Pharmacology Flashcards
Which of the following types of local anesthetics is metabolized in the liver?
A. Amides
B. Esters
***BOARDS***
A. Amides
Ester local anesthetics are metabolized by pseudocholinesterase in the ______.
A. Liver
B. Kidneys
C. Plasma
D. Stomach
***BOARDS***
C. Plasma
Amides = Liver
Esters = Plasma
All of the following local anesthetics are Esters EXCEPT:
A. Procaine
B. Cocaine
C. Tetracaine
D. Prilocaine
E. Benzocaine
D. Prilocaine
All of the following local anesthetics are Esters EXCEPT:
A. Procaine
B. Cocaine
C. Lidocaine
D. Tetracaine
E. Benzocaine
C. Lidocaine
Which of the following local anesthetics cause the least amount of vasodilation?
A. Lidocaine
B. Bupivicaine
C. Mepivicaine
D. Articaine
E. Prilocaine
C. Mepivicaine (carbocaine)
Which of the following is the safest local anesthetic to use on children?
A. Lidocaine
B. Bupivicaine
C. Mepivicaine
D. Articaine
E. Prilocaine
A. Lidocaine
Which of the following local anesthetics is the LEAST safe for children?
A. Lidocaine
B. Bupivicaine
C. Mepivicaine
D. Articaine
E. Prilocaine
B. Bupivicaine (Maricaine)
Which of the following local anesthetics has an ester chain in it chemical formula?
A. Lidocaine
B. Bupivicaine
C. Mepivicaine
D. Articaine
E. Prilocaine
D. Articaine
Which of the following local anesthetics is metabolized in both the liver and the plasma?
A. Lidocaine
B. Bupivicaine
C. Mepivicaine
D. Articaine
E. Prilocaine
***BOARDS***
D. Articaine
Note: Articaine is an amide that also contains one ester chain in its chemical formula thus it gets metabolized in both the liver and the plasma
Which of the following local anesthetics is linked to a blood disorder known as methemglobinemia?
A. Lidocaine
B. Bupivicaine
C. Mepivicaine
D. Articaine
E. Prilocaine
***BOARDS***
E. Prilocaine
note: Methemglobinemia is where an abnormal amount of met-hemoglobin is produced which leads to deprivation of oxygen
Which of the following local anesthetics has the longest duration (last the longest)?
A. Lidocaine
B. Bupivicaine
C. Mepivicaine
D. Articaine
E. Prilocaine
C. Mepivicaine
Which of the following local anesthetics has the shortest duration (doesn’t last long)?
A. Lidocaine
B. Bupivicaine
C. Mepivicaine
D. Articaine
E. Prilocaine
***BOARDS***
D. Articaine
Discuss each of the following local anesthetics:
- What’s the other name along w/ the percentage of LA for each of the following?
- Lidocaine
- Bupivicaine
- Mepivicaine
- Articaine
- Prilocaine
Which of the following local anesthetics is Carbocaine?
A. Lidocaine
B. Bupivicaine
C. Mepivicaine
D. Articaine
E. Prilocaine
C. Mepivicaine
Which of the following local anesthetics is Marcaine?
A. Lidocaine
B. Bupivicaine
C. Mepivicaine
D. Articaine
E. Prilocaine
B. Bupivicaine
Which of the following local anesthetics is Xylocaine?
A. Lidocaine
B. Bupivicaine
C. Mepivicaine
D. Articaine
E. Prilocaine
A. Lidocaine
Which of the following local anesthetics is Citanest?
A. Lidocaine
B. Bupivicaine
C. Mepivicaine
D. Articaine
E. Prilocaine
E. Prilocaine
Which of the following local anesthetics is Septocaine?
A. Lidocaine
B. Bupivicaine
C. Mepivicaine
D. Articaine
E. Prilocaine
D. Articaine
Local anesthetics on their own are usually vasodilators, which of the following is the exception to this being a vasoconstrictor?
A. Procaine
B. Cocaine
C. Tetracaine
D. Benzocaine
B. Cocaine
What is the mechanism of action for Local Anesthetics?
