Deck 7: Dose Calculations for Local Anesthetic Solutions
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Deck 7: Dose Calculations for Local Anesthetic Solutions
1
Match the following:
-Articaine
A) MRD 90 mg
B) MRD 0.04 mg
C) 3.2 mg/lb
D) 3.6 mg/lb
E) MRD 500 mg
F) 54 mg/cartridge
G) Based on child's weight
H) 1.8 ml
I) MRD 1.0 mg
J) Based on child's age
-Articaine
A) MRD 90 mg
B) MRD 0.04 mg
C) 3.2 mg/lb
D) 3.6 mg/lb
E) MRD 500 mg
F) 54 mg/cartridge
G) Based on child's weight
H) 1.8 ml
I) MRD 1.0 mg
J) Based on child's age
3.2 mg/lb
2
Match the following:
-Bupivacaine
A) MRD 90 mg
B) MRD 0.04 mg
C) 3.2 mg/lb
D) 3.6 mg/lb
E) MRD 500 mg
F) 54 mg/cartridge
G) Based on child's weight
H) 1.8 ml
I) MRD 1.0 mg
J) Based on child's age
-Bupivacaine
A) MRD 90 mg
B) MRD 0.04 mg
C) 3.2 mg/lb
D) 3.6 mg/lb
E) MRD 500 mg
F) 54 mg/cartridge
G) Based on child's weight
H) 1.8 ml
I) MRD 1.0 mg
J) Based on child's age
MRD 90 mg
3
Match the following:
-Cardiac dose
A) MRD 90 mg
B) MRD 0.04 mg
C) 3.2 mg/lb
D) 3.6 mg/lb
E) MRD 500 mg
F) 54 mg/cartridge
G) Based on child's weight
H) 1.8 ml
I) MRD 1.0 mg
J) Based on child's age
-Cardiac dose
A) MRD 90 mg
B) MRD 0.04 mg
C) 3.2 mg/lb
D) 3.6 mg/lb
E) MRD 500 mg
F) 54 mg/cartridge
G) Based on child's weight
H) 1.8 ml
I) MRD 1.0 mg
J) Based on child's age
MRD 0.04 mg
4
Match the following:
-Cartridge volume
A) MRD 90 mg
B) MRD 0.04 mg
C) 3.2 mg/lb
D) 3.6 mg/lb
E) MRD 500 mg
F) 54 mg/cartridge
G) Based on child's weight
H) 1.8 ml
I) MRD 1.0 mg
J) Based on child's age
-Cartridge volume
A) MRD 90 mg
B) MRD 0.04 mg
C) 3.2 mg/lb
D) 3.6 mg/lb
E) MRD 500 mg
F) 54 mg/cartridge
G) Based on child's weight
H) 1.8 ml
I) MRD 1.0 mg
J) Based on child's age
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5
Match the following:
-Clark's rule
A) MRD 90 mg
B) MRD 0.04 mg
C) 3.2 mg/lb
D) 3.6 mg/lb
E) MRD 500 mg
F) 54 mg/cartridge
G) Based on child's weight
H) 1.8 ml
I) MRD 1.0 mg
J) Based on child's age
-Clark's rule
A) MRD 90 mg
B) MRD 0.04 mg
C) 3.2 mg/lb
D) 3.6 mg/lb
E) MRD 500 mg
F) 54 mg/cartridge
G) Based on child's weight
H) 1.8 ml
I) MRD 1.0 mg
J) Based on child's age
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6
Match the following:
-Levonordefrin
A) MRD 90 mg
B) MRD 0.04 mg
C) 3.2 mg/lb
D) 3.6 mg/lb
E) MRD 500 mg
F) 54 mg/cartridge
G) Based on child's weight
H) 1.8 ml
I) MRD 1.0 mg
J) Based on child's age
-Levonordefrin
A) MRD 90 mg
B) MRD 0.04 mg
C) 3.2 mg/lb
D) 3.6 mg/lb
E) MRD 500 mg
F) 54 mg/cartridge
G) Based on child's weight
H) 1.8 ml
I) MRD 1.0 mg
J) Based on child's age
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7
Match the following:
-Lidocaine
A) MRD 90 mg
B) MRD 0.04 mg
C) 3.2 mg/lb
D) 3.6 mg/lb
E) MRD 500 mg
F) 54 mg/cartridge
G) Based on child's weight
H) 1.8 ml
I) MRD 1.0 mg
J) Based on child's age
-Lidocaine
A) MRD 90 mg
B) MRD 0.04 mg
C) 3.2 mg/lb
D) 3.6 mg/lb
E) MRD 500 mg
F) 54 mg/cartridge
G) Based on child's weight
H) 1.8 ml
I) MRD 1.0 mg
J) Based on child's age
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8
Match the following:
-Mepivacaine
A) MRD 90 mg
B) MRD 0.04 mg
C) 3.2 mg/lb
D) 3.6 mg/lb
E) MRD 500 mg
F) 54 mg/cartridge
G) Based on child's weight
H) 1.8 ml
I) MRD 1.0 mg
J) Based on child's age
-Mepivacaine
A) MRD 90 mg
