Question 29 of 46

Unfortunately, that response is incorrect.

The best choice would be Marcaine (epinephrine 1:200,000), Citanest Plain (does not contain epinephrine) and Xylocaine (contains 1:100,000 epinephrine).

The use of vasoconstrictor for someone with significant cardiovascular disease is a relative contraindication, which means that it would be preferable to avoid the drug in question (in this case, epinephrine).

An alternative drug that is not contraindicated should be used, however if this is not possible, the drug in question may be used judiciously. The minimum dose that will provide pain control is to be used. That is why in this situation, Ravocaine would not be appropriate because it contains 1:20,000 neo-cobefrin - that would not be using the amount of vasoconstrictor judiciously. You will recall that a 1:20,000 concentration contains considerably more vasoconstrictor than either a 1:100,000 or 1:200,000 concentration.