Anesthesia · single question
A patient who uses Adderall (amphetamine) needs local anesthesia. What is the primary concern with epinephrine-containing LA?
Show answer and explanation
Correct answer: A. Synergistic increase in heart rate and blood pressure
Amphetamines and cocaine are sympathomimetics. Adding exogenous epinephrine produces additive/synergistic cardiovascular stimulation, risking hypertensive crisis, arrhythmia, or myocardial ischemia. Use vasoconstrictor-free anesthetic (3% mepivacaine or 4% prilocaine plain) or minimize dose and monitor vitals.