B) MRD 0.04 mg
C) 3.2 mg/lb
D) 3.6 mg/lb
E) MRD 500 mg
F) 54 mg/cartridge
G) Based on child's weight
H) 1.8 ml
I) MRD 1.0 mg
J) Based on child's age
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9
Match the following:
-Prilocaine
A) MRD 90 mg
B) MRD 0.04 mg
C) 3.2 mg/lb
D) 3.6 mg/lb
E) MRD 500 mg
F) 54 mg/cartridge
G) Based on child's weight
H) 1.8 ml
I) MRD 1.0 mg
J) Based on child's age
-Prilocaine
A) MRD 90 mg
B) MRD 0.04 mg
C) 3.2 mg/lb
D) 3.6 mg/lb
E) MRD 500 mg
F) 54 mg/cartridge
G) Based on child's weight
H) 1.8 ml
I) MRD 1.0 mg
J) Based on child's age
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10
Match the following:
-Young's rule
A) MRD 90 mg
B) MRD 0.04 mg
C) 3.2 mg/lb
D) 3.6 mg/lb
E) MRD 500 mg
F) 54 mg/cartridge
G) Based on child's weight
H) 1.8 ml
I) MRD 1.0 mg
J) Based on child's age
-Young's rule
A) MRD 90 mg
B) MRD 0.04 mg
C) 3.2 mg/lb
D) 3.6 mg/lb
E) MRD 500 mg
F) 54 mg/cartridge
G) Based on child's weight
H) 1.8 ml
I) MRD 1.0 mg
J) Based on child's age
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11
The maximum recommended dose for each solution is dependent on the drug that limits the total volumes that may be delivered.
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12
In solutions containing both a local anesthetic and a vasoconstrictor drug, the maximum recommended dose of the local anesthetic is usually the limiting drug.
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13
The maximum safe dose of 1:50,000 epinephrine per appointment for a healthy adult is 0.2 mg or 5.5 cartridges.
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14
At a concentration of 4%, the amount of drug in a 1.8 ml cartridge is 7.2 mg.
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15
At a concentration of 0.5%, the amount of drug in a 1.8 ml cartridge is 9 mg.
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16
To calculate the milligrams of drug delivered, multiply the total number of cartridges by the total milligrams of drug in each cartridge.
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17
When two different drugs are injected, the total of the MRDs for both drugs is the maximum number of milligrams of drugs the patient may receive.
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18
Calculations of maximum safe doses for vasoconstrictors are determined by mg/lb or mg/kg.
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19
The maximum safe dose of 1:200,000 epinephrine per appointment for a patient with ischemic heart disease is 0.4 mg or 1.1 cartridges.
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20
Clark's rule for determining pediatric drug doses is based on a child's weight divided by 150 to get the approximate fraction of the adult dose.
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21
The maximum recommended dose per appointment for bupivacaine is ________.
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22
The maximum recommended dose per appointment for lidocaine is ________.
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23
The maximum mg/lb of mepivacaine per appointment is ________.
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24
The maximum mg/lb of prilocaine per appointment is ________.
