Which local anesthetic is most classically associated with methemoglobinemia when given in large doses?

  • Correct answer

    Prilocaine

  • Lidocaine

  • Mepivacaine

  • Bupivacaine

This question is one of 15 in AFK practice: Pharmacology, local anesthesia and emergencies. Test yourself on all of them.

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Explanations

  • Prilocaine is metabolized to o-toluidine, which oxidizes hemoglobin to methemoglobin. Lidocaine is metabolized in the liver to products that do not typically cause methemoglobinemia at dental doses.

    Source: Malamed, Handbook of Local Anesthesia — oneguy

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