INTERAÇÃO MEDICAMENTOSA ENTRE DROGAS PSICOESTIMULANES E ANESTÉSICOS LOCAIS COM VASOCONSTRITORES

The association between psychostimulants and local anesthetics containing epinephrine may intensify undesirable cardiovascular reactions, such as increased blood pressure, arrhythmias, and tachycardia. Given this potential risk, it is essential that dental practitioners possess comprehensive knowledge of the possible implications of this pharmacological interaction in order to adopt safe and individualized clinical approaches. This study aimed to conduct an integrative literature review on the drug interactions between psychostimulants and local anesthetics with vasoconstrictors, emphasizing clinical repercussions, professional guidelines, and best practices for safe management in dental settings. The study was based on a bibliographic review of books and scientific articles, using databases such as the Virtual Health Library (BVS), Medline, PubMed, LILACS, and SciELO, limited to the last 10 years. The main findings revealed that pharmacological interactions between psychostimulants and local anesthetics occur primarily due to the synergistic increase in catecholamine availability: while the medications modulate norepinephrine and dopamine levels, the epinephrine in anesthetics further enhances adrenergic stimulation. This combination can lead to dangerous blood pressure spikes, arrhythmias, and unpredictable hemodynamic responses, particularly in patients who chronically use stimulants or consume them in high doses. We conclude that it is crucial for dental professionals to conduct a thorough investigation of the patient’s pharmacological history in order to establish individualized therapeutic strategies that minimize the risk of adverse events, especially cardiovascular ones. Implementing evidence-based strategies, combined with thorough anamnesis, careful clinical evaluation, and a multidisciplinary approach, is fundamental to ensuring safety in the execution of the proposed treatment plan.