MCQs PHARMACOLOGY: Local anesthetics

001. Local anesthetics produce: a) Analgesia, amnesia, loss of consciousness b) Blocking pain sensation without loss of consciousness c) Alleviation of anxiety and pain with an altered level of consciousness d) A stupor or somnolent state


002. A good local anesthetic agent shouldn’t cause: a) Local irritation and tissue damage b) Systemic toxicity c) Fast onset and long duration of action d) Vasodilatation


003. Most local anesthetic agents consist of: a) Lipophylic group (frequently an aromatic ring) b) Intermediate chain (commonly including an ester or amide) c) Amino group d) All of the above


004. Which one of the following groups is responsible for the duration of the local anesthetic action? a) Intermediate chain b) Lipophylic group c) Ionizable group d) All of the above


005. Indicate the local anesthetic agent, which has a shorter duration of action: a) Lidocaine b) Procaine c) Bupivacaine d) Ropivacaine


006. Which one of the following groups is responsible for the potency and the toxicity of local anesthetics? a) Ionizable group b) Intermediate chain c) Lipophylic group d) All of the above


007. Indicate the drug, which has greater potency of the local anesthetic action: a) Lidocaine b) Bupivacaine c) Procaine d) Mepivacaine


008. Ionizable group is responsible for: a) The potency and the toxicity b) The duration of action c) The ability to diffuse to the site of action d) All of the above


009. Which one of the following local anesthetics is an ester of benzoic acid? a) Lidocaine b) Procaine c) Ropivacaine d) Cocaine


010. Indicate the local anesthetic, which is an ester of paraaminobenzoic acid: a) Mepivacaine b) Cocaine c) Procaine d) Lidocaine


011. Which of the following local anesthetics is an acetanilide derivative? a) Tetracaine b) Lidocaine c) Cocaine d) Procaine


012. Indicate the local anesthetic, which is a toluidine derivative: a) Lidocaine b) Bupivacaine c) Prilocaine d) Procaine


013. Which of the following local anesthetics is a thiophene derivative? a) Procaine b) Ultracaine c) Lidocaine d) Mepivacaine


014. Local anesthetics are: a) Weak bases b) Weak acids c) Salts d) None of the above


015. For therapeutic application local anesthetics are usually made available as salts for the reasons of: a) Less toxicity and higher potency b) Higher stability and greater lipid solubility c) Less local tissue damage and more potency d) More stability and greater water solubility


016. Which of the following statements is not correct for local anesthetics? a) In a tissue they exist either as an uncharged base or as a cation b) A charged cationic form penetrates biologic membranes more readily than an uncharged form c) Local anesthetics are much less effective in inflamed tissues d) Low ph in inflamed tissues decreases the dissociation of nonionized molecules


017. Which one of the following statements about the metabolism of local anesthetics is incorrect? a) Metabolism of local anesthetics occurs at the site of administration b) Metabolism occurs in the plasma or liver but not at the site of administration c) Ester group of anesthetics like procaine, are metabolized systemically by pseudocholinesterase d) Amides such as lidocaine, are metabolized in the liver by microsomal mixed function oxidases


018. Indicate the anesthetic agent of choice in patient with a liver disease: a) Lidocaine b) Bupivacaine c) Procaine d) Etidocaine


019. Which of the following local anesthetics is preferable in patient with pseudocholinesterase deficiency? a) Procaine b) Ropivacaine c) Tetracaine d) Benzocaine


020. The primary mechanism of action of local anesthetics is: a) Activation of ligand-gated potassium channels b) Blockade of voltage-gated sodium channels c) Stimulation of voltage-gated N-type calcium channels d) Blockade the GABA-gated chloride channels


021. Which of the following local anesthetics is more water-soluble? a) Tetracaine b) Etidocaine c) Procaine d) Bupivacaine


022. Indicate the local anesthetic, which is more lipid-soluble: a) Bupivacaine b) Lidocaine c) Mepivacaine d) Procaine


023. The more lipophylic drugs: a) Are more potent b) Have longer duration of action c) Bind more extensively to proteins d) All of the above


024. Which of the following fibers is the first to be blocked?a) Type A alpha fibers b) B and C fibers c) Type A beta fibers d) Type A gamma fibers


