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ADEX exam

ADEX Pharmacology Essentials – What You Must Know for the Exam

A streamlined guide to the high-yield drugs, interactions, and safety points ADEX examiners focus on during OSCE and scenario questions.

Quick Answers

What pharmacology topics appear most in ADEX?

Local anesthetics, antibiotics, analgesics, anticoagulants, drug allergies, and medical-dental interactions.

What is the most common ADEX drug error?

Giving the wrong drug to a patient with systemic risk—especially heart disease, diabetes, or anticoagulation.

What antibiotic is first-line for dental infections?

Amoxicillin; use clindamycin for penicillin allergy.

What pain control does ADEX expect?

NSAIDs as first-line, acetaminophen for gastric risk, and avoiding opioids when unnecessary.

What drug must you avoid in uncontrolled hypertension?

High doses of epinephrine-containing anesthetics.

1. What ADEX evaluates in pharmacology

Pharmacology questions in ADEX assess your ability to choose safe medications for common dental scenarios. You are not expected to memorize advanced drug mechanisms—only to recognize safe choices and contraindications.

The exam rewards conservative and medically sound decisions.

2. Local anesthetic essentials

High-yield LA concepts for ADEX:

  • Lidocaine 2% with 1:100,000 epi is standard.
  • Maximum safe dose of lidocaine with epi: 7 mg/kg.
  • Avoid high-epi doses in patients with uncontrolled hypertension or arrhythmias.
  • Mepivacaine 3% (plain) for patients who cannot receive vasoconstrictors.
  • Articaine for infiltration; avoid in specific nerve-block-only contraindications.

3. Antibiotics – simple and predictable

Most tested antibiotics:

  • Amoxicillin: first-line for dental infections.
  • Clindamycin: alternative for penicillin-allergic patients.
  • Amoxicillin + clavulanic acid: used for resistant infections.
  • Azithromycin: alternative but not first-line in ADEX-style questions.

ADEX often tests when not to prescribe antibiotics (e.g., reversible pulpitis, simple caries).

4. Pain control

  • NSAIDs: first-line for most dental pain.
  • Acetaminophen: used when NSAIDs are contraindicated.
  • Combination therapy: NSAID + acetaminophen for severe pain.
  • Opioids: rarely needed—avoid unless absolutely necessary.

5. Anticoagulants – high-yield risk area

ADEX focuses heavily on anticoagulated patients:

  • Warfarin: check INR; safe range generally ≤3.5 for minor procedures.
  • DOACs: time procedures relative to dosing.
  • Antiplatelets (aspirin, clopidogrel): continue unless instructed otherwise.
  • Use local hemostatic measures when performing extractions.

6. Allergies and drug contraindications

Classic ADEX test points:

  • Penicillin allergy → clindamycin or azithromycin.
  • Asthma → avoid NSAIDs if sensitive.
  • Liver disease → reduce acetaminophen.
  • Ulcer history → avoid NSAIDs.
  • Uncontrolled hypertension → minimize epinephrine.

7. Fast memory points

  • Amoxicillin first-line; clindamycin if allergic.
  • NSAIDs first-line for pain.
  • Lidocaine with epi is standard but caution with hypertension.
  • Check INR for warfarin patients.
  • Always consider systemic conditions before choosing medications.

How DentAIstudy helps

With Study Builder, you can generate:

  • Short pharmacology summaries for ADEX.
  • Drug-interaction OSCE scenarios.
  • Flashcards on antibiotic and analgesic choices.
  • Common safe/unsafe drug combinations.

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References

  • CDCA-WREB-CITA Pharmacology expectations.
  • Standard dental drug reference guidelines.
  • Commonly taught dental pharmacology principles.