Chapter: Modern Pharmacology with Clinical Applications: Local Anesthetics

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Topical Agents

EMLA cream (lidocaine 2.5% and prilocaine 2.5%) consists of a eutectic mixture of local anesthetics.

TOPICAL AGENTS

EMLA cream (lidocaine 2.5% and prilocaine 2.5%) consists of a eutectic mixture of local anesthetics. It is used to provide topical anesthetic to intact skin. Other topical preparations are effective only on mucosal sur-faces. EMLA has been shown to reduce pain on venipuncture and provide substantial anesthesia for skin graft donor sites. No significant local or systemic toxicity has been demonstrated.

TAC (tetracaine, adrenalin [epinephrine], and co-caine) is a combination topical anesthetic frequently used in pediatric emergency departments for repair of minor lacerations. The usual mixture is tetracaine 0.5%, epinephrine 1:2,000, and cocaine 11.8%. Because of po-tential complications (seizures), lower concentrations of cocaine and epinephrine in a tetracaine 1% solution have been suggested (TAC III).

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