ADC Practice Question — Local anaesthetic agents and properties

What is the immediate management priority for Rajesh's…

Pharmacology questions in the ADC written exam test applied prescribing decisions, not rote recall of drug names. This exam-level vignette tests your ability to work through clinical details and arrive at the correct management.

Rajesh Patel, a 58-year-old man, presents for extraction of his lower left first molar. His medical history includes type 2 diabetes mellitus, hypertension controlled with amlodipine and ramipril, and a myocardial infarction 4 months ago. He takes metformin, gliclazide, aspirin, and atorvastatin. The dentist administers 3.6 mL of articaine 4% with adrenaline 1:100,000 for an inferior alveolar nerve block. Ten minutes later, Rajesh becomes restless and anxious, complaining of tinnitus and dizziness. His heart rate increases to 110 bpm, and he appears confused. What is the immediate management priority for Rajesh's condition?

A. Continue with the extraction quickly before anaesthesia wears off
B. Administer intralipid emulsion therapy immediately
C. Stop local anaesthetic administration and provide supportive care
D. Give sublingual glyceryl trinitrate for cardiac protection
E. Administer intravenous diazepam to prevent seizures

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Sources cited

Therapeutic Guidelines v4 Odell's 3rd & 4th Ed IADT 2020 Code of Conduct CMS (Evans) Infection Control + more

Show the answer and cited explanation

Correct answer: C

According to TG, if signs of systemic toxicity occur or are suspected, stop administration of the local anaesthetic and provide appropriate management.

Source: Ch 8: Systemic toxicity of local anaesthetics

Remy's study tip — For pharmacology vignettes, read the patient’s medical history and allergies BEFORE looking at the drug options.

Exam preparation FAQ

Should I memorise guidelines word-for-word for Local anaesthetic agents and properties?

Focus on decision points — when the guideline says X vs Y. The exam tests application, not recitation.

How are Local anaesthetic agents and properties questions structured in the ADC written exam?

ADC Local anaesthetic agents and properties questions present as clinical vignettes requiring management decisions. The correct answer is always traceable to a guideline source.

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