Pain Control Flashcards
Acetaminophen
Type: Nonopioid analgesic, Antipyretic
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MOA:
May work peripherally to block pain impulse generation and inhibit prostaglandin synthesis in the CNS
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Indications: Pain and fever control
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Contraindications: Known hypersensitivity | Severe active liver disease
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Adverse Reactions: Nausea | Upper abdominal pain | Skin rash | Itching | Loss of appetite | An OD can cause hepatotoxicity
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Drug Interactions: Increased effect with caffeine | Decreased effect with antacids, anticholinergics, carbamazepine, phenytoin | Alcohol may increase hepatotoxicity risk
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Dosages:
Adult.
Give 15 mg/kg orally; Maximum dose is 1 g
Paediatric.
Fibrile Siezures: Give 15 mg/kg; Maximum dose is 650 mg; orally/PR/IV/IO
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Duration: Onset: 10 to 30 minutes | Peak effect: 30 to 60 minutes | Duration: 4 to 6 hours
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Special Conditions: Pregnancy safety: Category B | Limited dose of 325 mg when combined with other drugs
Acetic Acid (Vinegar)
Type: Otic anti-infective, Irrigating solution
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MOA:
Provides an acidic medium during irrigation of the ear that minimizes bacterial and fungal promulgation | Stabilizes nematocyst discharge in jellyfish found outside the United States, which would decrease the pain
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Indications: Otitis externa | Pain control for envenomation by jellyfish from outside the United States
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Contraindications: Hypersensitivity | Perforated tympanic membranes | May increase nematocyst discharge for US jellyfish and should be used only outside the United States
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Adverse Reactions: Skin irritation | Sensitivity | Stinging sensation
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Drug Interactions: N/A
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Dosages:
Adult and Paediatrics.
Position the patient on the side with the affected ear uppermost; Instill 4 to 6 drops into the external ear, and repeat every 2 to 3 hours
For jellyfish stings outside the US, rinse the area with vinegar for 30 seconds to limit the discharge of unfired nematocysts remaining on the skin
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Duration: Onset: 5 minutes | Peak effect: 45 to 90 minutes | Duration: 2 to 3 hours
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Special Conditions: Pregnancy safety: Category C | Safety and efficacy have not been established in children younger than 3 years
Aspirin (Acetylsalicylic Acid)
Type: Platelet inhibitor, NSAID, Anti-inflammatory agent
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MOA:
Prevents thromboxane A2 formation to prevent platelet aggregation and plug formations | Has antipyretic and analgesic properties
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Indications: New-onset chest discomfort suggestive of ACS
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Contraindications: Hypersensitivity to ASA or NSAIDs | Bleeding disorders | Hemolytic anemia | Lactating mothers
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Adverse Reactions: Anaphylaxis | Bronchospasm/wheezing in allergic patients | GI bleeding | Epigastric distress | N/V | Heartburn | Reye syndrome
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Drug Interactions: Increased risk of bleeding with anticoagulants and other NSAIDs | Diminished effects of ACE inhibitors and loop diuretics | Antacids reduce ASA absorption | Increased risk of hypoglycemia occurs with administration of oral hypoglycemic drugs | Effects are decreased by corticosteroids | Increased bleeding can occur when ASA is taken with certain herbs (ex: quai, feverfew, garlic, ginger, ginkgo, Korean ginseng, and saw plametto - because these herbs interfere w/ platelet aggregation)
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Dosages:
Adult.
162 mg to 325 mg orally (chewable)
Paediatric.
