Local

True/False: Esters, benzocaine, tetracaine, and procaine are hydrolyzed in the plasma by the enzyme pseudocholinesterase. Procaine is metabolized to PABA and is the major metabolic by-product responsible for allergic reactions.

Both statement are true.

What is the name of the portion of the sensory neuron that is easily excited and decides whether or not to send the impulse further further down the axon?

Axon hillock

True/False: There is no difference in pain control between 1:50,000 and 1:100,000 epinephrine. Levonordefrin is less effective in providing hemostasis compared to epinephrine.

Both are true

True/False: As the action potential moves down the line, its strength remains constant as it moves from one neuron to the next. A stimulus triggers nerve impulses causes a domino effect.

Both statements are true

True/False: Ester local anesthetics have a high probability of producing an allergic reaction compared to amide local anesthetics. A patient who has an allergic to one ester agent is likely to experience hypersensitivity to all ester anesthetics.

Both statements are true

True/False: Local anesthetic agents with vasoconstrictors are generally more acidic than plain formations because of the presence of sodium bisulfite.

Both statements are true

True/False: The lipoprotein sheath that surrounds many neurons is called the myelin sheath. The myelin sheath is composed of Schwann cells.

Both statements are true

True/False: The onset of action for benzocaine is rapid. The duration of action for benzocaine is 5-15 minutes.

Both statements are true

True/False: The smaller-diameter nerve fibers associated with supraperiosteal injections are more sensitive to local anesthetics. The larger-diameter nerve fibers of the IA and PSA require a larger volume of local anesthetic for successful nerve blocking.

Both statements are true

True/False: After absorption of the local anesthetics into the bloodstream, they are distributed throughout the body to all tissues. Highly vascular organs such as the brain, heart, liver, kidneys, and lungs have higher concentrations of anesthetics.

Both statements are true.

True/False: Adding vasoconstrictor to local anesthetics can result in reduces systemic toxicity and increased duration of the anesthetic because the vasoconstrictor reduces the rate of absorption.

Both the statement and reason are correct and related.

What nerve is not anesthetized when giving the IA?

Buccal

The local anesthetic with the longest duration of action is?

Bupivacaine

Local anesthetic overdose has an effect on which system?

CNS

If plasma concentrations of topical anesthetic become too high, the most prominent systemic effect will occur in which of the following systems?

CVD and CNS

Prilocaine is the generic name for which of the following?

Citanest

What is the name of the depression along the anterior border of the ramus that is an anatomical landmark for the inferior alveolar nerve block injection?

Coronoid notch

What factor/factors influences the duration of the effects of the local anesthetics?

Degree of protein binding. Vascularity of injection site. Addiction or absence of a vasoconstrictor.

Which patients may be more susceptible to adverse effects of topical anesthetic agents?

Elderly, Kids, and medically compromised

Undesirable side effects of incorporating sympathomimetic agents such as epinephrine into local anesthetic solutions include:

Increased rate and force of heart contractions

The time interval between the initial deposition of the anesthetic solution at the nerve site and complete conduction blockade is referred to as the:

Induction time

What preservative is included in Lidocaine 2% plain to prolong its shelf life?

No preservative is added

What is the term used to describe the persistent anesthesia or the altered sensation of tingling or itching beyond the expected duration of local anesthetic?

Paresthesia

What factors might contribute to an accidental overdose of vasoconstrictors?

Poor technique, wrong type of vasoconstrictor, administered to much vasoconstrictor

Which amide anesthetic is metabolized by the lungs before it reaches the liver?

Prilocaine

What is the propagation of action potential along myelinated axons from one node of Ranvier to another called?

Saltatory conduction

What is the reason that concentrations of topical anesthetic agent are higher than those of their injectable counterparts?

They facilitate diffusion of the topical anesthetic agent through the mucous membranes

Why are vasoconstrictors important additives to the local anesthetic solutions?

They provide hemostasis at the injection site, reduce the possibility of systemic toxicity, and prolong the duration of the anesthetics effect.

True/False: Anesthesia should be achieved to a depth of approx. 2-3 mm into the tissue.

True

True/False: Local anesthetics easily cross the blood-brain barrier.

True

True/False: The most potent local anesthetic is bupivacaine, which has the greatest degree of lipid solubility.

True

Which afferent nerve fiber is responsible for sharp dental pain?

