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Anesthesia · single question

What is the maximum recommended dose of 4% articaine (with epinephrine)?

  1. 7 mg/kg
  2. 4.4 mg/kg
  3. 7.4 mg/kg
  4. 6 mg/kg
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Correct answer: A. 7 mg/kg

The FDA-approved labeling for 4% articaine with epinephrine lists a maximum recommended dose of 7 mg/kg (equivalent to about 3.2 mg/lb), for both adults and pediatric patients 4-16 years old. 4.4 mg/kg is the commonly used conservative pediatric maximum for 2% lidocaine with epinephrine, not articaine.
  • A. The maximum recommended dose of articaine is 7 mg/kg (up to a maximum of 500 mg). Articaine's higher dosing limit compared to lidocaine is due to its rapid hydrolysis by plasma esterases (in addition to hepatic metabolism), reducing systemic toxicity risk.
  • B. 4.4 mg/kg is the maximum dose of 2% lidocaine WITH epinephrine — not articaine.
  • C. 7.4 mg/kg does not correspond to a standard articaine dosing guideline.
  • D. 6 mg/kg does not correspond to the standard articaine maximum dose.

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