Not recommended
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Duration: Onset: 15 to 30 minutes | Peak effect: 1 to 2 hours | Duration: 4 to 6 hours
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Special Conditions: Pregnancy safety: Category D | If there are no contraindications, non–enteric-coated, chewable aspirin should be given as soon as possible to all patients with a suspected ACS after symptom onset
FentanNYL Citrate (Sublimaze)
Type: Opioid analgesic; Synthetic opioid; Schedule II drug
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MOA:
Binds to opioid receptors, producing analgesia, euphoria, respiratory depression, and sedation
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Indications: Pain management | Anesthesia adjunct | Severe respiratory distress (palliative care)
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Contraindications: Known hypersensitivity; Patients who have taken an MAOI in the previous 14 days | Administer with caution to patients with a Glasgow Coma Scale (GCS) score less than 15 | Hypotension | Hypoxia after maximal supplemental oxygen therapy | Signs of hypoventilation
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Adverse Reactions: Confusion | Paradoxical excitation | Delirium | Drowsiness | CNS depression | Sedation | Respiratory depression | Apnea/dyspnea | Dysrhythmias | Hypotension | Syncope | N/V | abdominal pain | Dehydration/fatigue
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Drug Interactions: Increased respiratory depressant effects when paired with other CNS depressants
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Dosages:
Adult.
Severe respiratory distress: 25 mcg mixed in 2 mL saline nebulized
Moderate discomfort: 1 mcg/kg IM/IN (Maximum initial dose: 100 mcg; maximum total dose: 200 mcg)
Severe to excruciating discomfort: 1 mcg/kg IV/IO (Maximum initial dose: 100 mcg; maximum total dose: 200 mcg)
Paediatric.
Moderate discomfort: 1 mcg/kg IM/IN (Maximum initial dose: 100 mcg; maximum total dose: 200 mcg)
Severe to excruciating discomfort: 1 mcg/kg IV/IO (Maximum initial dose: 100 mcg; maximum total dose: 200 mcg)
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Duration: Onset: Immediate | Peak effect: 3 to 5 minutes | Duration: 30 to 60 minutes
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Special Conditions: Pregnancy safety: Category C | Opioid overdose may lead to chest wall rigidity and require positive end-expiratory pressure with doses of naloxone | Document pain severity on a scale of 0 to 10 before and after administration and on arrival
HYRDROmorphone (Dilaudid)
Type: Synthetic opioid analgesic; Schedule II drug
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MOA:
Opioid agonist-analgesic of opioid receptors; Inhibits ascending pain pathways; Increases the pain threshold; Produces analgesia, respiratory depression, and sedation
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Indications: Management of acute moderate to severe pain
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Contraindications: Known hypersensitivity | MAOI use during the previous 14 days | GI obstruction | Administer with caution in: Older adults; Patients with a GCS score less than 15; and Patients with hypotension, hypoxia, signs of hypoventilation, head injury, or concomitant use of CNS depressants
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Adverse Reactions: Dizziness/headache | Drowsiness/weakness | Hypotension | Syncope | Apnea
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Drug Interactions: MAOIs | SSRIs | Concurrent use with other CNS depressants can induce severe respiratory and/or CNS depression
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Dosages:
Adult and Paediatrics.
0.015 mg/kg IM, IV, or IO ; Maximum initial dose: 2 mg ; Maximum cumulative dose: 4 mg
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Duration: Onset: Variable IM ; 5 minutes IV ; 15 to 30 minutes oral | Peak effect: Variable IM ; 10 to 20 minutes IV ; 30 to 60 minutes oral | Duration: 2 to 3 hours
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Special Conditions: Pregnancy safety: Category C | 5 to 7 times more potent than morphine, with a shorter duration of analgesia | Respiratory depression is managed with naloxone | Document pain severity using a scare of 0 to 10 before and after administration and on arrival
Ibuprofen (Advil, Motrin)
Type: NSAID, Nonopoid analgesic
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MOA:
Inhibits prostaglandin synthesis, thereby reducing swelling, pain, and fever
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Indications: Acute pain management | Antipyretic
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Contraindications: Known ASA/NSAID hypersensitivity | ASA-sensitive asthma | Significant renal function impairment | Pregnancy | Known peptic ulcer disease | Active intracranial hemorrhage or GI bleeding | Thrombocytopenia | Coagulation defects | Proven or suspected necrotizing enterocolitis | Perioperative pain in the setting of coronary artery bypass graft surgery
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Adverse Reactions: Headache, dizziness, drowsiness, fatigue, restless sleep | Thirst/sweating | Tingling or numbness in hands and feet | Tinnitus | Blurred vision and eye irritation | Fluid retention | Nausea/vomiting | Frequent urination
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Drug Interactions: Additive risk for bleeding if given in combination with other agents that affect hemostasis (ex: ASA and other antiplatelet drugs, anticoagulants, SSRIs, SNRIs, and other NSAIDS) | Alfalfa, anise, and bilberry may enhance adverse effects | May diminish the antihypertensive effect of HydrALAZINE | May diminish the diuretic effect of loop, thiazide, and thiazide-like diuretics | TCAs may enhance the NSAID antiplatelet effects | May increase bleeding time in patients taking anticoagulants
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Dosages:
Adult.
