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Tropicamide
Pronunciation
U.S. Brand Names
Generic Available
Synonyms
Pharmacological Index
Use
Pregnancy Risk Factor
Contraindications
Warnings/Precautions
Adverse Reactions
Overdosage/Toxicology
Stability
Mechanism of Action
Pharmacodynamics/Kinetics
Usual Dosage
Monitoring Parameters
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
References

Pronunciation
(troe PIK a mide)

U.S. Brand Names
Mydriacyl®; Opticyl®; Tropicacyl®

Generic Available

Yes


Synonyms
Bistropamide

Pharmacological Index

Ophthalmic Agent, Mydriatic


Use

Short-acting mydriatic used in diagnostic procedures; as well as preoperatively and postoperatively; treatment of some cases of acute iritis, iridocyclitis, and keratitis


Pregnancy Risk Factor

C


Contraindications

Glaucoma, hypersensitivity to tropicamide or any component


Warnings/Precautions

Use with caution in infants and children since tropicamide may cause potentially dangerous CNS disturbances; tropicamide may cause an increase in intraocular pressure


Adverse Reactions

1% to 10%:

Central nervous system: Parasympathetic stimulations, drowsiness, headache

Dermatologic: Eczematoid dermatitis

Gastrointestinal: Xerostomia

Local: Transient stinging

Ocular: Blurred vision, photophobia with or without corneal staining, increased intraocular pressure, follicular conjunctivitis


Overdosage/Toxicology

Symptoms of overdose include blurred vision, urinary retention, tachycardia, cardiorespiratory collapse

Antidote is physostigmine, pilocarpine; 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 systemic effects.


Stability

Store in tightly closed containers


Mechanism of Action

Prevents the sphincter muscle of the iris and the muscle of the ciliary body from responding to cholinergic stimulation


Pharmacodynamics/Kinetics

Onset of mydriasis: ~20-40 minutes Duration: ~6-7 hours;

Onset of cycloplegia: Within 30 minutes; Duration: <6 hours


Usual Dosage

Children and Adults (individuals with heavily pigmented eyes may require larger doses):

Exam must be performed within 30 minutes after the repeat dose; if the patient is not examined within 20-30 minutes, instill an additional drop

Mydriasis: Instill 1-2 drops (0.5%) 15-20 minutes before exam; may repeat every 30 minutes as needed


Monitoring Parameters

Ophthalmic exam


Mental Health: Effects on Mental Status

May cause drowsiness


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

If irritation persists or increases, discontinue use, may cause blurred vision and increased light sensitivity


Nursing Implications

Finger pressure should be applied on the lacrimal sac for 1-2 minutes following topical instillation of the solution


Dosage Forms

Solution, ophthalmic: 0.5% (2 mL, 15 mL); 1% (2 mL, 3 mL, 15 mL)


References

Caputo AR and Schnitzer RE, "Systemic Response to Mydriatic Eyedrops in Neonates: Mydriatics in Neonates," J Pediatr Ophthalmol Strabismus, 1978, 15(2):109-22.


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