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Pronunciation |
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(hoe
MA troe
peen) |
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U.S. Brand
Names |
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AK-Homatropine® Ophthalmic;
Isopto® Homatropine
Ophthalmic |
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Generic
Available |
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Yes |
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Synonyms |
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Homatropine Hydrobromide |
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Pharmacological Index |
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Anticholinergic Agent, Ophthalmic; Ophthalmic Agent,
Mydriatic |
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Use |
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Producing cycloplegia and mydriasis for refraction; treatment of acute
inflammatory conditions of the uveal tract |
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Pregnancy Risk
Factor |
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C |
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Contraindications |
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Narrow-angle glaucoma, acute hemorrhage or hypersensitivity to the drug or
any component in the formulation |
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Warnings/Precautions |
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Use with caution in patients with hypertension, cardiac disease, or increased
intraocular pressure; safety and efficacy not established in infants and young
children, therefore, use with extreme caution due to susceptibility of systemic
effects; use with caution in obstructive uropathy, paralytic ileus, ulcerative
colitis, unstable cardiovascular status in acute hemorrhage |
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Adverse
Reactions |
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>10%: Ocular: Blurred vision, photophobia
1% to 10%:
Local: Stinging, local irritation
Ocular: Increased intraocular pressure
Respiratory: Congestion
<1%: Vascular congestion, edema, drowsiness, exudate, eczematoid
dermatitis, follicular conjunctivitis |
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Overdosage/Toxicology |
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Symptoms of overdose include blurred vision, urinary retention, tachycardia
Anticholinergic toxicity is caused by strong binding of the drug to
cholinergic receptors. For anticholinergic overdose with severe life-threatening
symptoms, physostigmine 1-2 mg (0.5 mg or 0.02 mg/kg for children) S.C. or I.V.,
slowly may be given to reverse these effects. |
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Stability |
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Protect from light |
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Mechanism of
Action |
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Blocks response of iris sphincter muscle and the accommodative muscle of the
ciliary body to cholinergic stimulation resulting in dilation and loss of
accommodation |
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Pharmacodynamics/Kinetics |
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Onset of accommodation and pupil effect: Ophthalmic:
Maximum mydriatic effect: Within 10-30 minutes
Maximum cycloplegic effect: Within 30-90 minutes
Duration:
Mydriasis: 6 hours to 4 days
Cycloplegia: 10-48 hours |
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Usual Dosage |
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Children:
Mydriasis and cycloplegia for refraction: Instill 1 drop of 2% solution
immediately before the procedure; repeat at 10-minute intervals as needed
Uveitis: Instill 1 drop of 2% solution 2-3 times/day
Adults:
Mydriasis and cycloplegia for refraction: Instill 1-2 drops of 2% solution or
1 drop of 5% solution before the procedure; repeat at 5- to 10-minute intervals
as needed; maximum of 3 doses for refraction
Uveitis: Instill 1-2 drops of 2% or 5% 2-3 times/day up to every 3-4 hours as
needed |
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Administration |
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Ophthalmic instillation: Finger pressure should be applied to lacrimal sac
for 1-2 minutes after instillation to decrease risk of absorption and systemic
reactions |
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Mental Health: Effects
on Mental Status |
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May cause drowsiness |
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Mental Health:
Effects on Psychiatric
Treatment |
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None reported |
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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 cause blurred vision; if irritation persists or increases, discontinue
use |
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Nursing
Implications |
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Finger pressure should be applied to lacrimal sac for 1-2 minutes after
instillation to decrease risk of absorption and systemic
reactions |
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Dosage Forms |
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Solution, ophthalmic, as hydrobromide:
AK-Homatropine®: 5% (15 mL)
Isopto® Homatropine 2% (5 mL, 15 mL); 5% (5 mL, 15 mL)
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References |
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Barker DB and Solomon DA,
"The Potential for Mental Status Changes Associated With Systemic Absorption of Anticholinergic Ophthalmic Medications: Concerns in the Elderly,"
DICP Ann Pharmacother, 1990, 24(9):847-50.
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