Give 10 mg/kg orally for patients older than 6 months (max dose: 800mg)
Paediatric.
Febrile seizures: 10 mg/kg orally, if able to swallow (max dose: 600mg)
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Duration: Onset: 30 to 60 minutes | Peak effect: 1 to 2 hours | Duration: 6 to 8 hours
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Special Conditions: Increased risk of heart attack or stroke in patients with or without heart disease or risk factors for heart disease | Increased risk of heart failure
Ketamine (Ketalar)
Type: Analgesic, General anesthetic, Dissociative anesthetic ; Schedule III drug
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MOA:
Blocks pain receptors and minimizes spinal cord activity, affecting the brain’s association pathways between the thalamus and the limbic system
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Indications: Procedural sedation | Management of agitated or violent behavior | pain control
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Contraindications: Known hypersensitivity | Infants younger than 3 months of age | Pregnancy | Angina | Heart failure | Symptomatic hyperthyroidism | Known or suspected schizophrenia | Conditions where hypertension would be hazardous to a patient’s care | Use with caution in any patient with the potential for increased ICP
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Adverse Reactions: Hypertension | Hallucinations | Nausea/vomiting | Nystagmus | Bronchodilation | Tachycardia | Increased secretions | Hypersalivation | Laryngospasm | Respiratory depression | Mild to moderate elevations in BP and heart rate
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Drug Interactions: Ketamine may enhance the CNS depressant effects of alcohol, cannabis, opioids, barbiturates, and nondepolarizing neuromuscular blockers | St. John’s wort can reduce its effectiveness
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Dosages:
Adult.
Procedural sedation: Give 1 to 2 mg/kg IV push over 1 to 2 minutes
Moderate pain control: 0.5 mg/kg IN (maximum initial dose: 55 mg; maximum total dose: 100 mg)
Severe to excruciating pain control: 0.25 mg/kg IM/IV/IO (maximum initial dose: 25 mg; maximum total dose: 100 mg)
Chemical restraint: 2 mg/kg IV or 4 mg/kg IM
Paediatric.
Procedural sedation: 1 to 2 mg/kg IV/IO push over 1 to 2 minutes
Chemical restraint: 1 mg/kg IV or 3 mg/kg IM
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Duration: Onset: 30 seconds | Peak effect: 30 seconds to 5 minutes | Duration: 10 to 15 minutes
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Special Conditions: Pregnancy safety: Category N (not classified) ; Contraindicated for pregnancy or breastfeeding pts | Dissociative anesthetic - pts can be conscious but insensitive to pain and have short-term amnesia| Shorter acting and less toxic that PCP | Some patients may experience an emergence reaction after the full duration of the medication’s effect, which may last a few hours
Ketorolac Tromethamine (Toradol)
Type: NSAID, Nonopoid analgesic
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MOA:
Potent analgesic that inhabits prostaglandin synthesis; Does not have any sedative or anxiolytic properties
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Indications: Acute management of moderate to severe pain
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Contraindications: NSAID or ASA allergy | ASA-sensitive asthma | Renal insufficiency | Pregnancy/Labour/Breastfeeding | Known peptic ulcer disease | Hypotension | Significant renal impairment | Previous or current GI bleeding | Intracranial bleeding | Coagulation defects | Patients at high risk of bleeding | Use with caution in older patients due to a higher risk of renal and fatal GI adverse reactions
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Adverse Reactions: Drowsiness | Dizziness/headache | Sedation | Bronchospasm | Dyspnea | Edema | Vasodilation | Hypotension/hypertension | GI bleeding | Diarrhea | Dyspepsia | Nausea
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Drug Interactions: May increase bleeding time in patients taking anticoagulants | TCAs may enhance the NSAID antiplatelet effects
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Dosages:
(One-time dose only)
Adult.
