Logothetis: Local Anesthesia for the Dental HygienistLogothetis: Local
Anesthesia for the Dental Hygienist, 2nd Edition 2025 Chapter 03:
Pharmacology of Local Anesthetic A Chapter 04: Pharmacology of
Vasoconstrictors Answers to End-of-chapter Review Questions
Terms in this set (80)
All of the following are desirable Answer E. Rationale: Desirable properties of local anesthetics
properties of local anesthetics include: potent local anesthesia, reversible local anesthesia,
EXCEPT one. Which one is the absence of local reactions, absence of systemic reactions,
EXCEPTION? absence of allergic reactions, rapid onset, satisfactory duration,
A. Reversible
adequate tissue penetration, low cost, stability in solution
B. Rapid onset
(long shelf life)
C. Stability in solution
D. Potent
E. Slow biotransformation
Topical anesthetics are available Answer A. Rationale: Topical esters include benzocaine and
in both esters and amides. tetracaine. Lidocaine is the only topical amide.
A. True
B. False
Local anesthetic overdose has an Answer A. Rationale: Once absorbed into the system and before
effect on which system? biotransformation, local anesthetics will affect the central
A. Central nervous system nervous system (CNS) and the cardiovascular system (CVS).
B. Skeletal system
C. Lymphatic system
D. Respiratory system
,Most amide local anesthetics are Answer D. Rationale: Lidocaine, mepivacaine, and bupivacaine are metabolised
biotransformed in the: solely in the liver, prilocaine is metabolized mostly in the liver,
A. Plasma and some in the lungs, articaine is metabolized predominately
B. Lungs
in the blood
C. Kidneys
D. Liver
Which of the following is Answer B. Rationale: The metabolite para-amino benzoic acid is
responsible for allergic reactions responsible for the allergic reactions with ester anesthetics, not
in ester anesthetics? the parent compound.
A. The parent compound .
B. Para-amino benzoic acid
C. Pseudocholinesterase
D. Sodium bisulfite
What is tachyphylaxis? Answer C. Rationale: If the dental procedure lasts longer than
A. A term used to describe the the duration of the anesthetic and the mantle and core fibers
inability of the anesthetic to have fully recovered, the reinjection of local anesthetic will be
reach the nerve ineffective. A term used to describe this phenomenon is
membrane because of anatomic tachyphylaxis.
barriers
B. Reinjection of anesthetic
before the mantle fibers
have fully recovered
C. Increased tolerance to a
drug that is administered
repeatedly
D. A term used to describe
only partial anesthesia
When the local anesthetic is Answer B. Rationale: The local anesthetic when administered diffuses
administered, the solution through the
nerve to the mantle bundles (outer core) first providing
reaches the core bundles first.
A. True concentrated anesthetic to the molar region, and then
B. False diffusing to the core bundles (inner core) providing a
more diluted anesthetic solution.
The mantle bundles of the inferior Answer A. Rationale: The mantle bundles of the inferior alveolar
alveolar nerve innervate which nerve innervate the molar area, and the core bundles innervate
teeth? anterior teeth at the end of the nerve
A. The molar area fiber.
B. The anterior teeth
C. The lingual tissue
D. The buccal tissue of the
,three molar teeth
Which of the following local Answer C. Rationale: Bupivacaine is the most lipid-soluble
anesthetics is the most lipid- compared to all other local anesthetics, and it is therefore more
soluble? potent because more of the anesthetic dose can enter the
A. Mepivacaine neurons.
B. Lidocaine
C. Bupivacaine
D. Prilocaine
Which of the following anesthetics Answer D. Rationale: Benzocaine has the lowest pKa of all
will anesthetics at 3.5 and therefore has the most rapid onse of
provide the most rapid onset
action.
based on its pKa?
A. Mepivacaine
B. Lidocaine
C. Bupivacaine
D. Benzocaine
, During manufacturing, local Answer C. Rationale: Synthetic local anesthetics are prepared as
anesthetics are formulated as weak bases and during manufacturing precipitate as powdered
which of the following to unstable solids that are poorly
render them water-soluble? soluble in water. They are combined with an acid to form a salt
A. Muriatic acid
(hydrochloride salt) to render them water-soluble.
B. Sodium bisulfite
C. Hydrochloride salt
D. Sodium bicarbonate
Ester type local anesthetics are no Answer B. Rationale: Esters are metabolized to para-
longer manufactured in aminobenzoic acid (PABA) and is the major metabolic by-
injectable form for dentistry product responsible for allergic reactions.
because:
A. Of their difficulty penetrating
the nerve
B. Of their high degree of
hypersensitivity
C. They increase the potential
for systemic overdose
D. They have significant vasodilatory
properties
The quaternary form of the local Answer A. Rationale: The quaternary form (four bonds) is
anesthetic molecule: positively charged and renders the molecule water-soluble,
A. Is the ionized form in the which is the form in the cartridge, and the active form of the
cartridge and is responsible for local anesthetic.
