Advisory on Benzocaine Sprays and Methemoglobinemia
FDA recently issued a Public Health Advisory to remind health care professionals that the overuse of benzocaine anesthetic sprays can cause methemoglobinemia, a potentially life-threatening condition that can result in cyanosis, confusion, hemodynamic instability and coma. Benzocaine sprays, including those sold under the brand names Hurricaine, Topex and Cetacaine, are used to anesthetize the mucous membranes of the mouth and throat when preparing patients for minor surgery, endoscopic procedures and endotracheal intubation. Methemoglobinemia is a known side-effect when benzocaine sprays are used, but the risk can increase when practitioners use multiple sprays or sprays of longer duration than recommended. FDA is reviewing the safety data for these products to determine if additional action is needed. FDA recommends the following actions to help minimize the risk: • Use only the minimum amount of benzocaine spray to produce the required anesthetic effect. • Carefully observe patients treated with benzocaine sprays for signs of methemoglobinemia. These include headache, lightheadedness, shortness of breath, anxiety, fatigue, pale, gray or blue colored skin, and tachycardia. Blood that's chocolate-brown in color is a late sign of life- threatening levels of methemoglobinemia. • Promptly treat patients suspected of having high levels of methemoglobin. Supplemental oxygen alone is not effective. The only known treatment is intravenous administration of methylene blue. • Do ...Asthma — Comprehensive overview covers symptoms, treatment of this
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