Pharm Test 2 Book Questions Flashcards
_ are the most important drug group in dentistry.
Local anesthetic
All local anesthetics in use today share similar chemical structures and can be categorized as being either _ or _
esters or amides
The mechanism of action of esters and amides is by blockade of _ through binding to _
the propagation of peripheral nerve impulses
their receptor within sodium channels.
The duration of local anesthetics is determined by _, NOT _
redistribution away from the site of action
NOT metabolism.
Most local anesthetics cause _ necessitating addition of a _ to provide appropriate duration of action for use in dentistry.
Vasodilation
Vasoconstrictor
The most common adverse reaction to local anesthetics is _ in nature, manifested as _
Psychogenic
Syncope
Toxicity from local anesthetics can occur with _ or by _
Excessive doses
Or by
Intravascular injection
_ are most susceptible to overdose from local anesthetics
Pediatric pts.
Balanced anesthesia, using _ is the common technique used today in general anest.
Multiple drugs
Inhalational anesthetics are now used primarily for _
maintenance of anesthesia.
The inhalational anesthetics are: (4)
Nitrous oxide
Isoflurane
Desflurane
Sevoflurane
Intravenous anesthetics are now used primarily for _
Induction of anesthesia.
Intravenous anesthetics include: (4)
propofol, methohexital, ketamine, and midazolam.
Adjuvant drugs to general anesthesia include: (6)
peripheral skeletal neuromuscular blockers dexmedetomidine analgesics sedatives antihistamines antimuscarinic drugs.
Treatment of dental pain associated with inflammation may be accomplished with _ , either alone or in combinations with _
Anti inflammatory drugs
Opioids
The mechanism of action of opioids is _ located on neurons located primarily within the central nervous system (CNS).
the binding to (“affinity”) and activation of (“efficacy”) 7-transmembrane G protein–coupled opioid receptors
The target receptor for most commonly used opioid analgesics is termed _
μ, mu, or MOR.
Opioids also produce undesirable effects, including: (5)
Sedation and somnolence Constipation Nausea and vomiting Respiratory depression Urinary retention
Repeated use of opioids can lead to: (3)
Analgesic tolerance
Physical dependence
Addiction
Opioids that are agonists are used principally for _ ; antagonists prevent or reverse _ and are used principally to reverse _
relief of pain
the effects of agonists
opioid intoxication
Inflammatory mediators include: (7)
histamine prostaglandin leukotrienes platelet-activating factor cytokines bradykinin nitric oxide.
The nonsteroidal antiinflammatory drugs (NSAIDs) block the production of _ by _
prostaglandins
by
inhibiting cyclooxygenase (COX).
Cox 1 is _
Cox 2 is _
Constitutive
Inducible
_ is the only enzyme that irreversibly inhibits COX.
Aspirin
Inhibition of the synthesis of thromboxane A2 by aspirin accounts for its _ effect
antiplatelet effect.
NSAIDs that inhibit both COX-1 and COX-2 include: 4
aspirin
ibuprofen
naproxen
ketorolac
Celecoxib is a selective COX-2 inhibitor, and therefore it is associated with _ compared to aspirin and the other nonselective COX inhibitors.
less GI toxicity