A fibers: delta

Which amide anesthetic agent is metabolized in both the plasma and the liver?

Articaine

How fast should a cartridge of anesthetic be injected?

At a rate of 1.8 mL per 2 minutes

Which of the following anesthetics are combined with levonordefrin?

2% Mepivacaine

You need to administer a local anesthetic which will provide 60 minutes of pulpal anesthesia to complete periodontal debridement for your patient. What will you select?

2% lidocaine, 1:100,000 epi

What is the available concentration of Oraqix?

2.5% lidocaine and 2.5% prilocaine

Why is lipid solubility an important characteristics of local anesthetic drug?

A greater lipid solubility: enhances the diffusion of the anesthetic drug through the nerve. Indicates a higher potency of the anesthetic drug. Allows for a lower effective dose of the local anesthetic drug.

What are the nerves that conduct signals from sensory neurons to the spinal cord or brain called?

Afferent Nerves

Which description best describes the mechanism by which local anesthetic drugs work?

Anesthetic drugs bind to the sodium channels, the influx of sodium is interrupted, the action potential cannot rise, and the signal conduction is inhibited.

The core bundles of the inferior alveolar nerve innervate which teeth?

Anterior teeth

Branches of which nerve are located in the parotid gland that can cause paralysis of the face and eye if inadvertently injected?

Facial

True or False: A comparison of levonordefrin and epinephrine reveals that hemostasis is less effective with the vasoconstrictor epinephrine.

False

True/False: Prilocaine is bio-transformed in the liver only?

False

True/False: The higher the pKa of an anesthetic, the faster the onset of action.

False

True/False: When the local anesthetic is administered, the solution reaches the core bundles first?

False

True/False: local anesthetics are vasoconstrictors and decreases the adsorption of the drug by the blood.

False

When comparing levonordefrin and epinephrine reveals that levonordefrin offers better pain control than epinephrine.

False

True/False: The A alpha nerve fiber type is the smallest and most numerous nerve fibers. In general, the larger the diameter of the axon, the faster the impulse

First statement is false, the second statement is true

True/False: To obtain the most benefit from the use of the topical anesthetic, you need to use a large amount. This amount mixes with the saliva and may numb the tongue, soft palate, or pharynx.

First statement is false, the second statement is true

What is the maximum recommended dose of Oraqix at one dental treatment session?

Five cartridges

Where should a clinician palpate in order to determine the location of the mental foramen?

From the mandibular first molar to the distal surface of the canine

What is another name for the elimination of the local anesthetic from the blood and tissues?

Half-life

What can a clinician safely do if a patient is experiencing excessive bleeding while undergoing root planning?

Infiltrate epi. 1:50,000 in small amounts directly into the area of bleeding

Considering local anesthetic structure, which of the following determines whether the anesthetic is an amide or ester?

Intermediate linkage

What condition is avoided by aspiration prior to deposition of a local anesthetic?

Intravascular injection

What statement best describes levonordefrin?

Is a vasoconstrictor added to Mepivacaine

What is the name of the only topical amide anesthetic currently on the dental market in the U.S.?

Lidocaine

Which component of the local anesthetic molecule improves the lipid solubility, facilitating the penetration of the anesthetic through the lipid-rich membrane where the receptor sites are located?

Lipophilic aromatic ring

What duration category best describes bupivacaine 0.5% 1:200,000 epinephrine?

Long-acting

Complete recovery from the inferior alveolar nerve block occurs first in the?

Mandibular anterior teeth, chin, and lip

The difference between the electrical charge on the outside of the cell and that on the inside of the cell is called what?

Membrane potential

What is the solution that WAS added to the cartridge of local anesthetics to prevent bacterial growth?

Methylparaben

What is the name of the type of injection that anesthetizes a larger area than the local infiltration because the local anesthetic agent is deposited near large nerve trunks?

Nerve block

Which ingredient added to the dental cartridge alkalinizes, or adjusts the pH, of the solution between 6 and 7?

Sodium hydroxide

What do local anesthetic drugs inhibit in order to prevent nerve cell stimulation?

Sodium influx

Possible localized adverse effects of topical anesthetics could include which of the following?

Stinging, tissue discoloration, and sloughing

The mantle bundles of the inferior alveolar nerve innervates which teeth?

The molar area

Which is the primary factor that determines the onset of action?

pKa of the anesthetic agent