***BOARDS***
Sodium channel blocker
Discuss the Pharmodynamics of Local Anesthetics in regards to each of the following:
- What does Pharmodynamics refer to?
- What is the Pharmodynamics of LA?
- Only ____ form can penetrate neuron membrane.
Discuss the Pharmacokinetics of LA in regards to each of the following:
- Increasing blood flow = ?
- Increasing lipid solubility/hydrophobicity = ?
- Increasing protein binding = ?
- Decreasing pKa = ?
Which of the following has a pKa of 8.1?
A. Mepivicaine
B. Lidocaine, Septocaine, Prilocaine
C. Bupivicaine
D. All of the above
C. Bupivicaine
Mepivicaine = pKa 7.6
Lidocaine, Septocaine, articaine = pKa 7.8
Bupivicaine = pKa 8.1
Which of the following has a pKa of 7.6?
A. Mepivicaine
B. Lidocaine, Septocaine, Prilocaine
C. Bupivicaine
D. All of the above
A. Mepivicaine
Mepivicaine = pKa 7.6
Lidocaine, Septocaine, articaine = pKa 7.8
Bupivicaine = pKa 8.1
Which of the following has a pKa of 7.8?
A. Mepivicaine
B. Lidocaine, Septocaine, Prilocaine
C. Bupivicaine
D. All of the above
B. Lidocaine, Septocaine, Prilocaine
Mepivicaine = pKa 7.6
Lidocaine, Septocaine, articaine = pKa 7.8
Bupivicaine = pKa 8.1
Discuss the calculations of local anesthetics:
- How many mg of anesthetic is in one 1.8mL carpule of 2% lidocaine?
- How many mg of anesthetic is in one 1.8mL carpule of 4% septocaine?
A carpule of 2% lidocaine solution with 1:100k epi would contain how much epinephrine in mg?
0.018mg
What are the 3 benefits to adding a vasoconstrictor (epinephrine) to local anesthetic?
***BOARDS***
The maximum lidocaine without a vasoconstrictor for a patient is ______.
A. 0.2mg
B. 0.4mg
C. 4.4mg/kg
D. 7mg/kg
C. 4.4mg/kg
The maximum epinephrine for a cardiac patient is ____.
A. 0.2mg
B. 0.4mg
C. 4.4mg/kg
D. 7mg/kg
B. 0.4mg
The maximum epinephrine for ASA I patients is:
A. 0.2mg
B. 0.4mg
C. 4.4mg/kg
D. 7mg/kg
A. 0.2mg
“Slow” injection is 1 carpule per ____.
“Slow” injection is 1 carpule per minute
The maximum lidocaine with a vasoconstrictor for a patient is ______.
A. 0.2mg
B. 0.4mg
C. 4.4mg/kg
D. 7mg/kg
D. 7mg/kg
Discuss needle dimensions: (length and gauge of needles)
Which of the following has the highest failure rate?
A. IAN block
B. Buccal nerve block
C. Mental nerve block
D. Incisive nerve block
A. IAN block
Which of the following is done in tandem with IAN block?
A. PSA nerve block
B. Buccal nerve block
C. Mental nerve block
D. Incisive nerve block
E. ASA nerve block
B. Buccal nerve block
Which of the following is the open mouth method for IAN block?
A. Halstead
B. Gow-Gates
C. Akinosi
B. Gow-Gates
Which of the following has the highest risk of hematoma?
A. IAN block
B. ASA nerve block
C. Buccal nerve block
D. PSA nerve block
E. Mental nerve block
***BOARDS***
D. PSA nerve block
How deep (in mm) do you need to go w/ your needle to hit the PSA nerve block?
***BOARDS***
Whihc of the following is also called “true ASA block”?
A. MSA nerve block
B. PSA nerve block
C. Nasopalatine nerve block
D. Infraorbital nerve block
E. IAN block
D. Infraorbital nerve block
All of the following antibiotic classes are bactericidal EXCEPT:
A. Sulfonamides
B. Fluoroquinolones
C. Penicillins
D. Cephalosporins
E. Monobactams
A. Sulfonamides
Which of the following antibiotics is a folate synthesis inhibitor?
