PHARMACOLOGY- ANESTHESIOLOGY 10.

Which local anesthetic has no place in the

1. Pharmaceutical agents that bring about routine practice of dentistry?
tissue responses resembling those a. Articaine
produced by stimulation of the sympathetic b. Cocaine
nervous system are called? c. Lidocaine
a. Cholinomimetic d. Bupivacaine
b. Antiadrenergic e. Prilocaine
c. Parasympathomimetic 11. Local anesthetics theoretically should be
d. Sympathomimetic less effective in acutely inflamed tissue
2. The medical uses of a drug having than in in normal tissue because in
adrenergic agonist actions would include inflamed tissue what happens?
which of the following? a. The pH rises, thus inactivating the
a. Reverse an anaphylactic reaction anesthetic
b. Treat hypertension b. The pH rise, thus decreasing
c. Prevent angina pectoris available freebase
d. Reduce anxiety c. The pH decreases, thus
e. All of the above decreasing available freebase
3. A fear reaction activates the sympathetic d. The pH remains the same, the
division of the autonomicro nervous extracellular fluid dilutes the
system to result in: anesthetic
a. Miosis 12. A dental anesthetic carpule contains 1.8
b. Bradycardia ml of a 2 solution of lidocaine with
c. Hypertension 1:100,000 epinephrine. How much
d. Increased salivation lidocaine and epinephrine does the
4. The amide local anesthetics are carpule contain?
metabolized primarily in the: a. 3.6 mg lidocaine and 0.18 mg
a. Lungs epinephrine
b. Plasma b. 3.6 mg lidocaine and 0.018 mg
c. Liver epinephrine
d. Kidney c. 36mg lidocaine and 0.18 mg
5. Which statement best describes the epinephrine
mechanism of action of local anesthetics d. 36 mg lidocaine and 0.018mg
on the nerve axon? epinephrine
a. Decreases sodium uptake 13. The maximal recommended adult dose of
through sodium channels of the lidocaine is 300 mg. How many milliliters of
axon 2% lidocaine need to be given to reach
b. Increases potassium outflow from this level?
inside to outside the nerve a. 7.5 milliliters
c. Increases the membrane's b. 10 milliliters
permeability to sodium c. 15 milliliters
d. Increases the excitability of the d. 20 milliliters
nerve axon 14. The maximum recommended dose of a
6. Which form of a local anesthetic can local anesthetic that can be administered
readily penetrate tissue membranes? to a child <10 years of age is determined
a. Ionized form by:
b. Non- ionized free base form a. Age
c. Both ionized and non ionized free b. Weight
base form c. Height
7. A sedative often used in the management d. Gender
of anxious pediatric dental patient is: 15. Local anesthetics depress which of the
a. Pentobarbital following nerve fiber first?
b. Secobarbital a. Large myelinated fibers
c. Chloralhydrate b. Small unmyelinated fibers
d. Meperidine c. Small myelinated fibers
8. Ester-type local anesthetics are d. Large unmyelinated fibers
metabolized where? 16. The maximum dose of articaine
a. Liver (septocaine) that is recommended in one
b. Lungs appointment is expressed as mg per
c. Plasma kilogram body weight rather than total
d. Kidneys milligrams. Which dose is the maximum
9. Which of the following is a contraindication recommended dose for articaine in
or precaution to the use of prilocaine? children and adults?
a. Billiary tract disease a. 7mg/kg
b. Type II diabetes b. 100mg/kg
c. Rheumatoid arthritis c. 1mg/kg
d. Hepatic disease d. 300mg/kg
17. Which is the most frequently utilized route c. 50% decrease in the time for
of administration for sedation in pediatric normal sensation to return
patients? d. 80% decrease in the time for
a. Oral normal sensation to return
b. Inhalation 25. Phentolamine mesylate (Oraverse ) is a
c. IV drug used to reverse soft tissue anesthesia
d. IM and the associated functional deficits
18. All of the following are advantages of using resulting from a local dental anesthetic
nitrous oxide analgesia except? containing a vasoconstrictor. Which
a. Rapid onset of action statement best describes its mechanism of
b. Lowers pain threshold action?
