A 48 year old woman goes to a dermatologist to have a mole removed. The patient tells her physician that she had allergic reaction to a local anaesthetic the last time she had dental work performed. Examination of her dental records by her dentist reveals that the patient received procaine for a tooth extraction. Which of the following drugs would be appropriate for the present procedure?

There are two classes of local anaesthetics: esters and amides. The rule of thumb is that if you are allergic to one drug in a given class (usually the ester class), you also will be allergic to other drugs of the same class. In this question, the patient recevied procaine, which is an ester. Therefore you need to identify the amide in the list of answers. The only amide listed is the Mepivacaine. Other amide local anaesthetics include lidocaine, bupivacaine, etidocaine, prilocaine and ropivacaine.