chapter 4

The number of 1:50,000 epinephrine-anesthesia cartridges that a patient with cardiovascular disease may have per dental appointment is_____.

1.1

Which of the following anesthetics are combined with levonordefrin?

2% mepivacaine

Which local anesthetic would be appropriate for a patient with a history of true bisulfite \allergy?

2% mepivacaine, 1:20,000 levonordefrin b. 4% prilocaine c. 4% articaine, 1:200,000 epinephrine

The number of 1:200,000 epinephrine-anesthesia cartridges that a healthy patient may have per dental appointment is____

22.2 cartridges.

The number of 1:200,000 epinephrine-anesthesia cartridges that a patient with cardiovascular disease may have per dental appointment

4.4

How long do adverse effects of vasoconstrictors last in the body?

5 to 10 minutes

The number of 1:50,000 epinephrine-anesthesia cartridges that a healthy patient may have per dental appointment is ______.

5.5 cartridges.

What inactivates epinephrine once it is in the bloodstream?

Adrenergic nerves

Vasodilation of the blood vessels at the site of the administration of a local anesthetic will cause what?

An increased rate of anesthetic absorption b. A decrease in the duration of the anesthetic c. Increased risk of toxicity

Which of the following may cause an endogenous release of epinephrine?

An injection of epinephrine b. Anxiety related to a divorce c. Apprehension about a dental appointment

Which receptors are the most sensitive to epinephrine?

Beta receptors

Which receptors have inhibitory actions from adrenergic drugs on smooth muscle?

Beta receptors

Which receptors relax bronchial smooth muscles, causing the bronchi of the lungs to dilate?

Beta receptors

Which vasoconstrictor is the most widely used in dentistry and the most potent?

Epinephrine

Neleen indicates on her health history that she is allergic to novocaine and sulfa drugs. What patient education might you provide to Neleen?

Explain that novocaine is in the ester family of drugs and you will be using a local anesthetic from the amide family.

What is the name of the vasoconstrictor, commonly combined with 3% prilocaine, that may be safely administered to patients with uncontrolled hyperthyroidism?

Felypressin

Undesirable side effects of incorporating sympathomimetic agents such as epinephrine into local anesthetic soluiton including

Increased rate and force of heart contractions

What effect does the endogenous release of epinephrine have on exogenous administration of epinephrine?

It may compound the effects.

Which of the following is true regarding norepinephrine?

Its use in dentistry is not recommended b. Has the same action as levonordefrin on alpha receptors c. Exhibits intense vasoconstriction

You have administered 2% lidocaine, 1:50,000 mg/mL epinephrine to a healthy patient. The patient experiences restlessness, nausea, and begins to hyperventilate. What should you suspect ?

Overdose of epinephrine

Which of the following vasoconstrictors are NOT added to dental local anesthetic drugs in the United States?

Phenylephrine b. Felypressin c. Norepinephrine

Which of the following statement(s) is/are true regarding the vasculature effects of epinephrine?

The effects of epinephrine on the blood vessels of the skeletal muscles are dose dependent due to the predominance of beta 2 receptors. b. Smaller doses of epinephrine affect the beta 2 receptors of the blood vessels of the skeletal muscles and produce vasodilation. c. Larger doses of epinephrine affect the alpha receptors of the blood vessels of the skeletal muscles and produce vasoconstriction.

Why are vasoconstrictors added to local anesthetics?

To counteract the vasodilating properties of the local anesthetic

What factors might contribute to an accidental overdose of vasoconstrictors?

a. Poor technique b. Selection of an inappropriate type of vasoconstrictor c. Too much vasoconstrictor administered

Why are vasoconstrictors important additives to the local anesthetic solution?

a. They provide hemostasis at the injection site. b. They reduce the possibility of systemic toxicity. c. They prolong the duration of the anesthetic's effect.

For all of the following conditions the risks of using a local anesthetic with a vasoconstrictor might outweigh the benefits except one.. what is the exception?

a. Unstable angina b. Recent knee replacement c. Uncontrolled diabetes d. Uncontrolled hypertension

A comparison of levonordefrin and epinephrine reveals that hemostasis is more effective with the vasoconstrictor epinephrine.

true

A comparison of levonordefrin and epinephrine reveals that levonordefrin offers similar pain control to that offered by epinephrine.

true

Adrenalin comes in concentrations of 1:50,000, 1:100,000, and 1:200,000.

true

Levarterenol is no longer available in the United States.

true

More diluted formulations of epinephrine are safer for patients who are cardiovascularly compromised. More concentrated formulations of epinephrine provide the greatest bleeding control.

true

The absorption of epinephrine is retarded because of the drug's vasoconstricting properties. It may take several hours for absorption to be completed.

true

The heart rate is increased when the beta 1 and beta 2 receptors are affected by the systemic effects of adrenergic amines.

true