c. Produces euphoria a. Prevents the influx of sodium into
d. Pleasant induction the neuron by locking neuronal
e. Titratable rapid and complete channels
recovery b. Causes vasodilation and
f. Virtually no adverse effects in increased blood flow in injection
absence of hypoxia area
g. Therapeutic sedative for many c. Prevents the efflux of sodium out
medically compromised patients of the neuron
h. Suitable for all ages d. Causes vasoconstriction and
19. All the following are considered to be what decreased blood flow in injection
type of anesthetic? area
a. Halothane 26. The most common adverse effects
b. Enflurane associated with benzodiazepines include
c. Isoflurane all of the following except:
d. Desflurane a. CNS depression (drowsiness and
20. Which stage of general anesthesia begins sedation)
with unconsciousness b. GI disturbances
a. stage I c. Confusion
b. stage II d. Respiratory depression
c. stage III e. Disorientation
d. stage IV f. Ataxia
21. Nitrous oxide is used as a single agent to 27. Buspirone (Buspar) is a partial agonist at a
produce general anesthesia. Nitrous oxide specific:
is used to produce sedation and mild a. GABA (gamma-aminobutyric
analgesia. acid) receptor
a. The first statement is true, the b. Norepinephrine receptor
second statement is false c. Dopamine receptor
b. The first statement is false, the d. Serotonin receptor
second statement is true 28. Which of the following side effects are
c. Both statements are true most common with the use of Diazepam
d. Both statements are false (Valium)?
22. Which component of a lidocaine local a. Rash, itch
anesthetic solution causes an allergy? b. Mouth, throat ulcers
a. Water c. Drowsiness, fatigue
b. Bisulfites d. Difficulty with urination
c. Lidocaine d. Epinephrine 29. The barbiturates Phenobarbital (Luminal),
(vasoconstrictor) Mephobarbital (Mebaral), and Primidone.
23. Of the amide- type local anesthetics, which (Mysoline) are classified as what type of
is the only one that is metabolized in the barbiturate?
bloodstream rather than the liver? a. Ultra-short acting
a. Articaine b. Short acting
b. Mepivacaine c. Intermediate acting
c. Lidocaine d. Long acting
d. Prilocaine 30. The brief duration of general anesthetic
e. Bupivacaine action of an ultra short acting barbiturate is
24. When phentolamine mesylate (oraVerse) due to what factor?
is given after a dental procedure to reverse a. Rapid rate of metabolism in the
the local anesthetics effects, approximately liver
how fast is the return to normal nerve b. Low lipid solubility, resulting in a
sensation compared to the normal time for minimal concentration in the brain
the anesthetic to wear off? c. High degree of binding to plasma
a. 10% decrease in the time for proteins
normal sensation to return d. Rapid rate of redistribution from
b. 25% decrease in the time for the brain to peripheral tissues
normal sensation to return e. Slow rate of redistribution from
the brain to peripheral tissues
 f. Slow rate of excretion by the d. Desvenlafaxine
kidneys e. Sertraline
31. All of the following statements concerning f. Duloxetine
barbiturates are true except? 38. All of the following are H1- receptor
a. Barbiturates may increase the blockers except:
half-lives of drugs metabolized by a. Diphenhydramine
the liver b. Chlorphenidramine maleate
b. Barbiturates depress neuronal c. Cimetidine
activity by increasing membrane d. Loratadine
ion conductance (primary e. Desloratadine
chloride), reducing glutamate- 39. For which of the following conditions can
induced depolarizations and ranitidine be used?
potentiating the inhibitory effects a. Prostitis
of GABA b. GERD (heartburn)
c. Compared with benzodiazepines, c. Toxic- shock syndrome
the barbiturates exhibit a steeper d. Renal failure
dose-response relationship. 40. Diphehydramine HCL, chlorpheniramine
d. Barbiturates may precipitate maleate, loratadine and desloratadine are
acute porphyria in susceptible antihistamines at which histamine receptor
patients site listed below?
32. The most commonly used tricyclic a. H1- receptor site
antidepressant (TCA) drug is: b. H2 receptor site
a. Imipramine 41. Antibiotic regimens for patients with
b. Amitriptyline prosthetic implants include all of the
c. Desipramine following drugs as standard therapy of first
d. Nortriptyline choice in patients not allergic to penicillin
e. Doxepin except?