025. Indicate the function, which the last to be blocked: a) Pain, temperature b) Muscle spindles c) Motor function d) Touch, pressure


026. Which of the following fibers participates in high-frequency pain transmission? a) Type A delta and C fibers b) Type A alpha fibers c) Type B fibers d) Type A beta fibers


027. Which of the following local anesthetics is an useful antiarrhythmic agent? a) Cocaine b) Lidocaine c) Bupivacaine d) Ropivacaine


028. Indicate the route of local anesthetic administration, which is associated with instillation within epidural or subarachnoid spaces: a) Topical anesthesia b) Infiltrative anesthesia c) Regional anesthesia d) Spinal anesthesia


029. The choice of a local anesthetic for specific procedures is usually based on: a) The duration of action b) Water solubility c) Capability of rapid penetration through the skin or mucosa with limited tendency to diffuse away from the site of application d) All of the above


030. Which of the following local anesthetics is a short-acting drug? a) Procaine b) Tetracaine c) Bupivacaine d) Ropivacaine


031. Indicate the local anesthetic, which is a long-acting agent: a) Lidocaine b) Bupivacaine c) Procaine d) Mepivacaine


032. The anesthetic effect of the agents of short and intermediate duration of action can not be prolonged by adding: a) Epinephrine b) Norepinephrine c) Dopamine d) Phenylephrine


033. A vasoconstrictor does not: a) Retard the removal of drug from the injection site b) Hence the chance of toxicity c) Decrease the blood level d) Reduce a local anesthetic uptake by the nerve


034. Vasoconstrictors are less effective in prolonging anesthetic properties of: a) Procaine b) Bupivacaine c) Lidocaine d) Mepivacaine


035. Which of the following local anesthetics is only used for surface or topical anesthesia? a) Cocaine b) Tetracaine c) Procaine d) Bupivacaine


036. Indicate the local anesthetic, which is mainly used for regional nerve block anesthesia: a) Dibucaine b) Bupivacaine c) Tetracaine d) Cocaine


037. Which of the following local anesthetics is used for infiltrative and regional anesthesia? a) Procaine b) Lidocaine c) Mepivacaine d) All of the above


038. Indicate the local anesthetic, which is used for spinal anesthesia: a) Tetracaine b) Cocaine c) Dibucaine d) Bupivacaine


039. Which of the following local anesthetics is called a universal anesthetic? a) Procaine b) Ropivacaine c) Lidocaine d) Bupivacaine


040. Most serious toxic reaction to local anesthetics is: a) Seizures b) Cardiovascular collapse c) Respiratory failure d) All of the above


041. Correct statements concerning cocaine include all of the following EXCEPT: a) Cocaine is often used for nose and throat procedures b) Limited use because of abuse potential c) Myocardial depression and peripheral vasodilatation d) Causes sympathetically mediated tachycardia and vasoconstriction


042. Which of the following local anesthetics is more cardiotoxic? a) Procaine b) Bupivacaine c) Lidocaine d) Mepivacaine


043. Most local anesthetics can cause: a) Depression of abnormal cardiac pacemaker activity, excitability, conduction b) Depression of the strength of cardiac contraction c) Cardiovascular collapse d) All of the above


044. Which one of the following local anesthetics causes methemoglobinemia? a) Prilocaine b) Procaine c) Lidocaine d) Ropivacaine


045. Procaine has all of the following properties EXCEPT: a) It has ester linkage b) Its metabolic product can inhibit the action of sulfonamides c) It readily penetrates the skin and mucosa d) It is relatively short-acting


046. Correct statements concerning lidocaine include all of the following EXCEPT: a) It is an universal anesthetic b) It has esteratic linkage c) It widely used as an antiarrhythmic agent d) It is metabolized in liver


047. Which of the following local anesthetics is more likely to cause allergic reactions? a) Lidocaine b) Bupivacaine c) Procaine d) Ropivacaine


048. Tetracaine has all of the following properties EXCET a) Slow onset b) Low potency c) Long duration d) High toxicity


049. Correct statements concerning bupivacaine include all of the following EXCEPT: a) It has low cardiotoxicity b) It has amide linkage c) It is a long-acting drug d) An intravenous injection can lead to seizures

 

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