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Benzocaine Butamben Tetracaine Brand Names- Cetacaine | Exactacain
What is Benzocaine Butamben Tetracaine
Benzocaine Butamben Tetracaine is a combination of topical anesthetics, available in gel, spray, and liquid formulations, for application to accessible mucous membrane except the eyes.
These products are used for topical anesthesia and mild pain control, including use during procedures such as endoscopy, surgery, or dental procedures. It can be used for gag reflex suppression as well. The onset of anesthesia is less than 1 minute and effects last 30 to 60 minutes.
Benzocaine and tetracaine are more likely than other local anesthetics to cause contact sensitization. The potential for sensitization increases with the duration of contact, and can be avoided with appropriate application technique.
Cases of methemoglobinemia have been reported from improper use of topical benzocaine-containing anesthetic sprays; benzocaine; butamben; tetracaine products should never be delivered in excess of 2-second sprays.
These products are not intended for prolonged application time or use.
Indications
- dental anesthesia
- mild pain
- mucosal anesthesia
- topical anesthesia
For topical anesthesia of all accessible mucous membranes, except the eyes; for the control of mild pain and for mucosal anesthesia during procedures (such as endoscopy or surgery) at sites including the ear, nose, mouth, pharynx, larynx, trachea, bronchi, esophagus, vagina when feasible, or rectum when feasible; for dental anesthesia, including anesthesia to subgingival tissue; and for use to control gagging
What is the Mechanism of Action?
- Benzocaine, butamben, and tetracaine are local anesthetics that cause a reversible blockade of nerve conduction by decreasing nerve membrane permeability to sodium.
- This decreases the rate of membrane depolarization, thereby increasing the threshold for electrical excitability.
- The blockade affects all nerve fibers in the following sequence: autonomic, sensory, and motor, with effects diminishing in reverse order.
- Clinically, loss of function occurs as follows: pain, temperature, touch, proprioception, and skeletal muscle tone.
- Direct nerve membrane penetration is necessary for effective anesthesia, which is achieved by applying the anesthetic topically to the area to be anesthetized.
- While systemic absorption of local anesthetics can produce effects on the central nervous and cardiovascular systems, systemic absorption of benzocaine; butamben; tetracaine is expected to be minimal with appropriate use.
Topical dosage (Cetacaine spray)
Adults:
Apply 200 mg directly to the site or tissue to be anesthetized by spraying for 1 second or less. Do not administer more than 400 mg or spray in excess of 2 seconds. Reduce dosage in acutely ill patients and in debilitated elderly patients.
Topical dosage (Exactacain spray)
Adults:
Apply 3 metered sprays directly to the site or tissue to be anesthetized, for normal anesthesia. Do not apply in excess of 6 metered sprays. Reduce dosage in acutely ill patients and in debilitated elderly patients.
Topical dosage (gel)
Adults:
Apply 200 mg to the desired area by thinly and evenly spreading the gel with a cotton swab. A 200 mg dose of gel is equivalent to a bead approximately 0.25 to 0.5 inches long. Do not apply in excess of 400 mg of gel (a bead approximately 1 inch long). Reduce dosage in acutely ill patients and in debilitated elderly patients.
Topical dosage (Liquid)
Adults:
Apply 200 mg, approximately 0.2 mL, directly to the tissue using an applicator such as a microbrush or a cotton applicator. If a cotton applicator is used, do not allow it to stay in position as local reactions could occur. Do not apply more than 400 mg, approximately 0.4 mL. Reduce dosage in acutely ill patients and in debilitated elderly patients.
Subgingival dosage (Cetacaine Liquid)
Adults:
Using a syringe fitted with a microcapillary tip, apply 200 mg of solution, approximately 0.2 mL, subgingivally by following the geography of the pocket. Do not apply in excess of 400 mg, approximately 0.4 mL, per dental visit. Reduce dosage in acutely ill patients and in debilitated elderly patients.
Maximum Dosage Limits:
•Adults
400 mg per procedure. For Exactacain metered spray, 6 metered sprays per procedure.
•Geriatric
400 mg per procedure. For Exactacain metered spray, an appropriate dosage has not been established.
•Adolescents
Safety and efficacy have not been established.
•Children
Safety and efficacy have not been established.
Patients with Hepatic Impairment Dosing
Specific guidelines for dosage adjustments in hepatic impairment are not available; it appears that no dosage adjustments are needed.
Patients with Renal Impairment Dosing
Specific guidelines for dosage adjustments in renal impairment are not available; it appears that no dosage adjustments are needed.
Side Effects of Benzocaine Butamben Tetracaine
- anaphylactoid reactions
- contact dermatitis
- edema
- erythema
- methemoglobinemia
- pruritus
- rash
- urticaria
Contraindications
- asthma
- breast-feeding
- bronchitis
- burns
- cardiac disease
- children
- chronic obstructive pulmonary disease (COPD)
- emphysema
- ester local anesthetic hypersensitivity
- G6PD deficiency
- geriatric
- infants
- intramuscular administration
- intravenous administration
- methemoglobin reductase deficiency
- methemoglobinemia
- neonates
- occlusive dressing
- ocular exposure
- ophthalmic administration
- para-aminobenzoic acid, PABA hypersensitivity
- parenteral administration
- pregnancy
- pseudocholinesterase deficiency
- skin abrasion
- skin atrophy
- subcutaneous administration
- tobacco smoking
Drug Interactions of Benzocaine Butamben Tetracaine
- Adapalene; Benzoyl Peroxide
- Amyl Nitrite
- Articaine; Epinephrine
- Benzoyl Peroxide
- Benzoyl Peroxide; Clindamycin
- Benzoyl Peroxide; Erythromycin
- Benzoyl Peroxide; Sulfur
- Bupivacaine
- Bupivacaine Liposomal
- Bupivacaine; Lidocaine
- Chloroprocaine
- Chloroxylenol; Hydrocortisone; Pramoxine
- Dapsone
- Dibucaine
- Erythromycin; Sulfisoxazole
- Ethyl Chloride
- Hydralazine; Isosorbide Dinitrate, ISDN
- Hydrocortisone; Pramoxine
- Isosorbide Dinitrate, ISDN
- Isosorbide Mononitrate
- Lidocaine
- Lidocaine; Prilocaine
- Lidocaine; Tetracaine
- Mepivacaine
- Mepivacaine; Levonordefrin
- Nitrates
- Nitroglycerin
- Penicillin G Benzathine; Penicillin G Procaine
- Penicillin G Procaine
- Pramoxine
- Pyrimethamine; Sulfadoxine
- Ropivacaine
- Sulfadiazine
- Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
- Sulfasalazine
- Sulfisoxazole
- Sulfonamides
- Tetracaine