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25
A 10% solution contains one tenth of a milligram per milliliter or ________ mg/ml.
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26
A 2% solution of lidocaine contains ________ mg/ml.
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27
A 2% solution of lidocaine contains ________ mg/cartridge.
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28
A 3% solution of mepivacaine contains ________ mg/ml.
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29
A 3% solution of mepivacaine contains ________ mg/cartridge.
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30
Ralph weighs 175 lb. He has received 72 mg of 2% lidocaine. Ralph can receive a maximum of ________ mg additional lidocaine.
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31
Susan is a healthy patient and weighs 130 lb. She has received 54 mg of 3% mepivacaine. She could receive a maximum of _________ mg of 4% prilocaine, 1:200,000 epinephrine.
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32
The MRD for bupivacaine is:
A) 200 mg
B) 90 mg
C) 300 mg
D) 500 mg
A) 200 mg
B) 90 mg
C) 300 mg
D) 500 mg
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33
Which of the following information for MRD is not correct?
A) Bupivacaine = 90 mg
B) Lidocaine = 500 mg
C) Mepivacaine = 300 mg
D) Prilocaine = 600 mg
A) Bupivacaine = 90 mg
B) Lidocaine = 500 mg
C) Mepivacaine = 300 mg
D) Prilocaine = 600 mg
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34
What is the MRD of vasoconstrictor for 2% lidocaine, 1:100,000 epinephrine for a healthy patient?
A) 0.02 mg
B) 2.0 mg
C) 1.0 mg
D) 0.2 mg
A) 0.02 mg
B) 2.0 mg
C) 1.0 mg
D) 0.2 mg
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35
What is the MRD in cartridges for 4% prilocaine, 1:200,000 epinephrine for a healthy 150 pound patient?
A) 5
B) 6
C) 8
D) 11
A) 5
B) 6
C) 8
D) 11
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36
How many milligrams of epinephrine 1:50,000 are available in one cartridge?
A) 0.018 mg
B) 0.050 mg
C) 0.036 mg
D) 0.2 mg
A) 0.018 mg
B) 0.050 mg
C) 0.036 mg
D) 0.2 mg
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37
How many milligrams of epinephrine 1:200,000 are available in two cartridges?
A) 0.018
B) 0.18
C) 0.036
D) 0.016
A) 0.018
B) 0.18
C) 0.036
D) 0.016
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38
Which of the following pieces of information is not usually required in order to calculate safe doses for local anesthetics and vasoconstrictors?
A) Patient factors such as height, weight, and age
B) Standard cartridge volume and dilution percentages
C) Maximum recommended dose and patient weight
D) Concentration of drug and dilution percentages
A) Patient factors such as height, weight, and age
B) Standard cartridge volume and dilution percentages
C) Maximum recommended dose and patient weight
D) Concentration of drug and dilution percentages
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39
A 150-pound patient has received two cartridges of 2% lidocaine, 1:100,000 epinephrine. How many additional cartridges with the same drugs can be administered before reaching the MRD?
A) 5
B) 6
C) 9
D) 11
A) 5
B) 6
C) 9
D) 11
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40
A 120-pound patient has received three cartridges of 4% prilocaine, 1:200:000 epinephrine. How many more milligrams of prilocaine can this patient receive before reaching the MRD?
A) 72 mg
B) 216 mg
C) 432 mg
D) 600 mg
A) 72 mg
B) 216 mg
C) 432 mg
D) 600 mg
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41
A healthy 160-pound patient has received three cartridges of 2% lidocaine, 1:50,000 epinephrine during an oral surgical procedure. How many more cartridges with the same drug could this patient receive before reaching the MRD?
A) 2
B) 5
C) 8
D) 10
A) 2
B) 5
C) 8
D) 10
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42
A patient has received four cartridges of 4% articaine, 1:200,000 epinephrine. How many milligrams of vasoconstrictor has the patient received?
A) 0.018
B) 0.036
C) 0.072
D) 0.36
A) 0.018
B) 0.036
C) 0.072
D) 0.36
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43
A 180-pound patient has received three cartridges of 2% lidocaine, 1:100,000 epinephrine. How many additional milligrams of 4% articaine, 1:200,000 epinephrine can be administered before reaching the MRD?
