DECATYLEN LOZENGES

Indications

• Local anesthesia for minor surgical procedures
• Topical anesthetic for skin and mucous membrane procedures
• Dental anesthesia

Dosage

Children: Refer to BNF for Children for specific dosing guidelines.

Adults: Refer to BNF for specific dosing guidelines.

Mechanism of action

Cinchocaine functions by blocking both the initiation and conduction of nerve impulses. It decreases the permeability of the neuronal membrane to sodium ions through inhibition of sodium channels. This stabilizes the membrane and inhibits depolarization, leading to the failure of propagated action potentials and subsequent conduction blockade. The anesthetic action progressively develops in a nerve, increasing the threshold for electrical excitability, slowing impulse conduction, and decreasing the probability of propagation of the action potential.

Pharmacodynamics

As an amide-type local anesthetic, cinchocaine shares pharmacodynamic properties with other agents in its class, such as lidocaine. It provides a reversible blockade of nerve conduction, effectively numbing the area to which it is applied. Its onset and duration of action may vary based on concentration and the specific formulation used.

Pharmacokinetics

Cinchocaine is absorbed through mucous membranes and the skin, with its onset of action typically occurring within minutes. The duration of action can vary, often lasting for several hours. It is metabolized primarily in the liver and excreted through the kidneys. The pharmacokinetic profile may be influenced by factors such as the route of administration and individual patient characteristics.

Adverse effects

• Local irritation
• Allergic reactions
• Systemic toxicity (e.g., seizures, cardiac arrest)

Precautions

• Use with caution in patients with a history of hypersensitivity to local anesthetics
• Caution in patients with severe hepatic impairment

Pregnancy

Cinchocaine should be used in pregnancy only if the potential benefit justifies the potential risk to the fetus. It is classified as a category B drug.

Breast-feeding

Cinchocaine is excreted in breast milk; caution should be exercised when administering to nursing mothers.

Storage

Store at room temperature, away from light and moisture. Keep out of reach of children.

Formulations

• Topical cream
• Gels
• Ointments

Indications

• Sore throat
• Gingivitis
• Stomatitis
• Oral infections
• Inflammatory conditions of the oral cavity

Dosage

Children: Refer to the BNF for Children for age-appropriate dosing recommendations, as this can vary based on the formulation and specific clinical scenario.

Adults: Refer to the specific product information or BNF for detailed dosing guidelines, as dosages can vary based on formulation and condition being treated.

Mechanism of action

Dequalinium acts by disrupting microbial cell membranes, which results in increased permeability and ultimately leads to cell lysis. The positively charged quaternary ammonium group interacts with the negatively charged components of the bacterial membrane, causing structural changes and loss of membrane integrity.

Pharmacodynamics

Dequalinium demonstrates broad-spectrum antibacterial activity, particularly against Gram-positive bacteria. It is effective against various strains of Staphylococcus and Streptococcus. Additionally, it has antifungal properties, making it useful in treating infections caused by certain fungi. The drug's antiseptic action is beneficial in reducing the microbial load in the oral cavity.

Pharmacokinetics

Dequalinium is poorly absorbed systemically when applied topically, which minimizes systemic side effects. Following topical administration, it acts locally at the site of application. The drug has a relatively long duration of action due to its adherence to mucosal surfaces. Clearance mechanisms are not well defined, but local metabolism and excretion are expected to occur.

Adverse effects

• Hypersensitivity reactions
• Local irritation
• Nausea
• Vomiting
• Diarrhea

Precautions

• Use with caution in patients with known allergies to similar compounds
• Monitor for local irritation during use

Pregnancy

The safety of dequalinium during pregnancy has not been established. Use only if the potential benefit justifies the potential risk to the fetus.

Breast-feeding

It is not known whether dequalinium is excreted in human milk. Caution is advised when administering to nursing mothers.

Storage

Store at room temperature, away from direct light and moisture. Keep out of reach of children.

Formulations

• Topical solution
• Lozenge

Mechanism of action

Local anesthetics block both the initiation and conduction of nerve impulses by decreasing the neuronal membrane's permeability to sodium ions through sodium channel inhibition. This reversibly stabilizes the membrane and inhibits depolarization, resulting in the failure of a propagated action potential and subsequent conduction blockade. ... PREVENT THE GENERATION & THE CONDUCTION OF THE NERVE IMPULSE. THEIR PRIMARY SITE OF ACTION IS THE CELL MEMBRANE. ... BLOCK CONDUCTION BY DECREASING OR PREVENTING THE TRANSIENT INCREASE IN THE PERMEABILITY OF EXCITABLE MEMBRANES TO NA IONS THAT IS NORMALLY PRODUCED BY A SLIGHT DEPOLARIZATION ... /LOCAL ANESTHETICS/ AS ANESTHETIC ACTION PROGRESSIVELY DEVELOPS IN A NERVE, THE THRESHOLD FOR ELECTRICAL EXCITABILITY GRADUALLY INCREASES, THE RATE OF RISE OF THE ACTION POTENTIAL DECLINES, IMPULSE CONDUCTION SLOWS, & THE SAFETY FACTOR FOR CONDUCTION DECREASES; THESE FACTORS DECREASE PROBABILITY OF PROPAGATION OF THE ACTION POTENTIAL, AND NERVE CONDUCTION FAILS. /LOCAL ANESTHETICS/ ... CAN BLOCK K ION CHANNELS. ... BLOCKADE OF CONDUCTION IS NOT ACCOMPANIED BY ANY LARGE OR CONSISTENT CHANGE IN RESTING MEMBRANE DUE TO BLOCK OF K ION CHANNELS. /LOCAL ANESTHETICS/ ... SITE AT WHICH LOCAL ANESTHETICS ACT, AT LEAST IN THEIR CHARGED FORM, IS ACCESSIBLE ONLY FROM THE INNER SURFACE OF THE MEMBRANE. ... LOCAL ANESTHETICS APPLIED EXTERNALLY FIRST MUST CROSS THE MEMBRANE BEFORE THEY CAN EXERT A BLOCKING ACTION. /LOCAL ANESTHETICS/ ... ACT ON ANY PART OF NERVOUS SYSTEM & ON EVERY TYPE OF NERVE FIBER. /LOCAL ANESTHETICS/

Pharmacodynamics

Dibucaine is an amide-type local anesthetic, similar to lidocaine.