Mepivacaine Plain Indications — MFDS Part 1 MCQ
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Correct answer: C — A brief restorative procedure when avoiding an adrenaline-containing cartridge is clinically appropriate
Explanation lettering: D = shown as A · E = shown as B · A = shown as C · C = shown as D · B = shown as E
A is correct. In dental practice, a plain local anaesthetic has a shorter duration of action than a preparation containing a vasoconstrictor. Therefore, 3% mepivacaine plain is a reasonable choice for a brief procedure when use of an adrenaline-containing cartridge is clinically inappropriate or best avoided. Adrenaline improves anaesthetic depth and duration, so B, C and D favour an adrenaline-containing preparation rather than mepivacaine plain. Adrenaline also reduces local bleeding through vasoconstriction; therefore, E is not an indication for a plain preparation. The choice should still be individualised: many potential adrenaline interactions can be managed by limiting the dose rather than automatically avoiding adrenaline.
Reference: NHS Specialist Pharmacy Service. Considering interactions with local anaesthetics in dentistry, section "Dental LA cartridges", updated 6 January 2025. https://sps.nhs.uk/articles/considering-interactions-with-local-anaesthetics-in-dentistry/