Question 1

Which of the following is a major route of delivery of local anesthetic drugs?

Accepted Answer

A)   Topical
B)   Intravenous
C)   Inhalation
D)   All options listedE) C) and D)
F) A) and B)

Question 2

The liver is the organ responsible for the entire metabolic process of most amides.The rate of biotransformation is faster in patients with significant liver dysfunction.

Accepted Answer

A)   Both statements are true.
B)   Both statements are false.
C)   The first statement is true;the second statement is false.
D)   The first statement is false;the second statement is true.E) B) and D)
F) A) and C)

Question 3

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

Accepted Answer

A)   Both statements are true.
B)   Both statements are false.
C)   The first statement is true;the second statement is false.
D)   The first statement is false;the second statement is true.E) A) and B)
F) A) and C)

Question 4

The speed of recovery from local anesthetic is determined by the degree of binding to the receptor site of each anesthetic.

Accepted Answer

A) True 
 B)False

Question 5

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

Accepted Answer

A)   pH of the tissues
B)   pKa of the anesthetic agent
C)   Administrative site
D)   Anesthetic agent
E)   None of the aboveF) A) and C)
G) B) and C)

Question 6

Which component of the local anesthetic molecule renders the molecule water soluble?

Accepted Answer

A)   Hydrophilic amino group
B)   Intermediate hydrocarbon ester or amide chain
C)   Lipophilic aromatic ring
D)   All options listedE) A) and B)
F) None of the above A

Question 7

Intravascular injections significantly increase the possibility of an overdose.

Accepted Answer

A) True 
 B)False  True

Question 8

If more anesthetic is needed for a procedure,it is important to reinject the anesthetic after the mantel fibers have fully recovered.

Accepted Answer

A) True 
 B)False

Question 9

What does the membrane expansion theory of the action of local anesthetics suggest?

Accepted Answer

A)   Anesthetics that are highly hydrophilic cause the matrix of the nerve membrane to expand,narrowing the sodium channels,thus preventing depolarization.
B)   Anesthetics that are highly lipid soluble cause the lipoprotein matrix of the nerve membrane to expand,narrowing the sodium channels,thus preventing depolarization.
C)   Anesthetics cause the sodium channels to expand,thus allowing the increase in protein binding within the channels.
D)   All options listedE) None of the above
F) All of the above

Question 10

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?

Accepted Answer

A)   Hydrophilic amino group
B)   Intermediate hydrocarbon ester or amide chain
C)   Lipophilic aromatic ring
D)   All options listedE) None of the above
F) All of the above

Question 11

Anesthetic recovery is a slower process than induction because the anesthetic binds to the receptor site in the sodium channel,releasing the anesthetic slowly into the systemic circulation.

Accepted Answer

A)   Both the statement and the reason are correct and related.
B)   Both the statement and reason are correct but NOT related.
C)   The statement is correct,but the reason is NOT.
D)   The statement is NOT correct,but the reason is correct.
E)   NEITHER the statement NOR the reason is correct.F) None of the above
G) B) and C)

Question 12

Local anesthetics easily cross the blood-brain barrier.

Accepted Answer

A) True 
 B)False

Question 13

Local anesthetics are vasoconstrictors and decrease the absorption of the drug by the blood.

Accepted Answer

A) True 
 B)False

Question 14

What factor/factors influence(s) the duration of the effects of local anesthetics?

Accepted Answer

A)   Degree of protein binding
B)   Vascularity of injection site
C)   Addition or absence of a vasoconstrictor
D)   All options listedE) All of the above
F) None of the above

Question 15

Why is protein binding an important characteristic of local anesthetic drugs?