Moderate discomfort: 30 mg IM in adults who are not pregnant
Severe to excruciating discomfort: 15 mg IV in adults who are not pregnant
Geriatric.
Moderate discomfort: 1 mg/kg IM (maximum dose: 30 mg)
Paediatric (2 - 16 years old).
Moderate discomfort: 1 mg/kg IM (maximum dose: 30 mg)
Severe to excruciating discomfort: 0.5 mg/kg IV (maximum dose: 15 mg)
Febrile seizures: 1 mg/kg IV (maximum dose: 15 mg) if unable to swallow
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Duration: Onset: 10 minutes | Peak effect: 1 to 2 hours | Duration: 2 to 6 hours
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Special Conditions: Pregnancy safety: Category C ; Contraindicated to pregnant and breastfeeding pts | Use caution if pain is possibly from a traumatic source | Document pain severity using a scale of 0 to 10 before and after administration and on arrival at the receiving facility
Meperidine Hydrochloride (Demerol)
Type: Opioid analgesic; Synthetic opioid; Schedule II drug
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MOA:
Synthetic opioid analgesic whose effects on the CNS and smooth muscle organs are similar to those of morphine; Primarily acts as an analgesic and a sedative
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Indications: Analgesia for moderate to severe pain
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Contraindications: Known hypersensitivity | Diarrhea caused by poisoning | Patients who have taken an MAOI during the previous 14 days | During labor or delivery for a premature infant | Administer with caution to patients with: A GCS score less than 15, Hypotension, Hypoxia after maximal supplemental oxygen therapy, Signs of hypoventilation | Decrease the dose for patients with hepatic or renal insufficiency
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Adverse Reactions: Seizures | Confusion | Sedation | Headache | Hallucinations | Increased ICP | Respiratory depression | Apnea | Hypotension/orthostatic hypotension | Syncope | Dysrhythmias | Nausea/vomiting | Constipation | Sweating
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Drug Interactions: Additive CNS depression with TCAs, alcohol, or other CNS depressants
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Dosages:
Adult.
50 to 100 mg IM ; 25 to 50 mg slowly IV/IO
Paediatric.
