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HIGH ALERT anesthetics (topical/mucosal) benzocaine (ben-zoe-kane)
Americaine, Americaine Anesthetic Lubricant, Americaine Hemorrhoidal, 
Baby Orajel, Canker Pain Relief, Children's Chloraseptic Lozenges, Dentocaine, Dent-Zel-Ite, DermaFlex, Endocaine, Hurricaine, Lagol, Lanacane, Orajel Mouth-Aid, Orabase Gel, Medicone, Maximum Strength Anbesol, Mycinettes, Numzident, Num-Zit Lotion, Orajel Liquid, Shield Burnasept Spray, Spec-T Sore Throat Anesthetic
dibucaine (dye-byoo-kane)
Nupercainal
dyclonine (dye-klon-een)
Sucrets Children's Sore Throat, Dyclone, Sucrets Maximum Strength, Vapor Lemon Sucrets
pramoxine (pra-mox-een)
Fleet Relief, ProctoFoam NS, Tronolane, Tronothane
tetracaine (tet-ra-kane)
Pontocaine, Viractin
Classification
Therapeutic: anesthetics (topical/local)
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Topical: Relief of pruritus or pain associated with minor skin disorders, including burns, abrasions, bruises, insect stings/bites, dermatitis, hemorrhoids, or other forms of skin irritation. Mucosal: Provide local anesthesia to mucosal surfaces before instrumentation, minor procedures, or endoscopy. Decrease irritation caused by minor mouth and throat conditions, including sore throat, gingivitis, stomatitis, or teething. Also used to suppress the gag reflex during endoscopy or intubation.
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Inhibit initiation and conduction of sensory nerve impulses. Therapeutic Effects: Local anesthesia with subsequent loss of sensation or relief of pain and/or pruritus.
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Adverse Reactions/Side Effects
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EENT: mucosal use: decreased or absent gag reflex. Derm: topical use: burning, edema, irritation, stinging, tenderness, urticaria. Misc: ALLERGIC REACTIONS, INCLUDING ANAPHYLAXIS.
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PHYSICAL THERAPY IMPLICATIONS
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Examination and Evaluation
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Monitor signs of allergic reactions and anaphylaxis, including pulmonary symptoms (laryngeal edema, bronchospasm, wheezing, cough, dyspnea) or skin reactions (rash, pruritus, urticaria). Notify physician or nursing staff immediately if these reactions occur.
When applied topically, assess the site of application and monitor any skin reactions such as tenderness, irritation, burning, swelling, or itching. Report severe or prolonged skin reactions to the physician.
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Patient/Client-Related Instruction
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Absorption: Benzocaine is poorly absorbed through intact skin. Other agents may be readily absorbed. Degree of absorption increases with surface area; presence of lesions, cuts, or abrasions; and amount of agent applied.
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Metabolism and Excretion: Ester-type agents (para-aminobenzoic acid [PABA] derivatives, benzocaine, tetracaine) are metabolized by plasma and liver cholinesterases. Small amounts of amide-type agents (dibucaine) that may be absorbed are mostly metabolized by the liver.
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Contraindications/Precautions
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Contraindicated in: Hypersensitivity. Cross-sensitivity may occur ...