Accepted Answer

A)   Increased protein binding allows more cations (RNH+) to bind to the receptor sites within the sodium channels,prolonging the presence of anesthetic at the site of action.
B)   Increased protein binding allows more RN molecules to bind to the receptor sites within the sodium channels,prolonging the presence of anesthetic at the site of action.
C)   Decreased protein binding allows more cations (RNH+) to bind to the receptor sites within the sodium channels,prolonging the presence of anesthetic at the site of action.
D)   Decreased protein binding allows more RN molecules to bind to the receptor sites within the sodium channels,prolonging the presence of anesthetic at the site of action.E) A) and C)
F) C) and D)

Question 16

Reflecting on your experience with Sam,what other factors may contribute to an incident similar to Sam's?

Accepted Answer

A)   The use of topical anesthetics plus intravascular injections
B)   An injection that is administered too rapidly
C)   The perio infection and inflammation
D)   All options listedE) A) and B)
F) C) and D)

Question 17

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

Accepted Answer

A)   Both statements are true.
B)   Both statements are false.
C)   The first statement is true;the second statement is false.
D)   The first statement is false;the second statement is true.E) A) and C)
F) C) and D)

Question 18

Which part of the chemical structure of a local anesthetic determines the pattern of biotransformation of the anesthetic?

Accepted Answer

A)   Lipophilic part
B)   Hydrophilic part
C)   Intermediate chain
D)   All options listedE) C) and D)
F) A) and D)

Question 19

Why is lipid solubility an important characteristic of local anesthetic drugs?

Accepted Answer

A)   A greater lipid solubility enhances the diffusion of the anesthetic drug through the nerve.
B)   A greater lipid solubility indicates a higher potency of the anesthetic drug.
C)   A greater lipid solubility allows for a lower effective dose of the local anesthetic drug.
D)   All options listed.E) B) and D)
F) A) and B)

Question 20

The higher the pKa of an anesthetic,the faster the onset of action.

Accepted Answer

A) True 
 B)False  False

Exam 3: Pharmacology of Local Anesthetic Agents

Which of the following is a major route of delivery of local anesthetic drugs?

Correct AnswerverifiedShow Answer

The liver is the organ responsible for the entire metabolic process of most amides.The rate of biotransformation is faster in patients with significant liver dysfunction.

Correct AnswerverifiedShow Answer

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

Correct AnswerverifiedShow Answer

The speed of recovery from local anesthetic is determined by the degree of binding to the receptor site of each anesthetic.

Correct AnswerverifiedShow Answer

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

Correct AnswerverifiedShow Answer

Which component of the local anesthetic molecule renders the molecule water soluble?

Correct AnswerverifiedA

Intravascular injections significantly increase the possibility of an overdose.

Correct AnswerverifiedTrue

If more anesthetic is needed for a procedure,it is important to reinject the anesthetic after the mantel fibers have fully recovered.

Correct AnswerverifiedShow Answer

What does the membrane expansion theory of the action of local anesthetics suggest?

Correct AnswerverifiedShow Answer

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?

Correct AnswerverifiedShow Answer

Anesthetic recovery is a slower process than induction because the anesthetic binds to the receptor site in the sodium channel,releasing the anesthetic slowly into the systemic circulation.

Correct AnswerverifiedShow Answer

Local anesthetics easily cross the blood-brain barrier.

Correct AnswerverifiedShow Answer

Local anesthetics are vasoconstrictors and decrease the absorption of the drug by the blood.

Correct AnswerverifiedShow Answer

What factor/factors influence(s) the duration of the effects of local anesthetics?

Correct AnswerverifiedShow Answer

Why is protein binding an important characteristic of local anesthetic drugs?

Correct AnswerverifiedShow Answer

Reflecting on your experience with Sam,what other factors may contribute to an incident similar to Sam's?

Correct AnswerverifiedShow Answer

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

Correct AnswerverifiedShow Answer

Which part of the chemical structure of a local anesthetic determines the pattern of biotransformation of the anesthetic?

Correct AnswerverifiedShow Answer

Why is lipid solubility an important characteristic of local anesthetic drugs?

Correct AnswerverifiedShow Answer

The higher the pKa of an anesthetic,the faster the onset of action.

Correct AnswerverifiedFalse

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A

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True

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The higher the pK_a of an anesthetic,the faster the onset of action.

Correct Answer
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False