A. Sulfonamides
B. Fluoroquinolones
C. Penicillins
D. Cephalosporins
E. Monobactams
A. Sulfonamides
Which of the following antibiotics is a DNA synthesis inhibitor?
A. Sulfonamides
B. Fluoroquinolones
C. Penicillins
D. Cephalosporins
E. Monobactams
B. Fluoroquinolones
Discuss the prefix/suffix you need to know to remember what class of antibiotics each of the following belong to:
- Sulfonamides
- Fluoroquinolones
- Penicillins
- Cephalosporins
- Monobactams
Sulfonamides = “sulfa”
Fluoroquinolones = “floxacin”
Penicillins = “cillin”
Cephalosporins = “cef”
Monobactams = “am”
All of the following are cell wall synthesis inhibitors, beta-lactam EXCEPT:
A. Fluoroquinolones
B. Penicillins
C. Cephalosporins
D. Monobactams
E. Carbapenems
A. Fluoroquinolones
Which of the following antibiotics has the broadest antimicrobial spectrum?
A. Penicillins
B. Tetracyclines
C. Lincosamides
D. Macrolides
E. Carbapenems
***BOARDS***
B. Tetracyclines
Which of the following is cross-allergenic with cephalosporins because they are chemically related?
A. Sulfonamides
B. Fluoroquinolones
C. Penicillins
D. Carbapenems
E. Monobactams
***BOARDS***
C. Penicillins
Which of the following Penicillins has the best/broadest gram-negative spectrum?
A. Penicillin G
B. Penicillin V
C. Ampicillin
D. Carbenicillin
E. Augmentin
C. Ampicillin
Which of the following penicillins is given IV because it is sensitive to acid degradation?
A. Penicillin G
B. Penicillin V
C. Ampicillin
D. Carbenicillin
E. Augmentin
A. Penicillin G
Note: Penicillin V is taken orally bc it is less sensitive to acid degradation
Which of the following penicillins is used specifically against pseudomonas?
A. Penicillin G
B. Penicillin V
C. Ampicillin
D. Carbenicillin
E. Augmentin
D. Carbenicillin
Which of the following penicillins are a combination of amoxicillin and clavulanic acid?
A. Penicillin G
B. Penicillin V
C. Ampicillin
D. Carbenicillin
E. Augmentin
E. Augmentin
Which of the following penicillins is beta-lactamase-resistant?
A. Penicillin G
B. Penicillin V
C. Ampicillin
D. Methicillin
E. Augmentin
D. Methicillin
Note: remember that MRSA is a very dangerous disease
Discuss the prefix/suffix you need to know to remember what class of antibiotics each of the following belong to:
- Carbapenems
- Tetracyclines
- Macrlides
- Lincosamides
Carbapenems = “nem”
Tetracyclines = “cycline”
Macrlides = “thromycin”
Lincosamides = “mycin”
Which of the following antibiotics is a protein synthesis inhibitor (30S ribosome)?
A. Carbapenems
B. Tetracyclines
C. Macrlides
D. Lincosamides
B. Tetracyclines
All of the following antibiotics are protein synthesis inhibitors EXCEPT:
A. Carbapenems
B. Tetracyclines
C. Macrlides
D. Lincosamides
A. Carbapenems
All of the following conditions require antibiotic prophylaxis EXCEPT:
A. Prosthetic heart valve
B. Mitral valve prolapse without valvular regurgitation
C. History of endocarditis
D. Heart transplant with valvulopathy/valve dysfunction
E. Congenital heart problems
B. Mitral valve prolapse without valvular regurgitation
What are the 4 cardiovascular conditions that require antibiotic prophylaxis?
What are the 3 compromised immunity conditions that require antibiotic prophylaxis?
Discuss antibiotic prophylaxis for Infective Endocarditis in regards to each of the following: (make sure to indicate the dose for each)
- First choice?
