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NBDE II > Pharm > Flashcards

Pharm Flashcards

1
Q

Which form of local anesthetic can penetrate through the nerve membrane?

A

The non ionized form

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2
Q

What will increased blood flow do to LA?

A

Shorten duration

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3
Q

What will an increase in lipid solubility or hydrophobicity do to LA?

A

More potent

Longer duration

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4
Q

What will increase protein binding do to LA?

A

Increase duration

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5
Q

What will a decreased pka of a LA do?

A

Faster onset of action

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6
Q

What is the pka of mepivicaine?

A

7.6

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7
Q

What is the pka of lidocaine?

A

7.8

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8
Q

What is the pka of articaine?

A

7.8

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9
Q

What is the pka of bupivicaine?

A

8.1

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10
Q

What is the pka of prilocaine?

A

7.8

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11
Q

How many mg of anesthetic is in 1% carp?

A

18 mg

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12
Q

How many mg of epinephrine is in 1 carp of 1:100,000?

A

.018 mg

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13
Q

What 3 things does a vasoconstricter do to a LA?

A
  1. Prolong numbness
  2. Decrease toxicity
  3. Promote hemostasis
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14
Q

What is max dose of epinephrine for asa I pt?

A

0.2 mg

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15
Q

What is mmax dose of epinephrine for a pt with cardiac issues?

A

0.04mg

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16
Q

What is max does lidocaine without epi?

A

4.4mg/kg

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17
Q

What is max does of lidocaine with epi?

A

7mg/kg

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18
Q

Which injection has the highest risk for hematomas?

A

PSA

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19
Q

How deep do you inject in a PSA block?

A

16 mm

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20
Q

Sulfonamides

A

Antibiotic
Start with prefix “sulfa”
Folate synthesis inhibitor (competes with PABA)
Bacteriostatic

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21
Q

Fluoroquinolones

A

Antibiotic
Have the term “floxacin” in the drug name
DNA synthesis inhibitor
Bacteriocidal

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22
Q

If you are allergic to penicillins, what other antibiotic are you likely allergic to?

A

Cephalosporins

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23
Q

Penicillins

A

B lactam antibiotic
Cell wall synthesis inhibitor
Broad ranged
Bacteriocidal

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24
Q

What is the difference between penicillin G and penicillin V and amoxicillin?

A

penicillin G is administered by IV and is more sensitive to acid degradation

Penicillin B is taken orally

Amoxicillin is broad spectrum

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25
Q

Augmentin

A

Type of penicillin

Contains amoxicillin and clavulanic acid (B lactatamase resistant)

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26
Q

What are the three penicillins that are B lactase resistant?

A

Augmentin, Methicillin, Dicloxacillin

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27
Q

Ampicillin

A

Best/broadest gram NEGATIVE spectrum

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28
Q

Carbenicillin

A

used specifically against psuedomonas

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29
Q

Cephalosporins

A

B lactam Antibiotic
cell wall synthesis inhibitor
All start with “Cef”
Bacteriocidal

30
Q

Monobactams

A

B lactam Antibiotic
cell wall synthesis inhibitor
Drug is called Aztreonam
Bacteriocidal

31
Q

Carbapenems

A

B lactam antibiotic
cell wall synthesis inhibitor
Drug is called Imipenem
Bacteriocidal

32
Q

Tetracyclines

A

Antibiotic
Protein synthesis inhibitor (30S ribosomal subunit)
end in “cycline”
Has broadest antimicrobial spectrum out of ALL antibiotics
Bacteriostatic

33
Q

Macrolides

A

Antibiotic
Protein synthesis inhibitor (50S ribosomal subunit)
End in “thromycin” (remember “Mac likes to throw mice”)
Bacteriostatic

34
Q

Lincosamides

A

Antibiotic
Protein Synthesis inhibitor (50S ribosomal subunit)
end in “mycin” (like Clindamycin etc….) “Link also hides mice”

35
Q

When is antibiotic prophylaxis required?

A

Cardiovascular conditions

  1. prosthetic heart valve
  2. Hx of endocarditis
  3. Hx of heart transplant with valve disfunction
  4. Congenital heart problems

OR if pt is immunocompromised

  1. Organ transplant
  2. Neutropenia
  3. Cancer therapy
36
Q

What is antibiotic prophylaxis prescription for children? what if they are allergic to penicillin?