Not recommended
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Duration: Onset: 10 to 15 minutes IM ; Within 1 minute IV | Peak effect: Within 60 minutes IM ; 5 to 7 minutes IV | Duration: 2 to 4 hours IV
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Special Conditions: Pregnancy safety: Category C | Use with caution in patients with asthma and COPD | May aggravate seizures in patients with known convulsive disorders | Has a shorter duration of action than morphine | Effects are reversible with naloxone | Document pain severity using a scale of 0 to 10 before and after administration and on arrival
Morphine sulfate (Roxanol, MS Contin)
Type: Opioid analgesic; Schedule II drug
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MOA:
Alleviates pain through CNS action | Suppresses the fear and anxiety centers in the brain | Depresses brainstorm respiratory centers | Increases peripheral venous capacitance and decreases venous return | Decreases preload and afterload, which decreases myocardial oxygen demand
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Indications: Management of acute pain
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Contraindications: Known hypersensitivity | Patients who have taken an MAOI during the previous 14 days | Paralytic ileus | Toxin-mediated diarrhea | Heart failure due to chronic lung disease | Head injuries | Brain tumors | Delirium tremens | Seizure disorders | During labor when premature birth is anticipated | Acute or severe bronchial asthma | Upper airway obstruction | Administer with caution to patients with: A GCS score less than 15, Hypotension, Hypoxia after maximal supplemental oxygen therapy, Signs of hypoventilation
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Adverse Reactions: Confusion | Sedation | Headache | CNS depression | Respiratory depression | Apnea | Bronchospasm | Dyspnea | Hypotension/orthostatic hypotension | Syncope | Bradycardia | Tachycardia | Nausea/vomiting | Dry mouth
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Drug Interactions: Additive effects with other CNS depressants | MAOIs may cause paradoxical excitation
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Dosages:
Adult.
Moderate discomfort: 0.1 mg/kg IM (maximum dose: 15 mg)
Severe to excruciating discomfort: 0.1 mg/kg slow IV/IO (maximum dose: 10 mg)
STEMI: Initial dose: 2 to 4 mg slow IV (over 1 to 5 minutes) Repeat dose: 2 to 8 mg at 5- to 15-minute intervals
NSTEMI/unstable angina: 1 to 5 mg slow IV push only if symptoms are not relieved by nitrates, provided additional therapy is used to manage the underlying ischemia
Paediatric. 0.1 to 0.2 mg/kg per dose IV/IO/IM (maximum dose: 5 mg)
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Duration: Onset: Immediate | Peak effect: 20 minutes | Duration: 2 to 4 hours
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Special Conditions: Pregnancy safety: Category C ; use caution in pregnant and breastfeeding pts ; morphine rapidly crosses the placenta ; Safety in neonates has not been established | Use with caution in older patients, those with asthma, and those susceptible to CNS depression | The effects are reversible with naloxone | Document pain severity using a scale of 0 to 10 before and after administration and on arrival | Do NOT abbreviate to avoid confusion with magnesium sulfate
Nitroglycerin (NGT)
Type: Vasodilator, Nitrate, Antianginal
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MOA:
Smooth muscle relaxant, which acts on the vasculature, bronchial, uterine, and intestinal smooth muscle | Dilated peripheral arterioles and veins | Reduces peripheral vascular resistance, preload, and afterload, decreasing the heart’s workload and myocardial oxygen demand
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Indications: Ischemic-type chest pain | Acute and symptomatic hypertension | Heart failure | Pulmonary edema
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Contraindications: Known hypersensitivity | Hypotension | Hypovolemia | Intracranial bleeding or head injury | Pericardial tamponade | Severe bradycardia or tachycardia | RV infarction | Previous administration of sildenafil or vardenafil within 24 hours or tadalafil within 48 hours | Use with caution in patients with: Hepatic disease, Anemia, Diabetes mellitus, Pregnancy, Breastfeeding
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Adverse Reactions: Headache | Dizziness | Weakness | Reflex tachycardia | Syncope | Hypotension | N/V | Dry mouth | Muscle twitching | Diaphoresis
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Drug Interactions: Increased hypotensive effect with alcohol, beta blockers, calcium channel blockers, antihypertensives, benzodiazepines, phenothiazines, and other vasodilators | Incompatible with other drugs given IV | Hawthorn increases NTG levels
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Dosages:
Adult.
SL: 0.3 to 0.4 mg; may repeat in 3 to 5 minutes to a maximum of 3 doses
Spray: 1 or 2 sprays; may repeat in 3 to 5 minutes to a maximum of 3 doses
NTG IV: 12.5 to 25 mcg bolus (if no SL or spray is given), then begin 10 mcg/min infusion, increase by 10 mcg/min every 3 to 5 minutes until symptom response or desired effect (maximum dose: 200 mcg/min)
Paediatric.
