Updated/Latest Local Anesthesia for the Dental Hygienist 2nd Edition Demetra Daskalos Logothetis Comprehensive Test Bank Study Guide Examination Questions and Answers for Dental Hygiene Local Anesthesia Pharmacology Injection Techniques Pain Control Neuro

LOCAL ANESTHESIA for the DENTAL HYGIENIST
Second Edition Demetra Daskalos Logothetis, RDH, MS
Professor Emeritus and Graduate Program Director
Departmen of Dental Medicine University of New Mexico, J




Albuquerque, New Mexico Educational Consultant, Albuquer

Acetylsalicylic/ Acid/ (Aspirin)/ -/ ANSWER:/ ASA/ J J J J J J




antipyretic/ -/ ANSWER:/ reduces/ fever/ (Tylenol,/ aspirin) J J J J J J




Epinephrine/ is/ naturally/ secreted/ by/the/ adrenal/ glands/ and/ the/ sympathetic/ nerve/ fibers./ The/
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hormone/ can/ be/ obtained/ via/ extraction/ from/ the/ adrenal/ glands/ of/ cattle/ and/ sheep,/ or/ it/ can/
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be/ made/ in/ a/ laboratory./ Synthetic/ production/ of/ epinephrine/ entails/ the/ reaction/ of/ catechol/
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and/ chloroacetyl/ chloride./ -/ ANSWER:
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antipyretic/ -/ ANSWER:/ reduces/ fever/ (Tylenol,/ aspirin) J J J J J J




In/ 1842,/ it/ was/ reported/ that/ William/ Clarke/ administered/ ether,/ via/ a/ towel,/ to/ a/ woman/ as/
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one/ ofher/ teeth/ was/ extracted/ by/ a/ dentist./ -/ ANSWER:
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Tagamet/ (cimetidine)/ decreases/ hepatic/ blood/ flow/ and/ inhibits/ hepatic/ metabolism/ of/
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amides,/ particularly/ lidocaine,/ by/ competing/ for/ binding/ to/ hepatic/ oxidative/ enzymes,/ and/
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therefore/ increases/ half/ life/ of/ the/ amide/ anesthetic,/ augmenting/ the/ risk/ for/ toxic/ overdose./ -/
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ANSWER:


Morphine/ -/ ANSWER:/ narcotic/ drug/ derived/ from/ opium,/ used/ to/ treat/ severe/ pain
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Horace/ Wells, / a/ dentist,/ first/ tried/ nitrous/ oxide/ for/ dental/ pain/ control/ after/ attending/ several/
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"laughing/ gas"/ parties./ -/ ANSWER: J J J J




He/ practiced/ on/ himself/ by/ using/ nitrous/ oxide,/ which/ he/ considered/ safer/ than/ ether,/ and/ had/
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a/ fellow/ dentist/ extract/ his/ tooth.He/ felt/ nothing/ during/ the/ extraction/ and/ discovered/ nitrous/
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oxide/ to/ be/ an/ effective/ anesthetic./ -/ ANSWER:
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,Halothane,/ a/ safe/ and/ stable/ chemical/ for/ inhalation/ anesthesia,/ was/ introduced/ in/ 1956./ -/
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ANSWER:


