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Benzocaine, sold under the brand name Orajel amongst others, is a local anesthetic, belonging to the amino ester drug class, commonly used as a topical painkiller or in cough drops. It is the active ingredient in many over-the-counter anesthetic ointments such as products for oral ulcers .
Drugs listed on the Beers List are categorized according to risks for negative outcomes. The tables include medications that have cautions, should be avoided, should be avoided with concomitant medical conditions, and are contraindicated and relatively contraindicated in the elderly population.
Benzodiazepines require special precaution if used in the elderly, during pregnancy, in children, in alcohol- or other drug-dependent individuals or those with comorbid psychiatric disorders. [39] Additional caution is required in critically ill patients, as accumulation of midazolam and its active metabolites may occur. [ 40 ]
For example, the British National Formulary uses the cautions versus contraindications pair, and various U.S. CDC webpages use precautions versus contraindications. The logic of the latter two styles is the idea that readers must never be confused: the word contraindication in that usage always is meant in its absolute sense , providing ...
In April 2005, FDA advisors requested that Pfizer place a boxed warning on their non-steroidal anti-inflammatory drug Celebrex for cardiovascular and gastrointestinal risks. [9] [10] In 2005, the FDA issued a boxed warning regarding the risk of atypical antipsychotics being prescribed among elderly patients with dementia. This advisory was ...
Ultimately, when a drug is marketed it may be used in patient populations that were not studied during clinical trials (children, the elderly, pregnant women, patients with co-morbidities not found in the clinical trial population, etc.) and a different set of warnings, precautions or contraindications (where the drug should not be used at all ...
As the evidence and consensus for use of the drug increases and strengthens, its class of indication is improved. [6] Preferred drugs (and other treatments) are also referred to a "first line" or "primary" while others are called "second line", "third line" etc. [7] [8] A drug may be indicated as an "adjunct" or "adjuvant", added to a first ...
However, combining these drugs with alcohol, opiates or tricyclic antidepressants markedly raises the toxicity. [22] [169] [170] The elderly are more sensitive to the side effects of benzodiazepines, and poisoning may even occur from their long-term use. [171]