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A topical anesthetic is a local anesthetic that is used to numb the surface of a body part. They can be used to numb any area of the skin as well as the front of the eyeball, the inside of the nose, ear or throat, the anus and the genital area.[1] Topical anesthetics are available in creams, ointments, aerosols, sprays, lotions, and jellies.Examples include benzocaine, butamben, dibucaine, lidocaine, oxybuprocaine, pramoxine, proparacaine, proxymetacaine, and tetracaine (also named amethocaine) all derived from the natural chemical cocaine from the coca plant which is still used for some medical procedures such as rhinoplasties.
Usage
Topical anesthetics are used to relieve pain and itching caused by conditions such as sunburn or other minor burns, insect bites or stings, poison ivy, poison oak, poison sumac, and minor cuts and scratches.
Topical anesthetics are used in ophthalmology and optometry to numb the surface of the eye (the outermost layers of the cornea and conjunctiva) to:
Perform a contact/applanation tonometry.
Perform a Schirmer's test (The Schirmer's test is sometimes used with a topical eye anesthetic, sometimes without. The use of a topical anesthetic might impede the reliability of the Schirmer's test and should be avoided if possible.).
Remove small foreign objects from the uppermost layer of the cornea or conjunctiva. The deeper and the larger a foreign object which should be removed lies within the cornea and the more complicated it is to remove it, the more drops of topical anesthetic are necessary prior to the removal of the foreign object to numb the surface of the eye with enough intensity and duration.
In dentistry, topical anesthetics are used to numb oral tissue before administering a dental local anesthetic due to the entry of the needle into the soft tissues of the oral cavity.
Some topical anesthetics (e.g. oxybuprocaine) are also used in otolaryngology.
Topical anesthetics are now commonly used in the temporary relief of premature ejaculation when applied to the glans (head) of the penis. Benzocaine or lidocaine are typically used for this purpose as they are available OTC (lidocaine is more powerful than benzocaine).
Duration of topical
The duration of topical anesthesia might depend on the type and amount applied, but is usually about half an hour.
When used excessively, topical anesthetics can cause severe and irreversible damage to corneal tissues and even loss of the eye. The abuse of topical anesthetics often creates challenges for correct diagnosis in that it is a relatively uncommon entity that may initially present as a chronic keratitis masquerading as acanthamoeba keratitis or other infectious keratitis.When a keratitis is unresponsive to treatment and associated with strong ocular pain, topical anesthetic abuse should be considered, and a history of psychiatric disorders and other substance abuse have been implicated as important factors in the diagnosis. Because of the potential for abuse, clinicians have been warned about the possibility of theft and advised against prescribing topical anesthetics for therapeutic purposes.
Some patients who suffer from eye pain, which is often considerably strong neuropathic pain caused by the irritation of the nerves within the cornea and/or conjunctiva, unfortunately try to illegally obtain oxybuprocaine or other eye anesthetics (for example by stealing them at their ophthalmologist or optometrist, by forging medical prescriptions or by trying to order it via an online pharmacy) and secretly use the substance to numb their eye pain, often ending up with irreversible corneal damage or even destruction (which is a vicious cycle and causes even much more pain). Often, such patients finally require corneal transplantation.
In case of prolonged or chronic eye pain, especially neuropathic eye pain, it is highly advisable to use centrally acting substances like anticonvulsants (pregabalin, gabapentin and in more serious cases carbamazepine) or antidepressants (for example SSRIs or the tricyclic antidepressant amitriptyline). Even very small amounts of an anticonvulsant and/or an antidepressant can almost completely stop eye pain and does not damage the eye at all.
If you are allergic to tartrazine, talk with healthcare provider. Some products contain tartrazine.
If you have an allergy to any type of nuts or seeds, talk with healthcare provider. Some products contain nuts.
Check medicines with healthcare provider. This medicine may not mix well with other medicines.
Tell healthcare provider if you are pregnant or plan on getting pregnant.
Tell healthcare provider if you are breast-feeding.
What are some possible side effects of this medicine?
Skin irritation.
Reasons to call healthcare provider immediately
If you suspect an overdose, call your local poison control center or emergency department immediately.
Signs of a life-threatening reaction. These include wheezing; chest tightness; fever; itching; bad cough; blue skin color; fits; or swelling of face, lips, tongue, or throat.
Severe skin irritation.
Any rash.
No improvement in condition or feeling worse.
Trolamine salicylate is used to treat minor aches and pains of the muscles/joints (such as arthritis, backache, sprains). It belongs to a class of drugs known as salicylates.
How to usePharmacist Pain Relief topical
Follow all directions on the product package. If you are uncertain about any of the information, consult your doctor or pharmacist.
This medication is for use on the skin only. Do not get this medication in your eyes, inside your nose or mouth, or inside the vagina. If you do get the medication in those areas, flush with plenty of water.
Apply the medication to the affected area no more than 3 to 4 times a day. Rub in gently and thoroughly. After applying the medication, wash your hands unless you are using this medication to treat the hands.
Do not apply this medication on broken or irritated skin. Do not bandage or tightly wrap the affected area or apply heat to the area (such as using a heating pad). Doing so may increase the risk of side effects. Ask your pharmacist for more details.
Tell your doctor if your condition persists for more than 7 days, if it worsens, or if it keeps returning. If you think you may have a serious medical problem, get medical help right away.
If your doctor has directed you to use this medication, remember that he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
Stop using this medication and tell your doctor right away if any serious side effects occur, including: blistering/peeling/redness/irritation at the application site, nausea/vomiting, ringing in the ears.
A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
Before using trolamine salicylate, tell your doctor or pharmacist if you are allergic to it; or to aspirin or other salicylates (such as salsalate); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: asthma, growths in the nose (nasal polyps).
Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
This drug is similar to aspirin. Children and teenagers should not use this drug if they have chickenpox, flu, or any undiagnosed illness or if they have recently received a vaccine. In these cases, this drug may increase the risk of Reye's syndrome, a rare but serious illness.
During the first 6 months of pregnancy, this medication should be used only when clearly needed. It is not recommended for use during the last 3 months of pregnancy due to possible harm to the unborn baby and problems with normal labor/delivery. Discuss the risks and benefits with your doctor.
It is unknown if this product passes into breast milk. Consult your doctor before breast-feeding.
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.
This medicine may be harmful if swallowed. If swallowing or overdose is suspected, contact a poison control center or emergency room immediately.
Notes
Keep all regular medical and laboratory appointments.
Missed Dose
If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.
Storage
Store at room temperature away from heat, light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.
Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Information last revised September 2013. Copyright(c) 2013 First Databank, Inc.
