RT Book, Section A1 Potestio, Chris A1 Freeman, Brian S. A2 Freeman, Brian S. A2 Berger, Jeffrey S. SR Print(0) ID 1102566844 T1 Drug Interactions T2 Anesthesiology Core Review: Part One Basic Exam YR 2014 FD 2014 PB McGraw-Hill Education PP New York, NY SN 9780071821377 LK accessanesthesiology.mhmedical.com/content.aspx?aid=1102566844 RD 2024/04/25 AB The formulation of drugs is often overlooked but may contribute to bioavailability and desired effects. For example, adding epinephrine to a local anesthetic solution gives the solution a much lower pH due to highly acidic commercial preparations of epinephrine. A more acidic solution of local anesthetic results in lower concentration of the ionized, membrane permeable form of the local anesthetic. This equilibrium change decreases tissue penetration and diminishes the desired effect.