Pharmacology · single question
Which of the following is the BEST local anesthetic for use in pregnant patients? (Choose the EXCEPTION — which should be AVOIDED?)
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Correct answer: B. Articaine with epinephrine — AVOID in pregnancy
Lidocaine (2%) with epinephrine is the safest and most recommended local anesthetic in pregnancy (FDA Category B). Articaine is FDA Category C (potential risk not ruled out) — it has not been adequately studied in pregnant populations and should be avoided when safer alternatives exist. Lidocaine without epinephrine may also be used but has shorter duration. The exception (to avoid) is articaine.
- A. Incorrect. Lidocaine with epinephrine is FDA Category B and is the PREFERRED local anesthetic in pregnancy — it should NOT be avoided.
- B. CORRECT. Articaine is FDA Category C — it should be avoided in pregnancy because adequate human studies are lacking and safer alternatives (lidocaine) exist.
- C. Incorrect. Lidocaine without epinephrine is safe in pregnancy; it's a correct choice (not the answer to avoid).
- D. Incorrect. Not all amide anesthetics have the same safety profile in pregnancy — lidocaine is Category B, articaine is Category C, bupivacaine is Category C.