Mepivacaine: a closer look at its properties and current utility

Self-Instruction Exercise No. 360
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Exercise No. 360
Subject Code: 132
Anesthesia and Pain Control

The 15 questions for this exercise are based on the article, “Mepivacaine: a closer look at its properties and current utility”, on pages 70-75. This exercise was developed by Anthony S. Carroccia, DDS, MAGD, ABGD, in association with the General Dentistry Self-Instruction committee.

Reading the article and successfully completing this exercise will enable you to:

  • identify mepivacaine’s properties;
  • recognize potential clinical implications; and
  • differentiate between mepivacaine and other local anesthetics.

Answers for this exercise must be received by October 31, 2015.
  1. Mepivacaine was first synthesized in which year?

    A. 1957
    B. 1982
    C. 1993
    D. 2007

  2. All of the following anesthetics are classified as intermediate for lipid solubility and anesthetic potencies. Which is the exception?

    A. mepivacaine
    B. articaine
    C. lidocaine
    D. prilocaine

  3. All of the following local anesthetics are considered pipecholyl xylidines except one. Which is the exception?

    A. mepivacaine
    B. bupivacaine
    C. ropivacaine
    D. lidocaine

  4. Bupivacaine differs from mepivacaine by the substitution of a(n)

    A. aromatic ring.
    B. tertiary amine.
    C. ethyl group.
    D. butyl group.

  5. Mepivacaine loses _____% of relative anesthetic potency in infected tissues.

    A. 27.2
    B. 64.7
    C. 66.5
    D. 72.8

  6. Mepivacaine has the largest increase in the cardiotoxic dose. This is because it is correlated to relative potency.

    A. Both statements are true.
    B. The first statement is true; the second is false.
    C. The first statement is false; the second is true.
    D. Both statements are false.

  7. Cross-reactivity among the amide anesthetics, though rare, was found in _____ cases, all between lidocaine and mepivacaine.

    A. 6
    B. 8
    C. 16
    D. 38

  8. Thirty years ago, case reports of allergic reactions to mepivacaine were due to which agent?

    A. metabisulphite
    B. methylparaben
    C. vasodilator
    D. vasoconstrictor

  9. Which of the following local anesthetics demonstrated a marked increase in arterial blood flow?

    A. cocaine
    B. lidocaine
    C. mepivacaine
    D. prilocaine

  10. Which local anesthetic has the most potential for chronic accumulation?

    A. 2% lidocaine
    B. 2% lidocaine with epinephrine
    C. 2% mepivacaine with levonordefrin
    D. 3% mepivacaine

  11. Prilocaine interactions with all of the following drugs may contribute to methemoglobinemia except one. Which is the exception?

    A. carbamazepine
    B. glyburide
    C. phenytoin
    D. acetaminophen

  12. Inhibition of mepivacaine metabolism can be accomplished by all of the following drugs except one. Which is the exception?

    A. Lithobid
    B. Luvox
    C. Paxil
    D. Prozac

  13. All of the following are factors that contribute to pediatric local anesthetic fatalities except one. Which is the exception?

    A. injecting additional anesthetics
    B. number of carpules used
    C. failing to understand synergism of opioids and/or depressants
    D. dosing by weight

  14. Among amide anesthetics, mepivacaine has the slowest total body clearance. Articaine has the fastest total body clearance.

    A. Both statements are true.
    B. The first statement is true; the second is false.
    C. The first statement is false; the second is true.
    D. Both statements are false.

  15. Which cytochrome has the major role when metabolizing mepivacaine?

    A. CYP1A1
    B. CYP1A2
    C. CYP3A
    D. CYP3A4

Evaluation
Please respond to the statements below, using the following scale:
1 Poor; 2 Below average; 3 Average; 4 Above average; 5 Excellent
Practicality of the content 1 2 3 4 5
Benefit to your clinical practice 1 2 3 4 5
Quality of illustrations 1 2 3 4 5
Clarity of objectives 1 2 3 4 5
Clarity of exercise questions 1 2 3 4 5
Relevance of exercise questions 1 2 3 4 5
 
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Did this article present new information? Yes No
How much time did it take you to complete this exercise? mins

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