Not recommended
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Duration: Onset: 1 to 3 minutes | Peak effect: 5 to 10 minutes | Duration: 20 to 30 minutes SL ; 1 to 10 minutes after discontinuation of IV infusion
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Special Conditions: Pregnancy safety: Category C ; has been used safely during pregnancy ; use caution w/ breastfeeding women and monitor infants for adverse effects | Hypotension is more common in older patients | If a 12-lead ECG shows an inferior wall infarct, rule out RV infarction via right-side 12-lead ECG before administering NTG | It must be kept in an airtight container | IV NTG must be administered only with an infusion pump direct from the bottle with a vented IV set and non-polyvinyl chloride tubing | The active ingredient may have stinging effect when administered
Nitrous oxide 50:50 (Nitronox)
Type: Gaseous analgesic & Anesthetic
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MOA:
Exact mechanism is unknown; the analgesic action is thought to occur by potentiating the release of endogenous endorphins that react w/ opioid receptors in the CNS and alter the pain threshold
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Indications: Analgesia in the patient who can self-administer this medication
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Contraindications: Known hypersensitivity | Impaired level of consciousness | Head injury | Inability to follow or comply with instructions | Decompression illness | Significant respiratory compromise | Suspected abnormal air-filled cavities | Maxillofacial trauma or facial burns | Relative contraindications include: stroke history, hypotension, pregnancy, known cardiac conditions, and known vitamin B12 deficiency
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Adverse Reactions: Light-headedness | Headache | Dizziness | Confusion | N/V | Hallucination
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Drug Interactions: Can potentiate the effects of CNS depressants
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Dosages:
Adult and Paediatric.
Self-administered ; Assess the patient’s ability to self-administer after the initial dose
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Duration: Onset: 2 to 5 minutes | Peak effect: 2 to 5 minutes | Duration: 2 to 5 minutes
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Special Conditions: Pregnancy safety: Category C | Some EMS agencies prohibit use inside ambulances because of the risk of rescuer exposure | It is nonflammable and nonexplosive | It is ineffective in 20% of the population | Document pain severity using a scale of 0 to 10 before and after administration and on arrival at the receiving facility
Lidocaine HCl (Xylocaine)
Type: Antidysrhythmic (Class Ib), Anesthetic
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MOA:
Cardiac: Inhibits recovery after repolarization, thereby inhibiting recovery after repolarization, and decreasing myocardial excitability and conduction velocity | Local anesthetic: Inhibits ion transport across the neuronal membrane, blocking conduciton of normal nerve impulses | RSI: May decreases ICP response during laryngoscopy
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Indications: Alternative to amiodarone in patients with cardiac arrest from: VT, VF ; Stable monomorphic VT ; or Stable polymorphic VT with normal baseline QT interval when ischemia is treated with electrolyte balance is corrected | Can be used for stable polymorphic VT with baseline QT interval prolongation if TdP is suspected | Can be used as a local anesthetic for various procedures
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Contraindications: Hypersensitivity to lidocaine or amide-type local anesthetics, second- or third-degree AV block in the absence of artifical pacemaker, Stokes-Adams syndrome, wide-complex ventricular escape beats w/ bradycardia, Wolff-Parkinson-White Syndrome | Prophylactic use in AMI is contraindicated
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Adverse Reactions: Drowsiness | Confusion | Seizures | Slurred speech | Hypotension | Dysrhythmias | Cardiac arrest | Nausea/vomiting
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Drug Interactions: Apnea induced with succinylcholine may be prolonged by high doses of lidocaine | Cardiac depression may occur in conjunction with administration of IV phenytoin | Procainamide may exacerbate the CNS effects | Metabolic clearance is decreased in patients with liver disease and patients taking beta blockers
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Dosages:
Adult.
