Alcaine

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Alcaine

Classes

Ophthalmological Local Anaesthetics

Adverse Reactions
Severe

corneal opacification / Delayed / Incidence not known
corneal erosion / Delayed / Incidence not known
visual impairment / Early / Incidence not known
keratitis / Delayed / Incidence not known

Moderate

iritis / Delayed / Incidence not known
impaired wound healing / Delayed / Incidence not known
conjunctival hyperemia / Early / Incidence not known
cycloplegia / Early / Incidence not known
contact dermatitis / Delayed / Incidence not known

Mild

lacrimation / Early / Incidence not known
ocular irritation / Rapid / Incidence not known
weakness / Early / Incidence not known
pallor / Early / Incidence not known
drowsiness / Early / Incidence not known
headache / Early / Incidence not known
fatigue / Early / Incidence not known
xerosis / Delayed / Incidence not known

Common Brand Names

Alcaine, Ocu-Caine, Ophthalmicaine, Ophthetic, Parcaine

Dea Class

Rx

Description

Ophthalmic ester-type local anesthetic
Used as a local anesthetic during short corneal and conjunctival procedures, suture or foreign body removal, and tonometry
Avoid prolonged use

Dosage And Indications
For ophthalmic anesthesia.
NOTE: Representative ophthalmic procedures in which the preparation provides good local anesthesia include measurement of intraocular pressure, removal of foreign bodies and sutures from the cornea, and conjunctival scraping in diagnosis and gonioscopic examination. Proparacaine is also indicated for use as a topical anesthetic prior to surgical operations such as cataract extraction.
NOTE: Prolonged use of a topical ocular anesthetic may produce permanent corneal opacification with accompanying loss of vision.
For the removal of foreign bodies and sutures, and for tonometry.
Ophthalmic dosage
Adults

Instill 1 or 2 drops in the affected eye(s) before the procedure.

Infants, Children, and Adolescents

Instill 1 or 2 drops in the affected eye(s) before the procedure.

Neonates

Instill 1 or 2 drops in the affected eye(s) before the procedure.

For anesthesia in short corneal and conjunctival procedures.
Ophthalmic dosage
Adults

Instill 1 drop in the affected eye(s) every 5 to 10 minutes for 5 to 7 doses.

Infants, Children, and Adolescents

Instill 1 drop in the affected eye(s) every 5 to 10 minutes for 5 to 7 doses.

Neonates

Instill 1 drop in the affected eye(s) every 5 to 10 minutes for 5 to 7 doses.

Dosing Considerations
Hepatic Impairment

Specific guidelines for dosage adjustments in hepatic impairment are not available; it appears that no dosage adjustments are needed.

Renal Impairment

Specific guidelines for dosage adjustments in renal impairment are not available; it appears that no dosage adjustments are needed.

Drug Interactions

There are no drug interactions associated with Proparacaine products.

How Supplied

Alcaine/Ocu-Caine/Ophthalmicaine/Ophthetic/Parcaine/Proparacaine Hydrochloride Ophthalmic Sol: 0.5%

Maximum Dosage
Adults

Specific maximum dosage information is not available.

Geriatric

Specific maximum dosage information is not available.

Adolescents

Specific maximum dosage information is not available.

Children

Specific maximum dosage information is not available.

Infants

Specific maximum dosage information is not available.

Neonates

Specific maximum dosage information is not available.

Mechanism Of Action

Proparacaine prevents the initiation and transmission of nerve impulses by stabilizing the neuronal membrane, so that the neuron is less permeable to ions. Specifically, proparacaine interferes with the large transient increase in the membrane permeability to sodium ions that is normally produced by a slight depolarization of the membrane. As the anesthetic action progressively develops in a nerve, the threshold for electrical stimulation gradually increases and the safety factor for conduction decreases. When this action is sufficiently well developed, block of conduction is produced. Proparacaine may limit sodium ion permeability by closing the pores through which the ions migrate in the lipid layer of the nerve cell membrane. Decreased sodium ion permeability may prevent the fundamental change necessary for the generation of the action potential.

Pharmacokinetics

Proparacaine is administered topically to the eye. Proparacaine is rapid-acting; the onset of anesthesia after a single drop usually begins within 30 seconds and persists for approximately 10 to 20 minutes; rarely reported to last up to 30 minutes.

Pregnancy And Lactation
Pregnancy

Proparacaine should be administered during pregnancy only if clearly needed. The ability of proparacaine to cause fetal harm or to affect reproductive capacity is unknown. Animal reproduction studies have not been conducted.  

It is not known whether proparacaine is excreted into breast milk. Use caution if this drug is administered to a woman who is breast-feeding an infant, as many drugs are excreted in human milk.