33. Which drug is the current drug of choice a. Cephalexin
for the treatment of manic phase of bipolar b. Cephradine
disorder (or manic-depressive syndrome) c. Amoxicillin
a. Phenobrbital d. Tetracycline
b. Imipramine 42. Clindamycin has which mode of action on
c. Lithium the bacteria cell?
d. Haloperidol a. Affects all cell membrane
34. Monoamine oxidase (MAO) inhibitors are b. Interferes with protein synthesis
often used as third-line agents in cases of c. Affects cell wall
refractory and a typical depression. Which d. Interferes with normal
drug below is MAO inhibitors? biosynthetic pathways
a. Doxein 43. Mefloquine (lariam) belongs to a class of
b. Tranylcypromine drugs which is useful in treating which of
c. Imiranine the following conditions?
35. The vasoconstrictor epinephrine in local a. Malaria
anesthetic injections must be used b. AIDS
cautiously in patients taking all of the c. Hepatitis
following antidepressant drugs except one d. Cancer
in order to avoid transient and significant e. Chlamydia
increases pressure. Which is the 44. Which of the following antibiotics is
exception? considered a broad-spectrum antibiotic?
a. Tricyclic antidepressants a. Penicillin VK
b. Selective serotonin reuptake b. Cefaclor
inhibitors c. penicillin G
c. Serotonin and nor epinephrine d. erythromycin
reuptake inhibitors 45. Tetracyclines are the drugs of first choice
36. Which two groups of antidepressant drugs in the treatment of all the following except?
has the highest incidence of dry mouth? a. Mycolasma pneumonia
a. Tricyclic antidepressants b. Chlamydia infections
b. Selective serotonin reuptake c. Rickettsial infections
inhibitors d. Staphylococcal infections
c. Serotonin and norepinephrine 46. Azithromycin (Z-Pak, Zithromax) is an
reuptake inhibitors antibiotic of the:
d. Monoamine oxidase inhibitors a. Macrolide
37. All of the following anti- depressant drugs b. Cephalosporin class of antibiotics
are serotonin and norepinephrine reuptake c. Qinolone class of antibiotics
inhibitors except: d. Glycopeptides class of antibiotics
a. Venlafaxine 47. Erythromycin is well known to cause:
b. Nortriptyline a. CNS effects
c. Desipramine b. GI effects
 c. Hematologic effects 57. Which of the following is known as the
d. Renal effects original penicillin?
48. The most commonly used a. Penicillin V
aminoglycosides is: b. Penicillin G
a. Neomycin c. Ampicillin
b. Streptomycin d. Amoxicillin
c. Tobramycin 58. Which penicillin is degraded in stomach
d. Gentamicin acid and is usually given parenterally (by
49. Sulfonamides (also known as sulfa drugs) injection)?
are structurally similar to: a. Penicillin VK
a. Penicillins b. Amoxicillin
b. Erythromycins c. Penicillin G
c. Acetylsalicylic acid d. Ampicillin
d. Para- aminobenzoic acid 59. The antibiotic of choice for standard
50. Which antibiotic is not only effective prophylactic regimen of antibiotic coverage
against most staphylococci, aerobic and for the prevention of bacterial endocarditis
anaerobic streptococci, but is most is:
effective in treating infections due to a. penicillin VK
bacteroides species? b. tetracycline
a. Penicillin K c. erythromycin
b. Erythromycin d. amoxicillin
c. Tetracycline
d. Cephalexin 60. Of the drugs listed which is the most
e. Clindamycin preferable antibiotic treatment of non-
f. Vancomycin penicillinase-producing gram-positive
51. Which antibiotic may cause bone marrow staphylococcal infections?
disturbances and has limited use due to a. Tetracycline
the side effects? b. Clindamycin
a. Penicillin c. Ampicillin
b. Tetracycline d. Cefaclor
c. Chloramphenicol e. Penicillin
d. Doxycycline 61. Which penicillin has the widest spectrum of
52. Nitazoxanide (alinia) is an oral antibacterial activity
antiprotozoal agent used to treat which of a. Penicillin VK
the following conditions? b. Dicloxacillin
a. Leprosy c. Amoxicillin
b. Malaria d. Pieracillin
c. AIDS 62. Which of the following has a clinically
d. Diarrhea caused by clostridium significant drug interactionwith amoxicillin?