- First choice for children?
- Penicillin allergy?
- Children w/ PCN allergy?
- Non-oral (IV or IM)?
- Children, non-oral?
What is the antibiotic prophylaxis used for a patient with a prosthetic joint?
Which of the following heart conditions is an indication for antibiotic prophylaxis?
A. Cardiac pacemaker
B. Rheumatic fever without valvular dysfunction
C. Mitral valve prolapse without valvular regurgitation
D. Prosthetic joints
E. Congenital heart problems
“YOU WILL SEE THIS ON BOARDS - MAYBE EVEN WORD FOR WORD”
E. Congenital heart problems
Note: careful, prosthetic joint is not a heart condition
When is Antibiotic Prophylaxis NOT required?
***BOARDS*** FORSURE***
Simple dental procedures do NOT require prophylaxis. Make sure to review the slide below
Which of the following antibiotics is associated with liver damage?
A. Clindamycin
B. Broad spectrum antibiotics
C. Tetracycline
D. Erythromycin estolate
E. Penicillin
***BOARDS***
C. Tetracycline
Which of the following antibiotics is associated with aplastic anemia?
A. Clindamycin
B. Broad spectrum antibiotics
C. Tetracycline
D. Erythromycin estolate
E. Chloramphenicol
***BOARDS***
E. Chloramphenicol
Which of the following antibiotics causes GI upset and pseudomonas colitis?
A. Clindamycin
B. Broad spectrum antibiotics
C. Tetracycline
D. Erythromycin estolate
E. Chloramphenicol
***BOARDS***
A. Clindamycin
Which of the following antibiotics is associated with allergic cholestatic hepatitis?
A. Clindamycin
B. Broad spectrum antibiotics
C. Tetracycline
D. Erythromycin estolate
E. Chloramphenicol
***BOARDS***
D. Erythromycin estolate
Which of the following antibiotics is most likely to cause a superinfection?
A. Clindamycin
B. Broad spectrum antibiotics
C. Tetracycline
D. Erythromycin estolate
E. Chloramphenicol
***BOARDS***
B. Broad spectrum antibiotics
What two classes of antibiotics cancel each other out?
Which of the following antibiotics concentrate on gingival crevicular fluid?
A. Clindamycin
B. Tetracycline
B. Tetracycline
Which of the following antibiotics concentrate on bone?
A. Clindamycin
B. Tetracycline
A. Clindamycin
Discuss antivirals and anti fungal in regards to each of the following:
- Acyclovir, Valcyclovir = ?
- Fuconazole, Ketoconazole = ?
- _____ is in troche form. ***He got a boards Q on this***
Which of the following is a COX 1 and 2 blocker that is metabolized in the liver?
A. Aspirin
B. Ibuprofen
C. Celecoxib
D. Meloxicam
B. Ibuprofen
Which of the following is a COX 1 and 2 blocker that is metabolized in the GI tract?
A. Aspirin
B. Ibuprofen
C. Celecoxib
D. Meloxicam
A. Aspirin
Which of the following are selective COX 2 blockers?
A. Aspirin
B. Ibuprofen
C. Celecoxib
D. Meloxicam
E. Two of the above
***BOARDS***
E. Two of the above
Discuss Acetaminophen in regards to each of the following:
- Is Acetaminophen an NSAID?
- Where is Acetaminophen metabolized?
- Where is Ibuprophen metabolized?
- Why is this the drug of choice for a feverish child? Why is aspirin bad for children?
- What syndrome can be caused in a child taking aspirin?
***BOARDS***
What is the maximum dose per day for each of the following:
- Ibuprofen?
- Acetaminophen?
Discuss the Therapeutic Effects of Aspirin in regards to each of the following:
- Analgesic = ?
- Anti-inflammatory = ?
- Antipyretic = ?
- Bleeding time = ?
***MOST IMPORTANT SLIDE IN ENTIRE PPT - BOARDS***
What is the number one toxic effect of aspirin?
Occult bleeding from GI tract