Cardiac arrest (pulseless VT/VF): Initial does: 1 to 1.5 mg/kg IV/IO. Repeat dose: 0.5 to 0.75 mg/kg IV/IO repeated in 5 to 10 minutes. Maximum total dose: 3 mg/k.
Maintenance infusion: 1 to 4 mg/min
Stable VT and stable regular wide-complex tachycardia: Initial does: 1 to 1.5 mg/kg IV/IO. Repeat dose: 0.5 to 0.75 mg/kg IV/IO repeated in 5 to 10 minutes. Maximum total dose: 3 mg/kg.
Maintenance infusion: 1 to 4 mg/min
Local anesthetic dose varies depending on the procedure and anatomic location. If IO on a conscious pt, consider 0.5 mg/kg of lidocaine 0.1 mg/mL slow push through the IO to max of 40mg to mitigate pain of IO med administration
Paediatric.
IV/IO dose: 1 mg/kg IV/IO push
Maintenance IV/IO infusion: 20 to 50 mcg/kg/mins. Repeat bolus dose if infusion started more than 15 minutes after initial bolus dose
ET dose: 2 to 3 mg/kg
RSI: 1 to 2 mg/kg IV/IO
Local anesthetic dose varies depending on the procedure and anatomic location
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Duration: Onset: 1 to 5 minutes | Peak effect: 5 to 10 minutes | Duration: 10 to 20 minutes
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Special Conditions: Pregnancy safety: Category B | Reduce the maintenance infusion in the presence of impaired liver function or left ventricular dysfunction | Discontinue the infusion immediately if signs of toxicity develop
Benzocaine Spray (Hurricane)
Type: Topical anesthetic
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MOA:
Prevents impulse transmission along sensory nerve fibers and at nerve endings
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Indications: Topical anesthetic (ex at larygnx, mouth, trachea, nasal cavity) to facilitate passage of diagnostic and tx devices | Suppresses the pharyngeal and tracheal gag reflex
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Contraindications: Hypersensitivity to benzocaine or other “caine” anesthetics
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Adverse Reactions: Signs of methemoglobinemia (include pale, gray- or blue-coloured skin, lips, and nail beds) | Headache, light-headedness, shortness of breath | Anxiety, fatigue, and tachycardia
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Drug Interactions: Rare and sometimes fatal cases of methemoglobinemia related to the topical or oromucosal benzocaine products | Nitrites and nitrates may induce methemoglobin formation
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Dosages:
Adult.
0.5- to 1-second spray; Repeat as needed
Paediatric.
0.25- to 0.5-second spray; Repeat as needed
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Duration: Onset: Immediate | Peak effect: Less than 5 minutes | Duration: 15 to 20 minutes
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Special Conditions: Pregnancy safety: Category C | Quantity in a single spray varies among different manufacturers | Potentially dangerous methemoglobin levels from use in the mouth and throat
Proparacaine Opthalmic (Alcaine, Ophthaine)
Type: Topical opthalmic anesthetic
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MOA:
Produces local anesthesia by blocking sodium ion channels, thereby stopping cellular depolarization and preventing the action potential development of nerve impulses at the ophthalmic pain nerve cell membrane
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Indications: Induction of topical anesthesia before eye irrigation in the management of a chemical injury to the eye
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Contraindications: Known hypersensitivity | Known or suspected trauma that may have results in intraocular injury | Use with caution in patients with cardiac disease or hyperthyroidism
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Adverse Reactions: Temporary stinging, burning, and conjunctival redness
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Drug Interactions: Data unavailable
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Dosages:
Adult and Paediatric.
1 to 2 drops in the affected eye(s)
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Duration: Onset: 15 to 60 seconds | Peak effect: 30 to 120 second | Duration: 10 to 20 minutes
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Special Conditions: Pregnancy safety: Category C | Each bottle is for single-patient use | The corneal epithelium may become dry during use | Instruct the patient not to rub, touch, or wipe the affected eye because the affected eye will be insensitive to touch for as long as 20 minutes after use
