABA or y-aminobutyric acid

Front 302

benzodiazepines and GABA allow what to flow into cell causing hyperplarization of the excitatory neurotransmitters which blocks their function and decreases excitation?

Back 302

Chloride

Front 303

diazepam's long half-,life and metabolism to an active metabolite prolongs its what

Back 303

duration of action

Front 304

where is the date rape drug available

Back 304

europe

Front 305

what is the most common side effect of benzodiazepines?

Back 305

depression manifested as fatigue, drowsiness, muscle weakness, and ataxia. (as in depression of these things)

Front 306

which benzodiazepine has an greater chance likelihood of anterograde amnesia in oral form

Back 306

halcion

Front 307

what benzodiazepine may cause thrombophlebitis because propylene glycol is used to solubulize it

Back 307

parenteral diazepam

Front 308

what benzodiazepine is soluble in water and less likely to cause thrombophlebitis

Back 308

midazolam

Front 309

which benzodiazepines are classified as x in pregnancy category

Back 309

triazolam and temazepam

Front 310

near term administration of the antianxiety agents temazepam and triazolam have resulted in what baby syndrome

Back 310

floppy infant syndrome

Front 311

true or false benzodiazepines have a wider therapeutic index then barbiturates

Back 311

true

Front 312

t or f barbiturates have a higher abuse potential then benzodiazepines

Back 312

true

Front 313

wide therapeutic index = wide range of

Back 313

safe dose

Front 314

the act of vomiting

Back 314

emesis

Front 315

what benzodiazepines are the drug of choice for epilepsy (seizures)

Back 315

diazepam or lorazepam

Front 316

what benzodiazepine is used in the dental office to allay apprehension

Back 316

diazepam

Front 317

parenteral benzodiazepines have been associated with what when used for conscious sedation

Back 317

respiratory depression and arrest

Front 318

valium =

Back 318

diazepam

Front 319

barbiturates are not used

Back 319

intramuscularly

Front 320

how do barbiturates produce their pharmocologic effect?

Back 320

by enhancing GABA receptor binding

Front 321

t or f barbiturates are a pain releaver

Back 321

f

Front 322

what is the main effect of barbiturates

Back 322

cns depression

Front 323

which barbiturates is controlled substance III

Back 323

butabarbital

Front 324

barbiturates are absolutely contraindicated in patients with what? why

Back 324

Porphyria-a group of disorders involving heme biosynthesis.
barbiturates can stimulate and increase the synthesis of porphyrins which are already in excess with this disease

Front 325

barbiturates are stimulators of liver what

Back 325

microsomal enzyme production

Front 326

an increase of microsomal enzyme production can increase what and decrease what

Back 326

rate of drug destruction
and decrease duration of action

Front 327

ultrashort-acting barbiturates are used intravenously for induction of what

Back 327

general anesthesia

Front 328

long-acting barbiturates are used for treatment of what?

Back 328

epilepsy

Front 329

what nonbenzodiazepine-nonbarbiturate sedative-hyupnotic is used in dentistry for preoperative sedation of children

Back 329

chloral hydrate (Noctec)

Front 330

what nonben-nonbarb sed-hyp is unique in structure and action and does not affect ability to drive

Back 330

buspirone

Front 331

what nonben-nonbarb sed-hyp does not produce tolerance or dependence and produces less CNS depression

Back 331

buspirone

Front 332

what is the latest group of drugs to treat insomnia?

Back 332

nonben-ben receptor agonists

Front 333

what are three nonben-ben receptor agonists and what do those do

Back 333

zolpidem, zaleplon(sonata) and eszopiclone (lunesta)
make you sleep

Front 334

what has the longest half life of the non ben-ben receptor agonists?

Back 334

eszopiclone (lunesta)

Front 335

what nonben ben receptor agonists are rapid acting, less potent, shorter action compared to ambien (zolpidem

Back 335

zaleplon (sonata)

Front 336

what is an example of a melatonin receptor agonist and what does it treat

Back 336

ramelteon (rozerem)
insomnia

Front 337

what condition is common with centrally acting muscle relaxants?

Back 337

xerostomia

Front 338

what is the the strongest and most sedating muscle relaxant

Back 338

cyclobenzapine (flexeril)