difficile a. Trazolam
e. Diarrhea caused by giardia b. Methotrexate
lamblia c. Calcitrol
53. All of the following drugs are useful for d. Candesartan
treating what disease? 63. In dentistry, a cholinergic drug is used to:
a. Isoniazid a. Produce a dry field for taking
b. Streptomycin impressions
c. Ritampin b. Calm an anxious patient
d. Ethambutol c. Treat dry mouth by inducing
e. Pyrazynamide salivation
54. The antiviral peniclovir is active against d. Reduce nausea
which virus? 64. The major natural glucocorticoid is:
a. Herpes zoster a. Triamcinolone
b. Genital herpes b. Cortisol
c. Herpes simplex type 1 c. Dexamethasone
d. Papilloma virus d. Prednisone
55. Which of the following is classified as an e. Prednisolone
antifungal agent? 65. All of the following are pharmacologic
a. Bacitracin effects of glucocorticoids except:
b. Amphotericin-B a. Stimulate protein breakdown,
c. Polymyxin-B which results in increased plasma
d. Neomycin amino acid levels
56. The drug of choice for treating candidiasis b. Stimulate gluconeogenesis in the
is: liver and inhibit peripheral
a. Penicillin glucose use
b. Erythromycin c. Impaired wound healing
c. Nystatin d. Reduce the immune response
d. Chloramphenicol e. Decreased lipolysis
 f. Inhibit local edema, capillary 74. Which of the following is a high molecular
dilation, migration and activation weight hetepolysaccharide that inactivates
of white blood cells, and thrombin and other coagulation factors and
phagocytosis by macrophages this prevents blood clotting?
g. Increase hemoglobin a. Thrombin
concentration and increase the b. Fibrin
numbers of circulating red blood c. Heparin
cells and platelets d. Plasmin
66. The major natural mineralocorticoid in 75. The majority of drugs penetrate
humans is: biomembranes by _____ through
a. Dexamethasone membrane phospholipids.
b. Aldosone a. Active transport
c. Cortisol b. Facilitated diffusion
d. Prednisone c. Filtration
e. Triamcinolone d. Simple diffusion
67. Which corticosteroid is administered by 76. Which drugs tend to concentrate is body
inhalation to treat asthma? compartments of high pH?
a. Hydrocortisone a. Permanently charged drugs
b. Prednisone b. Drugs that are not charged
c. Cortisone c. Weak organic acids
d. Fluticasone d. Weak organic bases
e. Methylprednisolone e. Inorganic ions
68. All of the following are angiotensin- 77. Drug agonists having the same intrinsic
converting enzyme (ACE) inhibitor except: activity also have the same
a. Catopril a. Maximal effect
b. Hydralazine b. Receptor affinity
c. Enapril c. Therapeutic index
d. Lisinoril d. Aqueous solubility
e. Fosinoril 78. What receptor or signaling pathway is
69. Verapamil is useful for the treatment of: linked most directly to a2-adrenoreceptor
a. Angina stimulation?
b. Hypertension a. G1 and a reduction is cAMP
c. Surventricular tachyarrythmias b. G2 and an increase in cAMP
d. All of the above c. Gg and calcium
70. Antihypertensive agents lower blood d. Sodium ion channel
pressure by reducing total peripheral 79. What tissue or organ has many muscarinic
resistance and by reducing cardiac output receptors but lacks innervations to those
through a variety of mechanisms. ACE receptors?
inhibitors inhibit the conversion of a. Heart
angiotensin I to the angiotensin II, a b. Parotid gland
vasoconstrictor. c. Blood vessels
a. The first statement is true, the d. Sweat glands
second statement is false 80. Which drug used in the therapy for
b. The first statement is false, the Parkinsonian does not cross the blood-
second statement is true brain barrier?
c. Both statements are true a. Amantadine
d. Both statements are false b. Carbidopa
71. Which is the most likely complication seen c. L-dopa
with chemotherapy treatment? d. Selegiline
a. Renal failure 81. After an injection, which drug would be
b. Alopecia excreted to have the longest duration of
c. Peripheral neuropathy action? (assume no vasoconstrictor was
d. Glaucoma injected with the local anesthetic.)
