Tetracaine


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : Subarachnoid Spinal anesth 1% soln diluted w/ an equal volume of CSF immediately prior to administration and infuse at 1 mL/5 sec. Anesth of perineum: 5 mg. Anesth of perineum and lower extremities: 10 mg. Spinal anesth extending up to the costal margin: 15-20 mg. Low spinal (saddle block) anesth in vag delivery: 2-5 mg as a hyperbaric soln. Ophth Anesth of the eye As 0.5-1% soln or 0.5% oint: Use as directed. Topical Topical anesth As 1% cream or 0.5% oint. For percutaneous local anesth before venepuncture or venous cannulation: Use 4% gel: Apply and cover w/ an occlusive dressing. Remove gel and dressing after 30 mins for venepuncture and after 45 mins for venous cannulation.
Dosage Details
Ophthalmic
Anaesthesia of the eye
Adult: Instil 0.5-1% tetracaine solution or 0.5% ointment.

Subarachnoid
Spinal anaesthesia
Adult: 1% solution diluted with an equal volume of CSF immediately prior to admin or 5 mg of powder dissolved in 1 ml of CSF and admin slowly at a rate of 1 ml/5 sec. For anaesthesia of perineum: 5 mg. For anaesthesia of perineum and lower extremities: 10 mg. For spinal anaesthesia extending up to the costal margin: 15-20 mg. For low spinal (saddle block) anaesthesia in vaginal delivery: 2-5 mg admin as a hyperbaric solution.
Elderly: Dose reduction may be needed.

Topical/Cutaneous
Topical anaesthesia
Adult: Apply as 1% cream or 0.5% ointment. For percutaneous local anaesthesia before venepuncture or venous cannulation: Apply 4% gel to the centre of the area to be anaesthetised and covered with an occlusive dressing. Remove gel and dressing after 30 minutes for venepuncture and after 45 minutes for venous cannulation.
Contraindications
Hypersensitivity to p-aminobenzoic acid or its derivatives, local anaesthesia of the ester type. Low plasma-cholinesterase concentrations, complete heart block. Bronchoscopy or cytoscopy. Application to inflamed, traumatised or highly vascular surfaces. Instillation into the middle ear.
Special Precautions
Topical: avoid prolonged application to eye or skin and rubbing of eyes until anaesthesia has worn off. Spinal anaesthsia: debilitated, elderly, acutely ill, obstetric patients, increased intra-abdominal pressure, cerebrospinal diseases, cardiogenic or hypovolaemic shock, or altered coagulation status. Epilepsy, impaired cardiac conduction or respiratory function, shock, hepatic impairment and myasthenia gravis. Pregnancy.
Adverse Reactions
Topical: Mild erythema at the application site, slight oedema or pruritus, blistering of the skin, stinging sensation. Excessive doses of topical application result in high blood concentrations that can initially produce CNS stimulatory effects (e.g. anxiety, restlessness, seizures, followed by CNS depression (e.g. drowsiness, unconsciousness and respiratory arrest). Long-term eyedrop use cause severe keratitis, permanent corneal opacification and scarring.
Intraspinal/IT/Ophth/Parenteral/Topical: C
Drug Interactions
May antagonise activity of sulfonamides and aminosalicylic acid; increased tetracaine levels with anticholinesterases; increased neuromuscular blocking action of suxamethonium.
Action
Description: Tetracaine acts by preventing the generation and transmission of impulses along nerve fibres and at nerve endings; depolarisation and ion-exchange are inhibited. In general, loss of pain occurs before loss of sensory, autonomic and motor functions.
Onset: 0.5% eyedrop: 25 sec. Topical application to mucosal surfaces: 5-10 min.
Duration: O.5% eyedrop: 15 min. Topical application to mucosal surfaces: 30 min. Gel and dressing: A single application may last for 4-6 hr. Spinal anaesthesia: 1.5-3 hr.
Pharmacokinetics:
Metabolism: Hydrolysed to p-aminobenzoic acid by plasma pseudocholinesterase.
Excretion: Excreted via urine.
Storage
Subarachnoid:
Store between 15-30°C. Do not freeze.
Disclaimer: This information is independently developed by MIMS based on Tetracaine from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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