McKenna's Pharmacology for Nursing, 2e

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A P P E N D I X D Ophthalmic agents

■■ TABLE D Ophthalmic agents (continued) Drug Usage

Special considerations

brinzolamide (Azopt, BrinzoQuin)

To decrease intraocular pressure in open-angle glaucoma To decrease intraocular pressure in open-angle glaucoma Direct-acting miotic; for treatment of glaucoma; miosis during surgery Treatment of bacterial conjunctivitis and other eye infections Treatment of severe bacterial conjunctivitis and corneal ulcers Mydriasis/cycloplegia in diagnostic procedures Treatment of inflammation and allergic conditions Photophobia: for use in individuals undergoing incisional refractive surgery Treatment of elevated IOP in open-angle glaucoma or ocular hypertension To decrease IOP in open-angle glaucoma or ocular hypertension in individuals who do not respond to beta-blockers alone Staining of the eye for ophthalmic examination Topical corticosteroid used for treatment of inflammatory conditions of the eye Treatment of conjunctivitis, minor infections, corneal abrasion Inhibition of intraoperative miosis Long-acting mydriatic and cycloplegic used for refraction and treatment of inflammatory conditions of the uveal tract Treatment of inflammatory eye conditions Temporary relief of symptoms of allergic conjunctivitis Temporary relief of itching due to allergic conjunctivitis Treatment of open-angle glaucoma or ocular hypertension in individuals intolerant or unresponsive to other agents Treatment of open-angle glaucoma or ocular hypertension in individuals intolerant or unresponsive to other agents Treatment of vernal conjunctivitis and keratitis Treatment of external eye infection

May be given with other agents; dosage: one drop t.d.s.; give 10 minutes apart from any other agents Shake bottle well prior to use. Apply one drop to affected eye b.d. Surgical dose: a one-use-only portion; for glaucoma: 1–2 drops up to t.d.s. as needed May cause local burning or stinging, crystalline precipitate Individuals with dark-pigmented irises may require higher doses; compress lacrimal sac for 1–2 minutes after administration to decrease any systemic absorption Apply 1–2 drops 4–6 times daily; not to be used with contact lenses Apply one drop q.i.d. beginning 24 hours after cataract surgery; continue through the first 2 weeks after surgery A sulfonamide; monitor individuals taking parenteral sulfonamides for possible adverse effects Administer one drop in affected eye b.d; monitor for cardiac failure; if absorbed, may mask symptoms of hypoglycaemia or thyrotoxicosis Care needs to be taken to ensure solution is kept sterile due to potential spread of eye infection Improvement should occur within several days; discontinue if no improvement is seen; discontinue if swelling of the eye occurs Two drops q 1–2 hours decreasing to 2–3 drops t.d.s. One drop half-hourly commencing 2 hours prior to surgery to total of four drops 1–2 drops into affected eye q 4 hours; apply pressure to tear duct following administration Individuals with dark-pigmented irises may require larger doses; 5–10 minutes is usually required for refraction Remove contact lenses before use—may be replaced 10 minutes after administration; an antihistamine/mast cell stabiliser Remove contact lenses before use and for 15 minutes after use; allow at least 5 minutes between this and the use of any other agents; expect blurring of vision Apply pressure to tear duct immediately following administration. Remove contact lenses before use and for 15 minutes after use Individuals should not wear contact lenses while using this drug; discontinue if stinging or burning persists after instillation Continued on following page Chronic use may result in toxicity Apply to affected eye(s) b.d. to q.i.d. One drop q.i.d. for up to 4 weeks

brinzolamide with timolol (Azarga) carbachol (Isopto, Miostat) chloramphenicol (Chloromycetin, Chlorsig) ciprofloxacin hydrochloride (CiloQuin, Ciloxin) cyclopentolate (Cyclogyl)

dexamethasone (Maxidex)

diclofenac sodium (Voltaren Ophtha)

dorzolamide (Trusopt)

dorzolamide 2% and timolol 0.5% (Cosopt)

fluorescein sodium (generic)

fluorometholone (Flarex, Flucon, FML)

framycetin sulfate (Soframycin) furbiprofen (Ocufen)

gentamicin (Genoptic)

homatropine (Isopto Homatropine)

hydrocortisone (Siguent Hycor Ointment)

ketorolac (Acular)

ketotifen (Zaditen)

latanoprost (Xalatan)

latanoprost with timolol (Xalacom)

lodoxamide (Lomide)