Epinephrine Contraindication — NDEB AFK MCQ
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Correct answer: E — Pheochromocytoma
Pheochromocytoma (a catecholamine-secreting tumour of the adrenal medulla) is an absolute contraindication for epinephrine use in dental local anaesthesia. Exogenous epinephrine can trigger a catecholamine crisis with severe hypertension, tachycardia, and potentially fatal cardiac arrhythmias or stroke. Other absolute contraindications include uncontrolled hyperthyroidism, recent (within 6 months) MI or CVA, unstable angina, and certain cardiac arrhythmias. Mepivacaine 3% without vasoconstrictor is the alternative.
Reference: Malamed – Handbook of Local Anesthesia, 7th ed., 2020