Drug Interaction:
Cycloplegic mydriatic include-
Atripine sulphate, homatropine Hbr, Scoplolamine Hbr, Cyclopentolate,Tropicamide
Refer - Homotropine Hbr
May antagonise antiglaucoma and miotic actions of opthalmic anticholinestrase, carbachol or pilocarpine solutions.
Indication:
FIXED DOSE COMBINATIONS APPROVED BY DCG(I) FROM JANUARY 1961 TILL NOVEMBER 2014
Name of Drug Indication Date of Approval
Di iodochlorohydroxyquinoline 300mg + Jan- 1980
Berbrine Hcl 40mg +
Homotropine methylbromide 0.8mg tablet
Treatment of uveitis
Cycloplegic mydriatic include- Atripine sulphate, homatropine Hbr, Scoplolamine Hbr, Cyclopentolate,Tropicamide
Refer - Homotropine Hbr
Adverse Reaction:
Seen in children/elderly on prolonged use, confusion, delerium, rarely convulsions, coma and death from respiratory failure.
Anterior uveitis, dilated pupils and inflammatory exudate in angles after prolonged use.
Contact dermititis of lid, allergic conjuntivitis, headache, blurred vision, Photophobia, pain, lacrimation, loss of taste, Nervousness, drowsiness, weakness, Flushing, and insomnia.
Contra-Indications:
Narrow angle glaucoma, chronic open angle glaucoma, mysthaenia gravis.
Special precautiions:
Fever, elevated enviromental temperature, renal/hepatic disease, CVS disease, throtoxicosis, children and neonates, hypertension.
Dosages/ Overdosage Etc:
Indications:
Treatment of uveitis
Dosage:
1 or 2 drops(2% solution) into theeyes, repeat in 5 or 10 minutes, if necessary.
Patient Information:
Cycloplegic mydriatic include- Opthalmic
Atropine sulphate, homatropine Hbr, Scoplolamine Hbr, Cyclopentolate,Tropicamide
Refer - Homotropine Hbr
1. To avoid contamination, do not touch dropper tip to any surface. Replace cap after using.
2. May cause blurred vision. Do not drive or engange in any hazardous activites while pupils are dilated.
3. May cause sensitivity to light. Protect eyes in bright illumination during dilation.
4. Keep out of reach of children. These drugs should not be taken orally. Wash your hands and the childs following administration.
5. If eye pain occurs, discontinue use and consult physician immediately.
6.Allergies-
Tell your doctor if you have ever had any unusual or allergic reaction to atropine,
homatropine, or scopolamine. Also tell your doctor if you are allergic to any other
substances, such as certain preservatives.
7.Pregnancy-
Studies on effects in pregnancy have not been done in either humans or animals.
however, these medicines may be absorbed into the body.
8.Breast -feeding-
These medicines may be absorbed into the body. Atropine passes into the breast
milk in very small amounts and may cause side effects , such as fast pulse, fever,
or dry skin, in babies of nursing mothers using optlamic atropine. It is not known
whether homatropine, or scoplolamine passes into breast milk in small amounts,
many of them may be used safely while breast-feeding.
Mothers who are using one of these medicines and who wish to breast feed should
discuss with their doctor.
9.Children-
Infants and young children with blond hair or blue eyes may be especially sensitive
to the effects of atropine, hemotropine, or scopolamine. This may increase the
chance of side effects.
10.Elderly-
Elderly people are especially sensitive to the effects of atropine, homotropine,
scopolamine. This may increase the chance of side effects during treatment
11.Other medicines -
Although certain medicines should not be used together at all, in other cases two
different medicines may be used together even if an interaction might occur. in such
cases your doctor may want to change the dose, or other precautions may be necessary.
Tell your health care professional if you are taking any other prescription or
non-prescription ( over -the-counter ) OTC medicine
12.Other medical problems-
The presence of other medical problems may affect the use of ophthalmic atropine,
homotropine or scopolamine. Make sure that you tell your doctor if you have any
other medical problems especially-
Brain damage( in children) or
Downs syndrome(monogolism) in children and adults) or
Glaucoma or
Other eye diseases or problems or
Spastic paralysis( in children) - use of opthalmic atropine, homotropine,
or scopolamine may make the condition worse.
Pharmacology/ Pharmacokinetics:
Ref- Drug Facts And comparisons(2010)
Beta-adrenergic blockers include-
Atenolol, Acebutol, Betaxolol, Bisoprolol,Cartelol,Esmolol,
Labetatol,Metoprolol, Nadolol,Penbutolol, Pinodol, Propranolol,
Solatol, Timolol,
Refer - Atenolol
Beta-adrenergic ophthalmic blocking agent-
Carteolol, Betaxolol, Levobunolol, Metipranol, Timolol
Refer- Timilol
Pharmacology-
Timilol, levobunolol, cartelol, and metipranol are non-cardio-selective (B1 and B2)
Beta blockers, Betaxolol, is a cardioselective B1 Beta blocker. Topical Beta-blockers
do not have significant membrane stabilizing (local- anesthetic actions or intrinsic
sympathomimetic activity. They reduce the elevated and normal IOP, with or without
glaucoma
Pharmacokinetics-
Pharmacokinetic of Ophthalmic Beta- Adrenergic blocking Agents
Parameters
Beta-receptor Onset Maximum effect Duration
selectivity (min) (hr) (hr)
Drug
Carteolol
B1 and B2 nd 2 12
Betaxolol
B1 <30 2 12
Levobunolol
B1 and B2 <30 2 to 6 <24
Metipranolol
B1 and B2 <30 ~2 24
Timolol
B1 and B2 <30 1 to 2 <24
Interaction with Food:
Not known.
Pregnancy and lactation:
Pregnancy:
Safety for use during pregnancy has not been established
Lactation:
Atropine and hematropine may be detectable in breast milk. It is not known if cyclopentolate is excreted in breast milk, Excercise caution while administering to a nursing woman.