A

amoxicillin 50mg/kg

clindamycin 20 mg/kg

37
Q

What is antibiotic prophylaxis that is non oral for adults and children?

A

ampicillin 2g 30 min before appt (IV or IM)
for kids
ampicillin 50mg/kg 30 min before appt

38
Q

What is prescription for prosthetic joint prophylaxis?

A

Keflex 2g, one hr before appt

39
Q

When is antibiotic prophylaxis NOT recommended?

A
  1. Cardiac pacemaker
  2. Rheumatic Fever without valvular disfunction
  3. Mitral valve prolapse without valvular regurgitation
40
Q

What antibiotic causes GI upset and psuedomonas colitis?

A

Clindamycin

41
Q

What is most likely to cause superinfection?

A

Broad spectrum antibiotics

42
Q

What is associated with aplastic anemia?

A

Chloramphenicol

43
Q

What antibiotic is associated with liver damage?

A

Tetracycline

44
Q

What is associated with allergic cholestatic hepatitis?

A

Erythromycin estolate

45
Q

what happens when you mix a bactericidal with a bacteriostatic drug?

A

They cancel each other out

46
Q

Where does clindamycin concentrate in the body?

A

In bone

47
Q

Where does tetracycline concentrate in the body?

A

Gingival Crevicular Fluid (it is often used in peril conditions)

48
Q

What meds are used for candidiasis?

A

Fluconazole or Ketoconazole

Clotrimazole (Mycelex) is in troche form

49
Q

What is another name for aspirin?

A

acetyl salicylic acid

50
Q

What is a side effect of aspirin?

A

GI issues in adults, (Reyes syndrome in children)

51
Q

What are side effects of ibuprofen?

A

Tough on kidney

52
Q

What are the 9 NSAIDS?

A
  1. Aspirin
  2. Ibuprofen (Motrin, advil)
  3. Naproxen (Aleve)
  4. Ketorolac (Acular)
  5. Indomethacin
  6. Phenylbutazone
  7. Diflunisal
  8. Celecoxib
  9. Meloxicam
53
Q

What is the most important thing to know about Acetaminophen?

A

It’s NOT an NSAID

54
Q

What organ is acetaminophen tough on?

A

Liver

55
Q

What are the 4 therapeutic effects of aspirin?

A
  1. Analgesic - inhibits COX 1 and 2 (! inhibits prostaglandin synthesis !)
  2. Anti-inflammatory - by same mechanism as analgesics
  3. Antipyretic - inhibits PG synthesis of hypothalamus
  4. Bleeding time - inhibits platelet aggregation
56
Q

What suffix do corticosteroids end in?

A

…one

57
Q

what is the therapeutic effect of corticosteroids?

A

inhibit phospholipase A2

58
Q

What is the rule of twos

A

adrenal suppression can occur is pt is taking 20 mg of cortisone for 2 weeks, within 2 years of dental tx

59
Q

What is mechanism for narcotics?

A

Mu Opioid repector agonist

60
Q

What is Vicodin

A

Hydrocodone and Acetaminophen (APAP)

61
Q

What is Percocet

A

Oxycodone and APAP (Acetaminophen)

62
Q

Tylenol 1

A

300 mg APAP +8mg codeine

63
Q

Tylenol 2

A

300 mg APAP + 15 mg codeine

64
Q

Tylenol 3

A

300 mg APAP + 30 mg codeine

65
Q

Tylenol 4

A

300 mg APAP + 60 mg codeine

66
Q

What are side effects of morphine

A 
MORPHINE
Mitosis (pupil constriction)
Out of it (sedation)
Respiratory depression
Pneumonia
Hypotension
Infrequency (urinary retention)
Nausea and vomiting
Euphoria and dysphoria
67
Q

What is Naloxone used for?

A

overdose

68
Q

What two drugs are used to treat addiction?

A

Naltrexone and Methadone

69
Q

What is the sensation before onset of Nitrous Oxide?

A

Tingling

70
Q

What is side effect of nitrous oxide?

A

Nausea

71
Q

What is long term exposure side effect of nitrous oxide?

A

peripheral neuropathy

72
Q

What is good baseline for children and adults?

A

children 30%

adults 30% to 50%

NBDE II (3 decks)

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