Deck 8: Determining Drug Doses

Question 1

Using the information from the previous question,how many additional cartridges of 3% mepivacaine can the patient receive?

A) 0 cartridges of 3% mepivacaine;a different local anesthetic should be selected
B) 1.8 additional cartridges of 3% mepivacaine
C) 6.4 additional cartridges of 3% mepivacaine
D) 2.4 additional cartridges of 3% mepivacaine

Answer 1

2.4 additional cartridges of 3% mepivacaine

Question 2

The manufacturer determines the MRD based on results from animal and human studies.The maximum doses determined by the manufacturer are approved by the U.S.Food and Drug Administration.

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.

Answer 2

Both statements are true.

Question 3

How much solution does the standard local anesthetic cartridge contain?

A) 1.6 mL
B) 1.7 mL
C) 1.8 mL
D) 2 mL

Answer 3

1.8 mL

Question 4

What is the formula for calculating the healthy patient's MRD in mg?

Question 5

What does the MRD depend on?

A) The patient's weight
B) The patient's health
C) Whether the anesthetic contains a vasoconstrictor or not
D) All options listed

Question 6

What is the MRD of mepivacaine 3% for a 130-lb female patient?

A) 390 mg of mepivacaine
B) 275 mg of mepivacaine
C) 300 mg of mepivacaine
D) 572 mg of mepivacaine

Question 7

Which of the following is the correct chart documentation for local anesthetic?

A) The number of cartridges of local anesthetic administered
B) The number of milligrams of local anesthetic administered
C) The percentage of a cartridge of local anesthetic administered
D) Any of the above

Question 8

If a patient's MRD is 240 mg and 108 mg of 3% mepivacaine has already been administered,how much more mepivacaine can the patient receive?

A) 0 mg of 3% mepivacaine;a different local anesthetic should be selected
B) 30 mg of 3% mepivacaine
C) 348 mg of 3% mepivacaine
D) 132 mg of 3% mepivacaine

Question 9

What is the formula for calculating how many milligrams of anesthetic solution were administered?

A) Subtract the MRD from the absolute MRD.
B) Multiply the percent concentration of local anesthetic agent by 10 mg.
C) Multiply the number of cartridges administered by the milligrams of anesthetic in each cartridge.
D) Multiply the milligrams of anesthetic in each cartridge by the patient's weight.

Question 10

Using the MRD from the previous question,how many cartridges of mepivacaine 3% can this 130-lb female receive?

A) 7.2 cartridges
B) 7.6 cartridges
C) 8.3 cartridges
D) 15.8 cartridges

Question 11

What is the number of milligrams per cartridge of 4% prilocaine?

A) 3.24 mg
B) 2.89 mg
C) 40 mg
D) 30 mg

Question 12

What is the formula for calculating the milligrams of anesthetic drug in 1 mL of the selected anesthetic?

Question 13

What is the formula for converting the maximum number of cartridges to milliliters?

Question 14

What is the name of the local anesthetic that is marketed as a different quantity of solution per individual cartridge?

A) Lidocaine
B) Articaine
C) Mepivacaine
D) Butacaine

Question 15

Which anesthetic/vasoconstrictor combination is most likely to limit the anesthetic drug?

A) Lidocaine 2% 1:50,000 epinephrine
B) Lidocaine 2% 1:100,000 epinephrine
C) Mepivacaine 3% 1:20,000 levonordefrin
D) All options listed

Question 16

If one has to estimate the amount of local anesthetic solution that was administered from one cartridge,the width of the rubber stopper would represent how much?

A) 2 mL of solution
B) 0.2 mL of solution
C) 0.02 mL of solution
D) Never estimate

Question 17

Which of the following is the first step in calculating the additional dose of a different drug?

A) Calculate how many milligrams of drug #1 have already been administered.
B) Calculate MRD of drug #2.
C) Review patient's history to determine appropriateness of new drug.
D) Consult with dentist and/or physician.

