Topical Anesthetics

Question 1

Topical Ocular Anesthetics:

Answer 1

Cocaine

Tetracaine

Proparacaine

Benoxinate

Question 2

most common used topical ocular anesthetic because of very few side effect

Answer 2

Proparacaine 0.5% - 1% (ALCAINE)

Question 3

onset of action of proparacaine:

Answer 3

10-20 sec

Question 4

duration of action:

Answer 4

10 - 20mins

Question 5

does not penetrate the cornea and conjunctiva

Answer 5

Proparacaine

Question 6

uses of proparacaine:

Answer 6

• tonometry & Gonioscopy
• minor conjunctival & corneal procedures

Question 7

proparacaine dosage/solution:

Answer 7

0.5% - 1% Proparacaine

Question 8

10x as potent as cocaine

10x more toxic as procaine

Answer 8

Tetracaine

Question 9

tetracaine dosage/solution:

Answer 9

0.5% tetracaine

Question 10

uses of Tetracaine:

Answer 10

• Corneal scraping
• ERG
• Foreign body removal
• Gonioscopy
• Paracentesis
• Suture removal
• Tonometry

Question 11

Tetracaine side effects:

Answer 11

transient stinging & burning sensation

conjunctival redness

Question 12

– alkaloids (lipid soluble) from Erythroxylon coca (natural-occurring), prototype

Answer 12

Cocaine

Question 13

Exhibits both anesthetic & adrenergic agonist activity

Answer 13

Cocaine

Question 14

available dosage/solution of cocaine:

Answer 14

2% / 4% / 10%

Question 15

onset of action of cocaine:

Answer 15

2 - 5 mins

Question 16

duration of action of cocaine:

Answer 16

30mins - 2 hrs

Question 17

• combined with epinephrine, phenylephrine, homatropine or atropine for resistant eyes to mydriasis

Answer 17

Cocaine

Question 18

uses of cocaine:

Answer 18

a. diagnosis of Horner’s syndrome – using 4% -10%
b. forced duction test
c. corneal epithelial debridement – loosed the cornel epithelium
d. dacryocystorhinostomy – using nasal spray
e. deepens anterior chamber after cataract surgery
f. breaks posterior synechiae

Question 19

cocaine dosage for Horner’s syndrome :

Answer 19

4% - 10%

Question 20

ocular Side effect of Cocaine:

Answer 20

corneal epithelial toxicity – grayish pits erosion

Question 21

C/I of Cocaine:

Answer 21

Hypertension

Angle CLOSURE glaucoma

Question 22

• para-aminobenzoic (PABA) acid ester of cocaine (substitute for cocaine)

Answer 22

Benoxinate

Question 23

• has antibacterial property to Pseudomonas aeruginosa, Escherichia coli, Hemophilus influenza and Streptococcus pneumoniae.

Answer 23

Benoxinate

Question 24

Benoxinate dosage/solution:

Answer 24

0.4%

Question 25

benoxinate uses:

Answer 25

Applanation tonometry

Question 26

Anesthetic activity is 10x times that of cocaine and 2x that of tetracaine (amethocaine).

Answer 26

Benoxinate

Question 27

onset of action of Benoxinate:

Answer 27

1 - 15 mins

Question 28

duration of Benoxinate:

Answer 28

20 - 30 mins