Exam 1 (1-4)

Question 1

What was the first local anesthetic ever used?

Answer 1

cocaine

Question 2

What is the most common LA used in dentistry?

Answer 2

Lidocaine

Question 3

Best method to manage an anxious patient

Answer 3

Prevention

Question 4

What age group has a higher pain tolerance?

Answer 4

older patients

Question 5

How many states can administer nitrous oxide?

Answer 5

33 states

Question 6

Pertains to the point at which a sensation starts to be painful and discomfort results

Answer 6

pain threshold

Question 7

A neurologic experience of pain

Answer 7

pain perception

Question 8

The person interpretation and response to the pain message and is highly variable among individuals

Answer 8

pain reaction

Question 9

What are the clinical signs of moderate anxiety?

Answer 9

unnaturally stiff posture
nervous play with tissue
white knuckle syndrome
sweaty
overwillingness to cooperate with clinician
quick answers

Question 10

Nerve tissues that lie in the periphery or the outer regions of the nervous system

Answer 10

PNS peripheral nervous system

Question 11

Consists of all incoming information traveling along sensory pathways

Answer 11

afferent division

Question 12

Consists of all outgoing information along motor pathways

Answer 12

efferent division

Question 13

Subdivision of the efferent division of the PNS and controls the body’s voluntary and reflex activities

Answer 13

somatic and autonomic nervous systems

Question 14

These are the basic functional unit of the nervous system that manipulate information and respond to either excitation or inhibition

Answer 14

nerve cells

Question 15

Carry information to the autonomic that control involuntary smooth muscle, cardiac muscle, or other involuntary tissue

Answer 15

autonomic nervous system

Question 16

This division prepares the body to deal with fight or flight response

Answer 16

sympathetic

Question 17

Within a nerve, each axon is surrounded by a layer of connective tissue called the

Answer 17

endoneurium

Question 18

Each fascicle is wrapped in a layer of connective tissue called the

Answer 18

perineurium

Question 19

The entire nerve is wrapped in a layer of connective tissue called the

Answer 19

epineurium

Question 20

Nerves that send signals from sensory neurons towards the spinal cord or brain

Answer 20

afferent nerves

Question 21

Also known as nerve impulse; a spike of positive and negative ionic discharge that travels along the membrane of a cell

Answer 21

action potential

Question 22

Means that the electrical charge on the outside of the membrane is positive while the elctrical charge on the inside of the membrane is negative

Answer 22

polarization

Question 23

The process whereby the action potential causes sodium channels to open, allowing an influx of sodium ions to change the electrochemical gradient

Answer 23

depolarization

Question 24

When local anesthetic drugs act mainly by inhibiting sodium influx through sodium-specific ion channels in the neuronal cell membrane

Answer 24

voltage gated sodium channels

Question 25

Properties of the Ideal Local Anesthetic:

Answer 25

``` potent local anesthesia reversible local absence of local reactions absence of systemic reactions absence of allergic reactions rapid onset satisfactory duration adequate tissue penetration low cost stability in solution (long shelf life) ease of metabolism ```

Question 26

Refers to the physiological effects of drugs on the body and the mechanisms of drug action and its relationship between drug concentration and effect

Answer 26

pharmacodynamics

Question 27

Improves the lipid solubility of the molecule, which facilitates the penetration of the anesthetic through the lipid rich membrane where the receptor sites are located

Answer 27

lipophilic aromatic ring

Question 28

Determines if the molecule is an ester or amide, and this chain is important because it predetermines the course of biotransformation

Answer 28

Intermediate hydrocarbon chain

Question 29

m=May exist in teritary form that is uncharged and lipid soluble or as a quaternary form that is positively charged and renders the molecule water soluble, which is how it is delivered from the dental hygienist's syringe into the patient's tissue

Answer 29

hydrophilic terminal amine

Question 30

Two major routes of delivery of local anesthetic drugs:

Answer 30

topical and submucosal injection

Question 31

Anesthetics applied to the surface of mucosal tissue that produce local insensibility to pain

Answer 31

topical anesthetics

Question 32

Anesthetics that are more effective than topical routes because the solution is injected and placed in close proximity to the nerve trunk of the area to be anesthetized

Answer 32

submucosal injections

Question 33

The base form of the local anesthetic (lipid soluble and penetrates the nerve)

Answer 33

anion

Question 34

A positively charged ion; the active form of the molecule that binds to the receptor sites in the sodium channel

Answer 34

cation

Question 35

The pka of a molecule represents the pH at which 50% of the molecules exist in the lipid soluble teritary form and 50% in the quaternary, water soluble form

Answer 35

dissociation constant

Question 36

higher pka=fewer base molecules= ?

Answer 36

slower onset of action

Question 37

lower pka=more base molecules= ?

Answer 37

rapid onset of action

Question 38

The study of the action of drugs within the body; ADME

Answer 38

pharmacokinetics

Question 39

Increased tolerance to a drug that is administered repeatedly

Answer 39

tachyphylaxis

Question 40

The period of time it takes 50% of the drug to be metabolized/removed from the body

Answer 40

half life

Question 41

The period from local anesthetic deposition near the nerve trunk to profound conduction block; the pKa is the primary factor

Answer 41

onset of action

Question 42

Systemic effects of LA:

Answer 42

``` nature of the drug concentration of the drug and dose administered route of administration rate of injection vascularity in the area of injection age of the patient weight of patient patient's health the route and rate of metabolism and excretion of the drug ```

Question 43

No longer manufactured in LA

Answer 43

esters

Question 44

How many cartridges of LA can a healthy patient have?

Answer 44

5.5

Question 45

The maximum recommended dose per visit of epinephrine for a healthy patient is

Answer 45

0.2mg

Question 46

A synthetic vasoconstrictor that is approximately one sixth as potent as epinephrine; it is manufactured in a higher concentration to achieve the same effects as epinephrine 1:100,000

Answer 46

Levonordefrin

Question 47

1899; highly effective as an analgesic and antipyrectic and proved to be remarkably safe and well tolerated by patients

Answer 47

Aspirin

Question 48

Most recent anesthetic introduced in 2000

Answer 48

Articaine

Question 49

perception of pain

Answer 49

nociception

Question 50

Local anesthetic drugs bind more readily to sodium channels when?

Answer 50

In an activated state, thus onset of neuronal blockade is faster in neurons that are rapidly firing