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Isoflurophate
Pronunciation
U.S. Brand Names
Generic Available
Synonyms
Pharmacological Index
Use
Pregnancy Risk Factor
Contraindications
Warnings/Precautions
Adverse Reactions
Overdosage/Toxicology
Drug Interactions
Stability
Mechanism of Action
Pharmacodynamics/Kinetics
Usual Dosage
Mental Health: Effects on Mental Status
Mental Health: Effects on Psychiatric Treatment
Dental Health: Local Anesthetic/Vasoconstrictor Precautions
Dental Health: Effects on Dental Treatment
Patient Information
Nursing Implications
Dosage Forms

Pronunciation
(eye soe FLURE oh fate)

U.S. Brand Names
Floropryl® Ophthalmic

Generic Available

No


Synonyms
DFP; Diisopropyl Fluorophosphate; Dyflos; Fluostigmin

Pharmacological Index

Acetylcholinesterase Inhibitor; Ophthalmic Agent, Antiglaucoma; Ophthalmic Agent, Miotic


Use

Treat primary open-angle glaucoma and conditions that obstruct aqueous outflow and to treat accommodative convergent strabismus


Pregnancy Risk Factor

X


Contraindications

Active uveal inflammation, angle-closure (narrow-angle) glaucoma, known hypersensitivity to isoflurophate, pregnancy


Warnings/Precautions

May retard corneal healing; because of the tendency to produce more severe adverse effects, use the lowest dose possible; keep frequency of use to a minimum to avoid cyst formation; some products may contain sulfites


Adverse Reactions

1% to 10%: Ocular: Stinging, burning eyes, myopia, visual blurring

<1%: Bradycardia, hypotension, flushing, nausea, vomiting, diarrhea, muscle weakness, retinal detachment, browache, miosis, twitching eyelids, watering eyes, dyspnea, diaphoresis


Overdosage/Toxicology

Symptoms of overdose include excessive salivation, urinary incontinence, dyspnea, diarrhea, profuse sweating

If systemic effects occur, administer parenteral atropine; for severe muscle weakness; pralidoxime may be used in addition to atropine


Drug Interactions

Increased toxicity: Succinylcholine, systemic anticholinesterases, carbamate or organic phosphate insecticides, may decrease cholinesterase levels


Stability

Protect from moisture, freezing, excessive heat


Mechanism of Action

Cholinesterase inhibitor that causes contraction of the iris and ciliary muscles producing miosis, reduced intraocular pressure, and increased aqueous humor outflow


Pharmacodynamics/Kinetics

Peak IOP reduction: 24 hours; Duration: 1 week

Onset of miosis: Within 5-10 minutes; Duration: Up to 4 weeks


Usual Dosage

Adults: Ophthalmic:

Strabismus: Instill 0.25" strip to each eye every night for 2 weeks then reduce to 0.25" every other night to once weekly for 2 months


Mental Health: Effects on Mental Status

None reported


Mental Health: Effects on Psychiatric Treatment

None reported


Dental Health: Local Anesthetic/Vasoconstrictor Precautions

No information available to require special precautions


Dental Health: Effects on Dental Treatment

No effects or complications reported


Patient Information

Notify physician if abdominal cramps, diarrhea, or salivation occur


Nursing Implications

Keep tube tightly closed to prevent absorption of moisture and loss of potency


Dosage Forms

Ointment, ophthalmic: 0.025% in polyethylene mineral oil gel (3.5 g)


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