chloroprocaine ophthalmic

Action and Spectrum

Actions and Spectrum: 

Action: 

Chloroprocaine is a local anesthetic primarily used for regional anesthesia, particularly in ophthalmic procedures. When used ophthalmically, chloroprocaine acts as a local anesthetic to induce reversible loss of sensation in the eye or surrounding tissues. It functions by blocking the flow of sodium ions through the nerve cell membrane, thereby preventing the generation and transmission of nerve impulses. 

Spectrum: 

Eye surgeries: It can be used for short-duration procedures such as cataract extraction, corneal surgery, and other ophthalmic surgeries where a rapid onset and short duration of action are desirable. 

Drug Interaction

Adverse Reaction

Frequency defined  

>10% 

Conjunctival hyperemia (11%) 

Mydriasis (26%) 

1-10% 

Eye irritation (6%) 

Black Box Warning

Black Box Warning:  

None

Contraindication / Caution

Contraindication/Caution:  

Hypersensitivity: Individuals with a known hypersensitivity or allergic reaction to chloroprocaine or any other local anesthetics should avoid its use in ophthalmic procedures due to the risk of severe allergic reactions. 

Eye Infections or Inflammation: Using Chloroprocaine in eyes with existing infections or inflammation, such as conjunctivitis or keratitis, can exacerbate the condition or cause further irritation. 

Corneal Abrasions or Damage: Chloroprocaine should not be used in cases of corneal abrasions or damage, as it may cause additional irritation or delay the healing process. 

Glaucoma: Patients with narrow-angle glaucoma should avoid chloroprocaine use due to its potential to increase intraocular pressure, which can worsen the condition and lead to complications. 

Pregnancy / Lactation

Pregnancy warnings:     

Pregnancy category: N/A 

Lactation: Excreted into human milk is unknown 

Pregnancy Categories:         

Category A: Studies that were well-controlled and met expectations revealed no risk to the fetus in either the first or second trimester. 

Category B: There were a lack of studies on pregnant women and no evidence of risk to the fetus in animal experiments.   

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    

Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.   

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.    

Category N: There is no data available for the drug under this category

Pharmacology

Pharmacology:  

Chloroprocaine is a local anesthetic that has been used primarily for spinal and epidural anesthesia in the past. 

Pharmacodynamics:  

Chloroprocaine, like other local anesthetics, acts by reversibly blocking sodium channels in nerve fibers, inhibiting the influx of sodium ions required for the generation and conduction of action potentials. This action results in the inhibition of nerve impulses, leading to temporary sensory and motor blockade.  

Pharmacokinetics: 

Absorption 

Chloroprocaine is typically applied topically to the surface of the eye. Through this route, the drug can be absorbed through the cornea and conjunctiva into the ocular tissues and may enter the bloodstream. 

Distribution 

After absorption, chloroprocaine can distribute throughout the ocular tissues, producing its local anesthetic effect. The extent of distribution beyond the eye may be limited due to the local application. 

Metabolism 

Chloroprocaine undergoes metabolism in the body, primarily through hydrolysis by plasma esterases and pseudocholinesterase. Metabolism of chloroprocaine primarily occurs in the blood and liver. 

Excretion and Elimination 

Metabolites of chloroprocaine, as well as any unchanged drug, are excreted from the body via the renal route (kidneys) as well as through biliary excretion in feces. 

Adminstartion

Administration:  

The healthcare provider usually determines the dosage of chloroprocaine ophthalmic solution based on the procedure and the patient’s individual factors such as age, weight, and medical condition. Follow the prescribed dosage exactly as directed by the physician. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: chloroprocaine ophthalmic 

Why do we use chloroprocaine ophthalmic?  

Chloroprocaine ophthalmic solution may be used to provide local anesthesia on the surface of the eye or surrounding tissues before certain eye procedures. It can help in reducing discomfort and pain during interventions like corneal abrasion repair, removal of foreign bodies from the eye, or other minor surgical procedures involving the eye. 

For minor eye surgeries or interventions where a short-acting local anesthetic is sufficient, chloroprocaine ophthalmic solution might be used to provide temporary numbing of the eye area.