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Pronunciation |
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(troe
PIK a
mide) |
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U.S. Brand
Names |
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Mydriacyl®; Opticyl®;
Tropicacyl® |
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Generic
Available |
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Yes |
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Synonyms |
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Bistropamide |
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Pharmacological Index |
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Ophthalmic Agent, Mydriatic |
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Use |
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Short-acting mydriatic used in diagnostic procedures; as well as
preoperatively and postoperatively; treatment of some cases of acute iritis,
iridocyclitis, and keratitis |
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Pregnancy Risk
Factor |
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C |
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Contraindications |
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Glaucoma, hypersensitivity to tropicamide or any
component |
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Warnings/Precautions |
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Use with caution in infants and children since tropicamide may cause
potentially dangerous CNS disturbances; tropicamide may cause an increase in
intraocular pressure |
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Adverse
Reactions |
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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 |
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Overdosage/Toxicology |
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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. |
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Stability |
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Store in tightly closed containers |
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Mechanism of
Action |
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Prevents the sphincter muscle of the iris and the muscle of the ciliary body
from responding to cholinergic stimulation |
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Pharmacodynamics/Kinetics |
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Onset of mydriasis: ~20-40 minutes Duration: ~6-7 hours;
Onset of cycloplegia: Within 30 minutes; Duration: <6 hours
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Usual Dosage |
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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 |
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Monitoring
Parameters |
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Ophthalmic exam |
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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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If irritation persists or increases, discontinue use, may cause blurred
vision and increased light sensitivity |
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Nursing
Implications |
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Finger pressure should be applied on the lacrimal sac for 1-2 minutes
following topical instillation of the solution |
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Dosage Forms |
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Solution, ophthalmic: 0.5% (2 mL, 15 mL); 1% (2 mL, 3 mL, 15
mL) |
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References |
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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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Copyright © 1978-2000 Lexi-Comp Inc. All Rights Reserved
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