Question 18

If an anesthetic contains a vasoconstrictor,how is the maximum recommended dose determined?

A) The vasoconstrictor is always the limiting factor.
B) The anesthetic is always the limiting factor.
C) Whichever of the drugs reaches its MRD first is the limiting factor.
D) It is determined by the weight of the patient.

Question 19

What is the formula for calculating the milligrams of solution in one cartridge of the selected anesthetic?

Question 20

What is the formula for converting the MRD to number of cartridges?

Question 21

What is the maximum number of cartridges of 1:50,000 epinephrine that can be administered to a medically compromised patient?

A) 5.5 cartridges
B) 11.1 cartridges
C) 2.2 cartridges
D) 1.1 cartridges

Question 22

What is the MRD for epinephrine for a compromised patient?

A) 0.04 mg per appointment
B) 0.04 mg per quadrant of scaling
C) 0.2 mg per appointment
D) 0.2 mg per tooth to be restored

Question 23

For medically compromised patients,an appointment for nonsurgical periodontal therapy for two quadrants that would normally be completed in one appointment could be completed in two shorter appointments rather than one longer appointment.This would increase the amount of local anesthetic needed per appointment,providing safer treatment to the medically compromised or elderly patient.

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.

Question 24

What is the limiting factor for anesthetic in a compromised patient?

A) Concentration of anesthetic
B) Vasoconstrictor
C) Patient's weight
D) Length of appointment

Question 25

What is the MRD for articaine for a 115-pound patient?

A) 368 mg
B) 297 mg
C) 230 mg
D) 69 mg

Question 26

Local anesthetic drug amounts are expressed in ratios.Vasoconstrictor drug amounts are expressed in percentages.

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.

Question 27

How many milligrams of lidocaine 2% 1:100,000 epinephrine may a patient with ischemic heart disease receive?

A) 620 mg
B) 500 mg
C) 399.6 mg
D) 79.2 mg

Question 28

If the dental hygienist were to administer two different local anesthetics,which MRD would she use?

A) Use the higher MRD
B) Use the lower MRD
C) Use the MRD for the local anesthetic administered in the greatest amount
D) Subtract the lower MRD from the higher MRD and use the resulting MRD

Question 29

MRD of the local anesthetic agent should be decreased for patients with medically compromised situations,the elderly patient,and children.The lowest effective dose should be administered to any of these patients.

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.

Question 30

What is the MRD of 1:100,000 epinephrine per appointment for a healthy patient?

A) 1.0 mg
B) 0.2 mg
C) 0.04 mg
D) 0.4 mg

Question 31

How many milligrams of lidocaine 2% 1:100,000 epinephrine may a healthy,200-lb patient receive?

A) 800 mg
B) 620 mg
C) 600 mg
D) 500 mg

Question 32

The dental hygienist has already administered two cartridges of 2% lidocaine to a patient.The patient is reporting that he is not getting numb.What should the hygienist do at this time?

A) Ask the dentist to administer more anesthetic solution.
B) Change to a different anesthetic solution.
C) Attempt to readminister the anesthetic,adjusting the technique.
D) Call the manufacturer to report a bad batch of anesthetic cartridges.

Question 33

For what kind of patient should the MRD of local anesthetic agents be decreased?

A) Children
B) Elderly
C) Medically compromised
D) All options listed

Question 34

What is the maximum dose of levonordefrin in a healthy patient?

A) 0.2 mg
B) 1.0 mg
C) 0.04 mg
D) Epinephrine should be used instead of levonordefrin.

Question 35

How much vasoconstrictor is in one cartridge of 1:50,000?

A) 0.036 mg per cartridge
B) 0.09 mg per cartridge
C) 0.018 mg per cartridge
D) 0.017 mg per cartridge

Question 36

A patient with ischemic heart disease may only receive 0.04 mg of epinephrine or 2.2 cartridges of 2% lidocaine 1:100,000 epinephrine.2.2  36 mg/cart = 79.2 mg