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Pronunciation |
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(a
pra KLOE ni
deen) |
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U.S. Brand
Names |
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Iopidine® |
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Generic
Available |
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Yes |
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Synonyms |
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Aplonidine; Apraclonidine Hydrochloride; p-Aminoclonidine |
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Pharmacological Index |
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Alpha2 Agonist, Ophthalmic |
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Use |
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Prevention and treatment of postsurgical intraocular pressure
elevation |
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Pregnancy Risk
Factor |
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C |
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Contraindications |
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Known hypersensitivity to apraclonidine or clonidine |
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Warnings/Precautions |
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Closely monitor patients who develop exaggerated reductions in intraocular
pressure; use with caution in patients with cardiovascular disease and in
patients with a history of vasovagal reactions |
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Adverse
Reactions |
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1% to 10%:
Central nervous system: Lethargy
Gastrointestinal: Xerostomia
Ocular: Upper lid elevation, conjunctival blanching, mydriasis, burning and
itching eyes, discomfort, conjunctival microhemorrhage, blurred vision
Respiratory: Dry nose
<1%: Allergic response, some systemic effects have also been reported
including GI, CNS, and cardiovascular symptoms (arrhythmias)
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Drug
Interactions |
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Increased effect: Topical beta-blockers, pilocarpine
additive
intraocular
pressure |
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Stability |
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Store in tight, light-resistant containers |
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Mechanism of
Action |
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Apraclonidine is a potent alpha-adrenergic agent similar to clonidine;
relatively selective for alpha2-receptors but does retain some
binding to alpha1-receptors; appears to result in reduction of
aqueous humor formation; its penetration through the blood-brain barrier is more
polar than clonidine which reduces its penetration through the blood-brain
barrier and suggests that its pharmacological profile is characterized by
peripheral rather than central effects. |
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Pharmacodynamics/Kinetics |
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Onset of action: 1 hour
Maximum IOP: 3-5 hours |
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Usual Dosage |
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Adults: Ophthalmic:
1%: Instill 1 drop in operative eye 1 hour prior to anterior segment laser
surgery, second drop in eye immediately upon completion of procedure
Dosing adjustment in renal impairment: Although the topical use of
apraclonidine has not been studied in renal failure patients, structurally
related clonidine undergoes a significant increase in half-life in patients with
severe renal impairment; close monitoring of cardiovascular parameters in
patients with impaired renal function is advised if they are candidates for
topical apraclonidine therapy
Dosing adjustment in hepatic impairment: Close monitoring of
cardiovascular parameters in patients with impaired liver function is advised
because the systemic dosage form of clonidine is partially metabolized in the
liver |
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Monitoring
Parameters |
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Closely monitor patients who develop exaggerated reductions in intraocular
pressure |
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Mental Health: Effects
on Mental Status |
|
May cause drowsiness |
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Mental Health:
Effects on Psychiatric
Treatment |
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Dry mouth may be exacerbated by concurrent use of
psychotropics |
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Dental Health: Local
Anesthetic/Vasoconstrictor
Precautions |
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No information available to require special precautions |
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Dental Health:
Effects on Dental Treatment |
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No effects or complications reported |
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Patient
Information |
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May sting on instillation, do not touch dropper to eye; visual acuity may be
decreased after administration; night vision may be decreased; distance vision
may be altered; read package instructions for insertion |
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Nursing
Implications |
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Wait 5 minutes between instillation of other ophthalmic agents to avoid
washout of previous dose; after topical instillation, finger pressure should be
applied to lacrimal sac to decrease drainage into the nose and throat and
minimize possible systemic absorption |
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Dosage Forms |
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Solution, ophthalmic, as hydrochloride: 0.5% (5 mL); 1% (0.1 mL, 0.25
mL) |
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