Provided herein are pharmaceutical compositions for local administration of metabolic inhibitors, methods of locally administering such compositions, and rapid diagnostic methods for identifying mutant allele during the course of a surgical procedure Aspects of the present disclosure provide pharmaceutical compositions comprising a population of particles coupled to a nicotinamide adenine dinucleotide (NAD) biosynthesis inhibitor. Other aspects of the present disclosure provide methods of local administration of a metabolic inhibitor, comprising locally administering a therapeutically effective amount of any of the pharmaceutical compositions described herein to a subject in need thereof. Other aspects of the present disclosure provide diagnostic methods comprising obtaining a sample from a subject; and detecting one or more mutations in a target nucleic acid in the sample; wherein the detecting is performed by isolating a nucleic acid comprising the target nucleic acid from the sample, and analyzing the nucleic acid for the presence of one or more allele-specific mutations; and wherein the detecting is performed in an intraoperative timeframe. Other aspects of the present disclosure provide methods of diagnosis and treatment of a cancer in a subject, comprising performing a surgical procedure on the subject; obtaining a sample from the subject; and determining whether the sample contains a one or more mutations in a target nucleotide sequence in the sample; wherein if the sample is determined to contain the one or more mutations, locally administering an agent with mutation selectivity to the subject during the surgical procedure. Other aspects of the present disclosure provide methods comprising performing any of the diagnostic methods described herein and performing any of the methods for local administration of an NAD biosynthesis inhibitor described herein. Yet other aspects of the present disclosure provide kits for the detection of mutant alleles.