Deck 8: Determining Drug Doses
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Deck 8: Determining Drug Doses
1
What is the formula for calculating the healthy patient's MRD in mg?
Multiply the patient's weight in pounds or kilograms by the absolute MRD per appointment for healthy patients.
2
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
A) 3.24 mg
B) 2.89 mg
C) 40 mg
D) 30 mg
40 mg
3
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 of the above
A) Lidocaine 2% 1:50,000 epinephrine
B) Lidocaine 2% 1:100,000 epinephrine
C) Mepivacaine 3% 1:20,000 levonordefrin
D) All of the above
Lidocaine 2% 1:50,000 epinephrine
4
What is the formula for converting the MRD to number of cartridges?
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5
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) 3 mL of solution
B) 0.3 mL of solution
C) 0.03 mL of solution
D) Never estimate
A) 3 mL of solution
B) 0.3 mL of solution
C) 0.03 mL of solution
D) Never estimate
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6
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
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
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7
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.
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.
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8
What is the name of the local anesthetic that does not follow the above rule and is packaged in a different quantity of solution per individual cartridge?
A) Lidocaine
B) Articaine
C) Mepivacaine
D) Butacaine
A) Lidocaine
B) Articaine
C) Mepivacaine
D) Butacaine
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9
Who determines the maximum doses of local anesthetics used in dentistry?
1) Council on Dental Therapeutics2. United States Pharmacopeial Convention3. American Dental Association4. Drug experts5. Drug manufacturer6. Dental professionals
A) 1, 2, 3, 4, 5, 6
B) 1, 2, 3
C) 4, 5, 6
D) Some other combination
1) Council on Dental Therapeutics2. United States Pharmacopeial Convention3. American Dental Association4. Drug experts5. Drug manufacturer6. Dental professionals
A) 1, 2, 3, 4, 5, 6
B) 1, 2, 3
C) 4, 5, 6
D) Some other combination
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10
What is the MRD of mepivacaine for a 130-lb female patient?
A) 260 mg of mepivacaine
B) 275 mg of mepivacaine
C) 300 mg of mepivacaine
D) 572 mg of mepivacaine
A) 260 mg of mepivacaine
B) 275 mg of mepivacaine
C) 300 mg of mepivacaine
D) 572 mg of mepivacaine
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11
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
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
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12
What is the formula for converting the maximum number of cartridges to milliliters?
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13
What is the formula for calculating the milligrams of anesthetic drug in 1 mL of the selected anesthetic?
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14
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 of the above
A) The patient's weight
B) The patient's health
C) Whether the anesthetic contains a vasoconstrictor or not
D) All of the above
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15
Using the MRD from the previous question,how many cartridges of mepivacaine can this 130-lb female receive?
A) 7.2 cartridges
B) 7.6 cartridges
C) 8.3 cartridges
D) 15.8 cartridges
A) 7.2 cartridges
B) 7.6 cartridges
C) 8.3 cartridges
D) 15.8 cartridges
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16
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
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
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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.
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.
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18
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
A) 1.6 mL
B) 1.7 mL
C) 1.8 mL
D) 2 mL
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19
What is the formula for calculating how many milligrams of anesthetic solution were administered?
A) Subtract the MRD from the absolute MRD.
B) Multiple the percent concentration of local anesthetic agent by 10 mg.
C) Multiple the number of cartridges administered by the milligrams of anesthetic in each cartridge.
D) Multiple the milligrams of anesthetic in each cartridge by the patient's weight.
A) Subtract the MRD from the absolute MRD.
B) Multiple the percent concentration of local anesthetic agent by 10 mg.
C) Multiple the number of cartridges administered by the milligrams of anesthetic in each cartridge.
D) Multiple the milligrams of anesthetic in each cartridge by the patient's weight.
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20
What is the formula for calculating the milligrams of solution in one cartridge of the selected anesthetic?
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21
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.
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.
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22
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.
A) 0.2 mg
B) 1.0 mg
C) 0.04 mg
D) Epinephrine should be used instead of levonordefrin.
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23
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
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
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24
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
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
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25
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
A) Concentration of anesthetic
B) Vasoconstrictor
C) Patient's weight
D) Length of appointment
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26
What is the MRD for articaine for a 115-pound patient?
A) 352 mg/lb
B) 297 mg/lb
C) 230 mg/lb
D) 69 mg/lb
A) 352 mg/lb
B) 297 mg/lb
C) 230 mg/lb
D) 69 mg/lb
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27
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.
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.
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28
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) 0.2 mg.
A) 1.0 mg
B) 0.2 mg
C) 0.04 mg
D) 0.2 mg.
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29
Which local anesthetic should be reduced or not used for a patient with chronic obstructive pulmonary disease?
A) Lidocaine
B) Bupivacaine
C) Prilocaine
D) Mepivacaine
A) Lidocaine
B) Bupivacaine
C) Prilocaine
D) Mepivacaine
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30
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.
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.
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31
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
A) 5.5 cartridges
B) 11.1 cartridges
C) 2.2 cartridges
D) 1.1 cartridges
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32
For what kind of patient should the MRD of local anesthetic agents be decreased?
A) For children
B) For elderly patients
C) For medically compromised patients
D) All of the above
A) For children
B) For elderly patients
C) For medically compromised patients
D) All of the above
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33
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
A) 0.036 mg per cartridge
B) 0.09 mg per cartridge
C) 0.018 mg per cartridge
D) 0.017 mg per cartridge
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