Halothane/ (Fluothane)/ -/ ANSWER:/ halogenated/ hydrocarbon/ volatile/ liquid/ anesthetic/
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with/ good/ maintenance
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The/ first/ local/ anesthetic,/ cocaine,/ was/ isolated/ from/ coca/ leaves/ by/Albert/ Niemann/ and/
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Francesco/ Di/ Stefano/ in/ Germany/ in/ the/ 1860s./ -/ ANSWER:
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Cocaine/ was/ first/ used/ as/ a/ local/ anesthetic/ in/ 1884/ by/ Karl/ Koller,/ who/ demonstrated/ the/ use/
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during/ painless/ ophthalmological/ surgery./ -/ ANSWER:
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In/ 1905,/ the/ ester/ procaine/ (Novocaine)/ was/ created/ in/ Germany/ and,/ when/ mixed/ with/ a/
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proportion/ of/ epinephrine,/ was/ found/ to/ be/ effective/ and/ safe/ -/ ANSWER:
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Procaine/ took/ a/ long/ time/ to/ produce/ the/ desired/ anesthetic/ result,/ wore/ off/ quickly,/ and/ was/
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not/ as/ potent/ as/ cocaine./ Additionally,/ many/ patients/ were/ allergic/ to/ procaine/ because/
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procaine/ is/ an/ ester/ that/ has/ a/ high/ potential/ for/ allergic/ reactions./ -/ ANSWER:
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In/ the/ 1940s,/ a/ new/ group/ of/ local/ anesthetic/ compounds,/ the/ amides,were/ introduced./ The/
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initial/ amide/ local/ anesthetic,/ lidocaine,/ was/ synthesized/ by/ the/ Swedish/ chemist/ Nils/
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Lofgren/ in/ 1943./ -/ ANSWER:/ Lidocaine/ revolutionized/ pain/ control/ in/ dentistry/
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worldwide,/ because/ it/ was/ both/ more/ potent/ and/ less/ allergenic/ than/ procaine./ In/ the/
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succeeding/ years,/ other/ amide/ local/ anesthetics/ (prilocaine/ in/ 1959,/ bupivacaine/ and/
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mepivacaine/ in/ 1957)/ were/ introduced. J J J J




These/ new/ amide/ local/ anesthetics/ provided/ the/ dental/ practitioner/ with/ an/ array/ of/ local/
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anesthetics/ for/ pulpal/ anesthesia/ that/ could/ last/ from/ 20/ minutes/ (mepivacaine/ plain)/ to/ 3/
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hours/ (bupivacaine/ with/ epinephrine)/ -/ ANSWER:
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In/ 1969,/ Rusching/ and/ colleagues/ prepared/ a/ new/ drug,/ carticaine,/ which/ differed/ from/ the/
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previous/ amide/ local/ anesthetics/ -/ ANSWER:/ Renamed/ articaine/ in/ 1984,/ the/ drug/ was/
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derived/ from/ thiophene/ and/ thus/ contained/ a/ thiophene/ ring/ in/ its/ molecule/ instead/ of/ the/
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usual/ benzene/ ring./ Articaine/ became/ available/ in/ 2000/ for/ marketing/ in/ the/ United/ States/ in/
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a/ 4%/ 1:100,000/ epinephrine/ formulation.
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,Today,/ lidocaine/ remains/ the/ most/ popular/ anesthetic/ used/ in/ dentistry/ in/ the/ United/ States;/
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however,articaine/ is/ increasing/ in/ its/ popularity/ and/ is/ a/ close/ second/ to/ lidocaine.Many/ J J J J J J J J J J J J J




patients/ do/ not/ understand/ the/ distinction/ among/ the/ agents/ and/ still/ ask/ for/ Novocaine,/
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which/ is/ no/ longer/ available/ in/ dentistry./ -/ ANSWER:
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levonordefrin/ (Neo-Cobefrin)/ -/ANSWER:/Vasoconstrictor/ J J J J J




1/6th/ as/ strong/ as/ EPI
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Mostly/act/ on/ Alpha/ receptors/ (75%)/ Beta/ (25%)/
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Less/ systemic/ effects/ than/ EPI
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Max/ Dose/ in/ ALL/ Pt's/ =/ 1mg/appt/ =/ 11/ cartridges
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2%/ carbocaine/ with/ 1:20,000/ Levonordefrin
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inact/ -/ ANSWER:/ To/ bring/ into/ action/ or/ a/ state/ of/ activity.
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Pain/ threshold/ pertains/ to/ the/ point/ at/ which/ a/ sensation/ starts/ to/ be/ painful/ and/ discomfort/
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results./ This/ threshold/ varies/ among/ individuals/ and/ may/ be/ altered/ by/ some/ drugs/ such/ as/
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local/ anesthesia./ -/ ANSWER:/ Many/ patients/ fear/ the/ dental/ provider/ because/ they/ are/
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apprehensive/ about/ a/ "dental/ shot." J J J J




Local/ anesthetics/ are/ known/ as/ membrane-stabilizing/ drugs,/ which/ work/ by/ decreasing/ the/
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rate/ of/ depolarization/ when/ a/ membrane/ potential/ is/ initiated./ -/ ANSWER:/ When/ neurons/
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are/ firing/ quickly,/ causing/ sodium/ channels/ to/ be/ in/ their/ activated/ state,/ the/ local/ anesthetic/
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drugs/ bind/ easier/ to/ the/ sodium/ channels,/ increasing/ the/ onset/ of/ neuronal/ blockade./ This/
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phenomenon/ is/ called/ state/ dependent/ blockade J J J J J




