Tetracaine

Tetracaine
Clinical data
AHFS/Drugs.com	Monograph
MedlinePlus	a682640
Routes of; administration	Topical, Epidural, Spinal
ATC code	C05AD02 (WHO) D04AB06 (WHO) N01BA03 (WHO) S01HA03 (WHO);
Legal status
Legal status	In general: ℞ (Prescription only);
Pharmacokinetic data
Protein binding	75.6
Identifiers
	IUPAC name 2-(dimethylamino)ethyl 4-(butylamino)benzoate;
CAS Number	94-24-6 ; 136-47-0 (hydrochloride);
PubChem CID	5411;
ChemSpider	5218 ;
UNII	0619F35CGV;
KEGG	D00551 ;
ChEBI	CHEBI:9468 ;
ChEMBL	ChEMBL698 ;
PDB ligand	TE4 (PDBe, RCSB PDB);
CompTox Dashboard (EPA)	DTXSID1043883 ;
ECHA InfoCard	100.002.106
Chemical and physical data
Formula	C15H24N2O2
Molar mass	264.363 g/mol g·mol−1
3D model (JSmol)	Interactive image;
	SMILES O=C(OCCN(C)C)c1ccc(NCCCC)cc1;
	InChI InChI=1S/C15H24N2O2/c1-4-5-10-16-14-8-6-13(7-9-14)15(18)19-12-11-17(2)3/h6-9,16H,4-5,10-12H2,1-3H3 ; Key:GKCBAIGFKIBETG-UHFFFAOYSA-N ;
	(verify)

Tetracaine (INN, also known as amethocaine; trade name Pontocaine. Ametop and Dicaine) is a potent local anesthetic of the ester group. It is mainly used topically in ophthalmology and as an antipruritic, and it has been used in spinal anesthesia.

In biomedical research, tetracaine is used to alter the function of calcium release channels (ryanodine receptors) that control the release of calcium from intracellular stores. Tetracaine is an allosteric blocker of channel function. At low concentrations, tetracaine causes an initial inhibition of spontaneous calcium release events, while at high concentrations, tetracaine blocks release completely.^[1]

Tetracaine is the T in TAC, a mixture of 5 to 12 per cent tetracaine, 0.05 per cent adrenaline, and 4 or 10 per cent cocaine hydrochloride used in ear, nose & throat surgery and in the emergency department where numbing of the surface is needed rapidly, especially when children have been injured in the eye, ear, or other sensitive locations.^[2]

It is on the World Health Organization's List of Essential Medicines, a list of the most important medication needed in a basic health system.^[3]

A systematic review investigated tetracaine for use in emergency departments, especially for IV cannulation in children, in view of its analgesic and cost-saving properties - however it did not find a statistically significant improvement in first attempt cannulations.^[4]

References

^ Györke, S; Lukyanenko, V; et al. (1997). "Dual effects of tetracaine on spontaneous sodium release in rat ventricular myocytes". 500 (2). J Physiol: 297–309. {{cite journal}}: Cite journal requires |journal= (help)
^ Appleton's Nursing Manual - "Cocaine"
^ "WHO Model List of EssentialMedicines" (PDF). World Health Organization. October 2013. Retrieved 22 April 2014.
^ Pywell, A; Xyrichis, A (2014). "Does topical Amethocaine cream increase first-time successful cannulation in children compared with a eutectic mixture of local anaesthetics (EMLA) cream? A systematic review and meta-analysis of randomised controlled trials". 0 (0). Emerg Med J: 1–5. doi:10.1136/emermed-2014-204066. {{cite journal}}: Cite journal requires |journal= (help)

References

Further reading