Intro and Pharmacology

Question 1

Define analgesia.

Answer 1

The loss of pain sensation.

Question 2

What is local anaesthesia?

Answer 2

A method of anaesthesia which acts in a specific area and does not result in a loss of conciousness.

Question 3

Topical is the anaesthesia of surface tissues, what procedures is it used for in dentistry?

Answer 3

1. Pain free injections
2. Very minor oral surgery (biopsy)
3. Abscess incision
4. Palate for taking impressions on people with strong gag reflex

Question 4

What is the main factor which limits the effectiveness of an infiltration injection?

Answer 4

The permeability of the tissues through which the anaesthetic has to pass.

Question 5

What makes anaesthetising the upper molars by infiltration difficult?

Answer 5

They are surrounded by thicker bone.

Question 6

What is a regional block injection?

Answer 6

Anaesthesia achieved by blocking a nerve trunk at some distance from the site of operation. Eg. Inferior alveolar nerve block

Question 7

What is the UK trade name for mepivacaine?

Answer 7

Scandonest

Question 8

What is the drug name of septanest?

Answer 8

Articaine with adrenaline

Question 9

What component of the anaesthetic usually causes allergic reactions?

Answer 9

The preservative which is added when there is a vasoconstrictor.

Question 10

Which anaesthetic drug is the longest lasting and is it an ester or an amide?

Answer 10

Bupivicaine

Amide

Question 11

What makes articaine different in structure to other drugs and what does this factor do to the rate in which it is broken down?

Answer 11

It has both an amide and an ester link, this causes it to be broken down more readily.

Question 12

If a drug has a low pH what does this tell you about the onset?

Answer 12

It will be slow onset.

Question 13

What effect does the protein binding ability of the drug have on it’s action?

Answer 13

It prolongs the duration of the drug as binding to protein there is a pool of the drug available.

Question 14

Which type of nerve fibre is anaesthetised the quickest?

Answer 14

C fibres

Question 15

Which nerve fibres are the first to regain activity after the administration of a local anaesthetic?

Answer 15

A alpha

Question 16

What effect do local anaesthetics have on the myocardium?

Answer 16

Reduces the excitability and conductivity.

Question 17

What is the initial effect of local anaesthetics on the CNS?

Answer 17

Stimulation

Question 18

What type of drug is primarily broken down in the plasma?

Answer 18

Articaine

Question 19

Why are vasoconstrictors added to local anaesthetics?

Answer 19

• increase speed of onset
• counteract their vasodilatory effect
• extend duration
• lower blood levels of LA
• reduces haemorrhage

Question 20

What are the two types of vasoconstrictors added?

Answer 20

Sympathomemetic amines and synthetic polypeptides (e.g. Felypressin)

Question 21

What does of adrenaline would you expect in a cartridge of local?

Answer 21

1:80000

Question 22

What makes felypressin not effective at causing haemostasis?

Answer 22

It works on the venous side

Question 23

When should you reduce the dose given to a patient?

Answer 23

Liver disease
On beta blockers
Calcium channel blocker
Drug abuse
Tricyclics anti-depressants
Mono-amine oxidase inhibitors

Question 24

Define anaesthesia.

Answer 24

The loss of all sensation.