72. Which of the following is a pharmacologic a. Bupivacaine
antagonist of aldosterone in the collecting b. Lidocaine
tubule? c. Mepivacaine
a. Mannitol d. Rilocaine
b. Glycerine 82. A very low blood gas solubility coefficient
c. Sinolactone partition coefficient (partition coefficient
d. Urea +0.47), analgesic effect, and a drug that
73. All of the following are effects of insulin inhibits methionine synthase best
except: describes which drug?
a. Decreased gluconeogenesis a. Ketamine
b. Increased triglyceride storage b.
c. Decreased protein synthesis c. Propofol
d. Increased glycogen synthesis d. Nitrous oxide
e. Halothane
83. Levonordefrin is added to certain cartridge b. Activation of antithrombin III with
containing mepivacaine. The desired effect resulting inhibition of clotting
of levenordefrin is due to what factor Xa
pharmacological effect? c. Indirect activation of tissue
a. Inhibition of nicotinic cholinergic plasminogen activator
receptor d. Direct inhibition of plasminogen
b. Inhibition of muscarinic with resulting degradation of fibrin
cholinergic receptors 92. Oropharyngeal candidiasis is an adverse
c. Stimulation of alpha-adrenergic effect most likely with which drug?
receptor a. Inhaled salmeterol
d. Stimulation of dopamine receptor b. Inhaled ipratropium
84. The analgesia effects of dextromethorphan c. Inhaled nedocromil
are due to what receptor effect? d. Inhaled beclomethasone
a. Gama and aminobutyric acid 93. Oral antacids are most likely to reduce the
(GABA) receptor antagonism absorption of which drug when it is given
b. Dopamine receptor antagonism orally?
c. Nicotinic cholinergic receptor a. Clarithromycin
antagonism b. Clindamycin
d. N-methyl -D- aspartate (NMDA) c. Metronidazole
receptor antagonism d. Tetracycline
85. Naloxone antagonizes the therapeutic and 94. A decrease in glycogenolysis in the liver
toxic effects of which drug? would be expected from which drug?
a. Acetaminophen a. Albuterol
b. Aspirin b. Epinephrine
c. Carbamazepine c. Glucagon
d. Fentanyl d. Insulin
86. What is the mechanism of the analgesic 95. Nitrates and nitrites have what effect on
action of aspirin? blood vessel smooth muscle?
a. Stimulates U opioid receptors a. Increase in the level of
b. Blocks histamine H2 receptors intracellular calcium
c. Inhibits cyclooxygenase b. Increase in the level of cyclic
d. Inhibits lipoxygenase guanosine monophosphate
87. What is the clinical setting for the use of c. Antagonism at alpha-1 adrenergic
ketorolac by the oral route? receptor
a. For severe pain d. Antagonisn at beta-1 adrenergic
b. For initial treatment of pain receptor
c. To continue therapy after an IV or 96. Clavulanic offers an advantage
IM dose of ketorolac therapeutically because it has action?
d. Only is combination with an a. It inhibits streptococci at a low
opioid minimum inhibitory concentration
88. The use of H2 histamine receptor blockers (MIC)
is most clinically useful a what type? b. It inhibits transetidase
a. Beta cells of the pancreas c. It inhibits penicillinase
b. Basophils d. It inhibits anaerobes at a low MIC
c. Mast cells 97. Identify the enzyme whose inhibition is
d. Parietal cells most responsible wall synthesis inhibitory
89. Which class of antihypertensive drug most effect of penicillin G.
effectively reduces the release of rennin a. Beta-lactamase
from the kidney? b. DNA gyrase
a. B-adrenergic receptor blockers c. Nitro reductase
b. ACE inhibitors d. Transpetidase
c. Alpha- adrenergic blockers 98. Which drug is often combined with
d. Calcium channel blockers sulfamethoxazole for the treatment of
90. The administration of which compound will respiratory tract and urinary tract
give "epinephrine reversal” (drop in blood infections?
pressure from epinephrine) if given prior to a. Amoxicillin
administration of epinephrine? b. Ciprofloxacin
a. Guanethidine c. Clindamycin
b. Propranolol d. Trimethoprim
c. Phenoxybenzamine 99. Which of the following organisms is usually
d. Tyramine sensitive to clindamycin?
91. What is the mechanism of action of a. Candida albicans
enoxaparin? b. Klebsiella pneumonia
a. Inhibition of synthesis of clotting c. Methicillin-resistant
factors II< VII, IX, X staphylococcus aureus
d. Streptococcus viridians
100. Dihydrofolate reductase is an enzyme
inhibited by which anticancer drug?
a. Bleomycin
b. Cislatin
c. Doxorubicin
d. 5-fluorouracil
e. methotrexate