Patient allergic to lidocaine. Which alternative local anesthetic can you use?

Correct answer: C. Mepivacaine (amide — different chemical class, generally safe in lidocaine-allergic patients)

• A. Tetracaine is an ester-type anesthetic; while a different class from lidocaine (an amide), true lidocaine allergy is exceedingly rare and often related to preservatives rather than the amide itself — however, tetracaine is not the answer highlighted here, given the cross-reactivity concerns within the ester class generally.
• B. Pilocarpine is a cholinergic agonist used for salivary stimulation, not a local anesthetic at all, making it inappropriate here.
• C. Correct. Mepivacaine is an amide-type local anesthetic from a different specific chemical structure category, generally considered a safe and effective alternative in patients reporting lidocaine allergy/sensitivity.
• D. Articaine is also an amide, generally well tolerated, but the source material identifies mepivacaine specifically as the answer of choice in this scenario.

Note: For true lidocaine allergy, switching to a different amide (e.g., mepivacaine, bupivacaine) is generally recommended; verify the specific allergy subtype before selecting an alternative.