INBDE PHARMACOLOGY PRACTICE
SET 2026 TESTED QUESTIONS AND
CORRECT SOLUTIONS
◉ Amide Local Anesthetics. Answer: Anything that is NOT Procaine,
Tetracaine or Cocaine and ends in "-caine"
◉ Lidocaine. Answer: 1. SAFEST to use in children
2. 2%
3. pKa = 7.8
◉ Bupivacaine. Answer: 1. LEAST SAFE to use in children
2. 0.5%
3. pKa = 8.1
◉ Mepivicaine. Answer: 1. Causes LEAST amount of Vasodilation,
thus can be packaged WITHOUT Epinephrine
2. 2% or 3%
3. pKa = 7.6
◉ Articaine. Answer: 1. Has an Ester Chain and Amide Chain, thus can
be metabolized in BOTH Liver and Plasma
2. 4%
3. pKa = 7.8
,◉ Where are Amides metabolized?. Answer: Liver
◉ Where are Esters metabolized?. Answer: Plasma via Esterases
◉ What toxic effect can Prilocaine cause?. Answer:
Methemoglobinemia
◉ How do Local Anesthetics work?. Answer: Block Na+ Channels
◉ What form of Local Anesthetics can cross membrane?. Answer: Free
Base or NON-Ionized
◉ Short Acting Local Anesthetics. Answer: Procaine
◉ Moderate Acting Local Anesthetics. Answer: Prilocaine, Mepivacaine
and Lidocaine
◉ Long Acting Local Anesthetics. Answer: Bupivacaine, Tetracaine and
Etidocaine
◉ What does increased blood flow do to drug duration?. Answer:
SHORTENS
,◉ What does increased lipid solubility/hydrophobicity do to drug
potency and duration?. Answer: INCREASES
◉ What does lower pKa do to drug activation time?. Answer: Makes it
FASTER
◉ What does increased protein binding do to drug duration?. Answer:
INCREASES
◉ MAX Epi for ASA I Patient. Answer: 0.2mg
◉ MAX Epi for Cardiac Patient. Answer: 0.04mg (1x 1:50,000 or 2x
1:100,000 or 4x 1:200,000)
◉ MAX Lido with Epi. Answer: 4.4mg/kg
◉ MAX Lido without Epi. Answer: 7.0mg/kg
◉ What is the injection technique that has highest risk of hematoma?.
Answer: PSA
◉ How much of needle is required to enter for PSA?. Answer: 16mm
◉ Lidocaine and Propranolol. Answer: 1. Propranolol DECREASES
Lidocaine Breakdown
, 2. Compete for SAME Enzyme
◉ Initially, Local Anesthetics inhibit.... Answer: Central Inhibitory
Neurons
◉ At greater doses, Local Anesthetics inhibit.... Answer: BOTH Central
Inhibitory and Excitatory Neurons
◉ Local Anesthesia and Graves Disease (Hyperthyroidism). Answer:
Graves Disease = Hyperthyroidism, which makes patient MORE
SENSITIVE to LA
◉ Cardiovascular collapse due to high dose of LA may be caused by.
Answer: Myocardial Depression
◉ What is the only Local Anesthesia that causes vasoconstriction?.
Answer: Cocaine
◉ What Local Anesthesia can produce powerful stimulation of cerebral
cortex?. Answer: Cocaine because it BLOCKS reuptake of NE, which
potentiates nerve endings
◉ Which antibiotics are not cross-allergenic with Penicillin?. Answer:
Macrolides like Erythromycin
SET 2026 TESTED QUESTIONS AND
CORRECT SOLUTIONS
◉ Amide Local Anesthetics. Answer: Anything that is NOT Procaine,
Tetracaine or Cocaine and ends in "-caine"
◉ Lidocaine. Answer: 1. SAFEST to use in children
2. 2%
3. pKa = 7.8
◉ Bupivacaine. Answer: 1. LEAST SAFE to use in children
2. 0.5%
3. pKa = 8.1
◉ Mepivicaine. Answer: 1. Causes LEAST amount of Vasodilation,
thus can be packaged WITHOUT Epinephrine
2. 2% or 3%
3. pKa = 7.6
◉ Articaine. Answer: 1. Has an Ester Chain and Amide Chain, thus can
be metabolized in BOTH Liver and Plasma
2. 4%
3. pKa = 7.8
,◉ Where are Amides metabolized?. Answer: Liver
◉ Where are Esters metabolized?. Answer: Plasma via Esterases
◉ What toxic effect can Prilocaine cause?. Answer:
Methemoglobinemia
◉ How do Local Anesthetics work?. Answer: Block Na+ Channels
◉ What form of Local Anesthetics can cross membrane?. Answer: Free
Base or NON-Ionized
◉ Short Acting Local Anesthetics. Answer: Procaine
◉ Moderate Acting Local Anesthetics. Answer: Prilocaine, Mepivacaine
and Lidocaine
◉ Long Acting Local Anesthetics. Answer: Bupivacaine, Tetracaine and
Etidocaine
◉ What does increased blood flow do to drug duration?. Answer:
SHORTENS
,◉ What does increased lipid solubility/hydrophobicity do to drug
potency and duration?. Answer: INCREASES
◉ What does lower pKa do to drug activation time?. Answer: Makes it
FASTER
◉ What does increased protein binding do to drug duration?. Answer:
INCREASES
◉ MAX Epi for ASA I Patient. Answer: 0.2mg
◉ MAX Epi for Cardiac Patient. Answer: 0.04mg (1x 1:50,000 or 2x
1:100,000 or 4x 1:200,000)
◉ MAX Lido with Epi. Answer: 4.4mg/kg
◉ MAX Lido without Epi. Answer: 7.0mg/kg
◉ What is the injection technique that has highest risk of hematoma?.
Answer: PSA
◉ How much of needle is required to enter for PSA?. Answer: 16mm
◉ Lidocaine and Propranolol. Answer: 1. Propranolol DECREASES
Lidocaine Breakdown
, 2. Compete for SAME Enzyme
◉ Initially, Local Anesthetics inhibit.... Answer: Central Inhibitory
Neurons
◉ At greater doses, Local Anesthetics inhibit.... Answer: BOTH Central
Inhibitory and Excitatory Neurons
◉ Local Anesthesia and Graves Disease (Hyperthyroidism). Answer:
Graves Disease = Hyperthyroidism, which makes patient MORE
SENSITIVE to LA
◉ Cardiovascular collapse due to high dose of LA may be caused by.
Answer: Myocardial Depression
◉ What is the only Local Anesthesia that causes vasoconstriction?.
Answer: Cocaine
◉ What Local Anesthesia can produce powerful stimulation of cerebral
cortex?. Answer: Cocaine because it BLOCKS reuptake of NE, which
potentiates nerve endings
◉ Which antibiotics are not cross-allergenic with Penicillin?. Answer:
Macrolides like Erythromycin