A) 72 mg
B) 192 mg
C) 228 mg
D) 392 mg
A) 72 mg
B) 192 mg
C) 228 mg
D) 392 mg
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44
A 120-pound patient has received 2 cartridges of 2% mepivacaine, 1:20,000 and does not remain adequately numb during the procedure. How many additional cartridges of 2% lidocaine, 1:100,000 epinephrine may the patient receive before reaching the MRD?
A) 6
B) 9
C) 11
D) 13
A) 6
B) 9
C) 11
D) 13
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45
What is the MRD of levonordefrin for a 210 pound male patient with ischemic heart disease?
A) 0.02 mg
B) 0.2 mg
C) 0.04 mg
D) 0.4 mg
A) 0.02 mg
B) 0.2 mg
C) 0.04 mg
D) 0.4 mg
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46
A patient with cardiovascular disease has received one cartridge of 2% lidocaine, 1:100:000 epinephrine. How many milligrams of vasoconstrictor has this patient received? How many additional milligrams of vasoconstrictor can the patient receive before reaching MRD?
A) 0.018 mg received; 0.022 mg additional
B) 0.009 mg received; 0.391 mg additional
C) 0.36 mg received; 0.4 mg additional
D) 0.18 mg received; 0.22 mg additional
A) 0.018 mg received; 0.022 mg additional
B) 0.009 mg received; 0.391 mg additional
C) 0.36 mg received; 0.4 mg additional
D) 0.18 mg received; 0.22 mg additional
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47
A patient with cardiovascular disease has received two cartridges of 4% articaine, 1:200:000 epinephrine. How many milligrams of vasoconstrictor has this patient received? How many additional cartridges of the same drug solution can the patient receive?
A) 0.009 mg received; two additional cartridges
B) 0.018 mg received; two additional cartridges
C) 0.18 mg received; no additional cartridges
D) 0.036 mg received; no additional cartridges
A) 0.009 mg received; two additional cartridges
B) 0.018 mg received; two additional cartridges
C) 0.18 mg received; no additional cartridges
D) 0.036 mg received; no additional cartridges
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48
Using Clark's rule, calculate the milligrams of 2% lidocaine an 8-year old, 60 pound child can receive before reaching MRD.
A) 60 mg
B) 120 mg
C) 200 mg
D) 300 mg
A) 60 mg
B) 120 mg
C) 200 mg
D) 300 mg
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49
Using Clark's rule, a 12-year old, 90 pound child has received two cartridges of 2% lidocaine. How many more cartridges of lidocaine can this child receive before reaching MRD?
A) 3
B) 6
C) 7
D) 8
A) 3
B) 6
C) 7
D) 8
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50
Using Clark's rule, calculate the maximum number of milligrams of 3% mepivacaine a 5-year old, 40-pound child can receive before reaching the MRD?
A) 40 mg
B) 80 mg
C) 106 mg
D) 117 mg
A) 40 mg
B) 80 mg
C) 106 mg
D) 117 mg
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51
Using Young's rule, calculate the mg of 2% lidocaine a 10-year old, 60-pound child can receive before reaching the MRD?
A) 125 mg
B) 136 mg
C) 200 mg
D) 227 mg
A) 125 mg
B) 136 mg
C) 200 mg
D) 227 mg
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52
What is the MRD of 4% prilocaine plain for a healthy 205 pound male patient?
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53
What factors are needed to calculate the local anesthetic drug dose delivered for a given patient?
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54
A 140-pound patient received 144 mg of 2% lidocaine plain. How many more milligrams of the same drug can the patient receive without exceeding the MRD? Provide mathematical formulas required to calculate the correct answer.
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55
A 180-pound patient received 108 mg of 3% mepivicaine. How many cartridges were used? Provide mathematical formulas required to calculate the correct answer.
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56
A 120-pound patient received 108 mg of 2% lidocaine. How many mg of 4% articaine can this patient receive? Provide mathematical formulas to calculate the correct answer.
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57
Complete the missing information in the table below.


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