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Re: Selegeline/EMSAM + dentist - risk from freezing? » Tony P

Posted by Larry Hoover on February 7, 2008, at 18:22:47

In reply to Selegeline/EMSAM + dentist - risk from freezing?, posted by Tony P on February 7, 2008, at 17:49:06

> I understand anesthetics without any epinephrine are available & I've left a message with my dentist's office asking about that. I don't know about the XXX-ocaine itself, though.

Absolutely true. Adrenaline is used as a vasoconstrictor, and extends the action of the anaesthesia, and reduces bleeding. It's not necessary to get a local with adrenaline. It's just the common way of doing things.

There are two newer drugs, mepivicaine (Carbocaine) and prilocaine (Citanest), that can be used without the adrenaline vasoconstrictor. They are used for patients taking beta blockers and tricyclic antidepressants (and MAOIs), because of the known interactions. Perhaps your dentist is unfamiliar with the MAOI interaction, but he should know about the tricyclic/beta-blocker issue.....the remedy is the same.

Also, there's always nitrous oxide. Or lidocaine (Xylocaine) without epinephrine. But the two -caines I first mentioned are the best options.

You don't need to go off the selegeline.

Lar

 

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