binding to the receptor site
B. Is the unionized form in the
cartridge and is responsible
for binding to the
receptor site
C. Is the ionized form of the
molecule that penetrates the
nerve membrane
D. Is the unionized form of the
molecule that penetrates the
nerve membrane
Anesthesia for the Dental Hygienist, 2nd Edition 2025 Chapter 03:
Pharmacology of Local Anesthetic A Chapter 04: Pharmacology of
Vasoconstrictors Answers to End-of-chapter Review Questions
Terms in this set (80)
All of the following are desirable Answer E. Rationale: Desirable properties of local anesthetics
properties of local anesthetics include: potent local anesthesia, reversible local anesthesia,
EXCEPT one. Which one is the absence of local reactions, absence of systemic reactions,
EXCEPTION? absence of allergic reactions, rapid onset, satisfactory duration,
A. Reversible
adequate tissue penetration, low cost, stability in solution
B. Rapid onset
(long shelf life)
C. Stability in solution
D. Potent
E. Slow biotransformation
Topical anesthetics are available Answer A. Rationale: Topical esters include benzocaine and
in both esters and amides. tetracaine. Lidocaine is the only topical amide.
A. True
B. False
Local anesthetic overdose has an Answer A. Rationale: Once absorbed into the system and before
effect on which system? biotransformation, local anesthetics will affect the central
A. Central nervous system nervous system (CNS) and the cardiovascular system (CVS).
B. Skeletal system
C. Lymphatic system
D. Respiratory system
,Most amide local anesthetics are Answer D. Rationale: Lidocaine, mepivacaine, and bupivacaine are metabolised
biotransformed in the: solely in the liver, prilocaine is metabolized mostly in the liver,
A. Plasma and some in the lungs, articaine is metabolized predominately
B. Lungs
in the blood
C. Kidneys
D. Liver
Which of the following is Answer B. Rationale: The metabolite para-amino benzoic acid is
responsible for allergic reactions responsible for the allergic reactions with ester anesthetics, not
in ester anesthetics? the parent compound.
A. The parent compound .
B. Para-amino benzoic acid
C. Pseudocholinesterase
D. Sodium bisulfite
What is tachyphylaxis? Answer C. Rationale: If the dental procedure lasts longer than
A. A term used to describe the the duration of the anesthetic and the mantle and core fibers
inability of the anesthetic to have fully recovered, the reinjection of local anesthetic will be
reach the nerve ineffective. A term used to describe this phenomenon is
membrane because of anatomic tachyphylaxis.
barriers
B. Reinjection of anesthetic
before the mantle fibers
have fully recovered
C. Increased tolerance to a
drug that is administered
repeatedly
D. A term used to describe
only partial anesthesia
When the local anesthetic is Answer B. Rationale: The local anesthetic when administered diffuses
administered, the solution through the
nerve to the mantle bundles (outer core) first providing
reaches the core bundles first.
A. True concentrated anesthetic to the molar region, and then
B. False diffusing to the core bundles (inner core) providing a
more diluted anesthetic solution.
The mantle bundles of the inferior Answer A. Rationale: The mantle bundles of the inferior alveolar
alveolar nerve innervate which nerve innervate the molar area, and the core bundles innervate
teeth? anterior teeth at the end of the nerve
A. The molar area fiber.
B. The anterior teeth
C. The lingual tissue
D. The buccal tissue of the
,three molar teeth
Which of the following local Answer C. Rationale: Bupivacaine is the most lipid-soluble
anesthetics is the most lipid- compared to all other local anesthetics, and it is therefore more
soluble? potent because more of the anesthetic dose can enter the
A. Mepivacaine neurons.
B. Lidocaine
C. Bupivacaine
D. Prilocaine
Which of the following anesthetics Answer D. Rationale: Benzocaine has the lowest pKa of all
will anesthetics at 3.5 and therefore has the most rapid onse of
provide the most rapid onset
action.
based on its pKa?
A. Mepivacaine
B. Lidocaine
C. Bupivacaine
D. Benzocaine
, During manufacturing, local Answer C. Rationale: Synthetic local anesthetics are prepared as
anesthetics are formulated as weak bases and during manufacturing precipitate as powdered
which of the following to unstable solids that are poorly
render them water-soluble? soluble in water. They are combined with an acid to form a salt
A. Muriatic acid
(hydrochloride salt) to render them water-soluble.
B. Sodium bisulfite
C. Hydrochloride salt
D. Sodium bicarbonate
Ester type local anesthetics are no Answer B. Rationale: Esters are metabolized to para-
longer manufactured in aminobenzoic acid (PABA) and is the major metabolic by-
injectable form for dentistry product responsible for allergic reactions.
because:
A. Of their difficulty penetrating
the nerve
B. Of their high degree of
hypersensitivity
C. They increase the potential
for systemic overdose
D. They have significant vasodilatory
properties
The quaternary form of the local Answer A. Rationale: The quaternary form (four bonds) is
anesthetic molecule: positively charged and renders the molecule water-soluble,
A. Is the ionized form in the which is the form in the cartridge, and the active form of the
cartridge and is responsible for local anesthetic.
binding to the receptor site
B. Is the unionized form in the
cartridge and is responsible
for binding to the
receptor site
C. Is the ionized form of the
molecule that penetrates the
nerve membrane
D. Is the unionized form of the
molecule that penetrates the
nerve membrane
