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Anesthetic Agents and Surgery during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Local anesthetics have an aromatic ring with an intermediate alkyl chain with either (1) an amide or (2) an ester linkage. Protein-bound fraction is directly related to anesthetic potency, and duration of action is determined by the amount of binding. Anesthetics that are highly protein bound are lipid soluble and readily cross the placenta (Morishima et al., 1966; Pedersen and Finster, 1987). The frequency of birth defects among offspring of women who used lidocaine (n = 293), benzocaine (n = 47), or tetracaine (n = 23) during the first trimester, showed there were no adverse fetal effects when these agents were used any time during pregnancy (Heinonen et al., 1977). The Swedish Birth Defects Registry reported 20 infants whose mothers used tetracaine during the first trimester for local anesthesia, and no birth defects were reported (Kallen, 2019). The meaning of these small sample sizes is unclear. No animal teratology studies of these agents have been published.
Tetracaine
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
Tetracaine is a benzoic acid ester-type local anesthetic. It is present in many antihemorrhoidal creams and ointments, eardrops, eye drops and preparations for analgesia of the skin and mucosae (e.g. lubricant gels). In pharmaceutical products, both tetracaine and tetracaine hydrochloride (CAS number 136-47-0, EC number 205-248-5, molecular formula Ci5H25CIN202) may be employed (1).
Models of Toxicity Screening Using Cultured Cells
Published in John J. Lemasters, Constance Oliver, Cell Biology of Trauma, 2020
Roberta L. Grant, Daniel Acosta
From initial cytotoxicity tests, we determined the concentration range over which toxicity occurred after 60 min of treatment with local anesthetics: tetracaine (0.5 to 2.5 mM); proparacaine (1 to 5 mM); and cocaine (5 to 10 mM). We then treated the cells for 15 min, a time before toxicity occurred, to study early events that may contribute to the oculotoxicity of local anesthetics. Each local anesthetic caused a dose-dependent increase in [Ca++]i after 15 min of treatment (Table 1). This finding indicates that a rise in calcium may be an early event in the toxicity of local anesthetics to corneal epithelial cells.
Tetracaine from urethral ointment causes false positive amphetamine results by immunoassay
Published in Clinical Toxicology, 2021
Robin Wijngaard, Marina Parra-Robert, Lourdes Marés, Anna Escalante, Emilio Salgado, Bernardino González-de-la-Presa, Jordi To-Figueras, Mercè Brunet
Tetracaine is a local anesthetic drug, structurally-related to cocaine. Tetracaine inhibits pain sensation by acting as a reversible blocker in the sodium channels of the neuronal cell membrane and suppressing the nerve signal conduction [10–12]. The clinical indications of tetracaine are mainly restricted to topical or ophthalmological applications [11,12]. In our hospital, tetracaine is used as topical lubricating and anesthetic ointment during urinary catheterization in men. In particular, patients attending the emergency department (ED) with an altered level of consciousness undergo urine catheterization in order to collect urine samples for drug testing and rule out potential drug intoxications. Approximately 12.5 g of Lubristesic® ointment (Galenicum Health SL, Barcelona, Spain) containing 7.5 mg of tetracaine hydrochloride/1 g of ointment is used per patient.
Trichloroacetic acid 10% injection for treatment of conjunctival inclusion cysts
Published in Orbit, 2020
Abbas Bagheri, Koroush Shahraki, Shahin Yazdani
All procedures were performed in the operating room under sterile conditions using a surgical microscope. In adult subjects, topical anesthesia using tetracaine 0.5% (Sinadarou, Tehran, Iran) was employed while children received general anesthesia. The cyst was entered using a #27 needle on a 2 ml syringe which was partially filled with TCA 10%, and its content was aspirated; thereafter diluted TCA was injected into the cyst space until the cyst was completely filled. The injected volume was aspirated after 5 s and cyst filling with diluted TCA was immediately repeated one more time for another 5 s. The needle and syringe were not changed during aspirations/injections and caution was made to remain inside the cyst space with minimal movement or manipulation throughout the procedure. At the end, the cyst content was aspirated until it collapsed, the needle was removed, and socket or ocular surface was copiously irrigated with normal saline solution (Figure 1).
Tetracaine induces apoptosis through a mitochondrion-dependent pathway in human corneal stromal cells in vitro
Published in Cutaneous and Ocular Toxicology, 2018
LAs are commonly used medicines in ophthalmology and can cross cytoplasmic and intracellular membranes and interact with charged targets, including structural proteins and signalling systems, depending on their amphipathic characteristics. Although the pharmacological and toxicological target sites of LAs are the voltage-gated sodium channels, many alternative sites are considered to be other targets, such as potassium channels, calcium channels, nicotinic acetylcholine receptors and G-protein coupled receptors17,18. Because of their chemical characteristics, LAs may produce various toxic effects on corneal cells, including superficial punctate keratitis, persistent epithelial defects, stromal ring infiltrates, corneal oedema, endothelial damage and ocular inflammation19. Tetracaine, an effective sodium ion channel blocker, has been frequently used in eye clinic as an active first-line LA. The toxicity of tetracaine should be studied to improve our knowledge of the relative local toxicity of tetracaine to the cornea. In our study, the cytotoxicity was determined on an HCS cell line, which was established through a non-transfection method and was previously shown to have normal phenotypes and functions14. Moreover, this cell line was not only easier to grow and to manipulate for these experiments but is also a validated in vitro model for cytotoxicity studies and testing20.