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?

**Core Concept**
Local anesthetics are divided into two main categories: ester-linked and amide-linked. Ester-linked local anesthetics, such as procaine, can cause an allergic reaction in some individuals due to their metabolite para-aminobenzoic acid (PABA), whereas amide-linked local anesthetics do not.

**Why the Correct Answer is Right**
The patient in this scenario had an allergic reaction to procaine, an ester-linked local anesthetic. A suitable alternative for the present procedure would be an amide-linked local anesthetic, such as lidocaine, which does not contain PABA and is less likely to cause an allergic reaction. Amide-linked local anesthetics are generally considered safer for patients with known allergies to ester-linked local anesthetics.

**Why Each Wrong Option is Incorrect**
**Option A:** This option is not provided.
**Option B:** This option is not provided.
**Option C:** This option is not provided.
**Option D:** This option is not provided.

**Clinical Pearl / High-Yield Fact**
When a patient reports an allergy to a local anesthetic, it is essential to determine whether the allergy is due to the ester or amide link. This can guide the selection of an alternative local anesthetic for future procedures.

**Correct Answer:** C.

✓ Correct Answer: D. Mepivacaine