Nissl/ substance/ is/ a/ basophilic/ material/ primarily/ composed/ of/ ribonucleic/ acid/ (RNA)/ and/
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proteins/ in/ aggregate/ with/ rough/ endoplasmic/ reticulum./ This/ substance/ is/ involved/ in/ protein/
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synthesis/ and/ cellular/ metabolism./ Nissl/ substance/ can/ vary/ in/ quantity,/ form,/ and/
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distribution/ in/ different/ types/ of/ neurons./ -/ ANSWER: J J J J J J J




breech-loading/ aspirating/ syringe/ -/ ANSWER: J J J J




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, Vazirani-Akinosi/ mandibular/ block/ -/ ANSWER:/ include/ the/ IN,/ lingual, / mental,/ incisve,/ J J J J J J J J J J J




and/ mylohyoid/ nerves/ within/ the/ pterygomandibular/ space/ and/ long/ buccal/ nerve/
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approximately/ 75%/ of/ the/ time J J J J




Morphine/ -/ ANSWER:/ narcotic/ drug/ derived/ from/ opium,/ used/ to/ treat/ severe/ pain/
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Helothane/ -/ ANSWER: J J




Procaine/ (Novocain)/ -/ ANSWER:/ used/ as/ an/ anasthetic,/ derived/ from/ the/ coca/ plant
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Myelin/ (lipoprotein/ sheath)/ is/ composed/ of/ about/ 75%/ lipid,/ about/ 20%/ protein,/ and/ about/
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5%/ carbohydrates./ Myelin/ is/ made/ up/ primarily/of/ a/ glycolipid/ called/ galactocerebroside/ and/
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almost/ completely/ insulates/ the/ axon/ from/ the/ outside./ -/ ANSWER:
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Unmyelinated/ fibers/ and/ myelinated/ axons/ of/ the/ CNS/ do/ not/ regenerate./ The/ demyelination/
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of/ axons/ is/ the/ cause/ of/ the/ multitude/ of/ neurologic/ symptoms/ seen/ in/ multiple/ sclerosis./ -/
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ANSWER:


saltatory/ conduction/ -/ ANSWER:/ Rapid/ transmission/ of/ a/ nerve/ impulse/ along/ an/ axon,/
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resulting/ from/ the/ action/ potential/ jumping/ from/ one/ node/ of/ Ranvier / to/ another,/ skipping/ the/
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myelin-sheathed/ regions/ of/ membrane. J J J




Unmyelinated/ nerves/ are/ free/ nerve/ endings;/ the/ smallest/ nerve/ fibers/ are/ also/ known/ as/ C/
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fibers./ C/ fibers/ are/ the/ most/ numerous/ fiber/ type/ in/ the/ PNS./ -/ ANSWER:
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Peripheral/ nerve/ fibers/ differ/ substantially/ and/ can/ be/ classified/ based/ on/ axonal/ conduction/
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velocity,/ frequency/ of/ firing,/ degree/ of/ myelination,/ and/ fiber/ diameter./ -/ ANSWER:/ For/
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example,/ there/ are/ slow-conducting/ unmyelinated/ C/ fibers/ and/ faster-conducting/ myelinated/
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Aδ/ fibers./ All/ these/ factors/ influence/ the/ ability/ of/ the/ local/ anesthetic/ to/ block/ the/ nerve/
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conduction.


Type/ A/ fibers/ are/ the/ largest/ fibers/ present/ in/ mammalian/ nerves,/ and/ with/ the/ rate/ of/
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impulse/ transmission/ directly/ proportional/ to/ fiber/ diameter,/ this/ group/ comprises/ the/ most/
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rapidly/ conducting/ axons./ -/ ANSWER:/ They/ are/ responsible/ for/ conducting/ pressure/ and/
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motor/ sensations.Type/ A/ fibers/ are/ further/ divided/ into/ four/ groups,/ α/ through/ δ./ Aδ/ fibers
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