Read Mosby's 2014 Nursing Drug Reference Online
Authors: Linda Skidmore-Roth
Mosby's 2014 Nursing Drug Reference (440 page)
Ophthalmic, otic, nasal, and topical products
PRODUCTS
lidocaine (Rx)
Akten
proparacaine (Rx)
(proe-par′a-kane)
Alcaine, Diocaine
, Parcaine
tetracaine (Rx)
(tet′ra-kane)
Tetcaine, TetraVisc
alcaftadine (Rx)
Lastacaft
emedastine (Rx)
(ee-med′ah-steen)
Emadine
olopatadine (Rx)
(oh-loh-pat′ah-deen)
Pataday, Patanol
azithromycin (Rx)
(ay-zi-thro-my′sin)
AzaSite
besifloxacin (Rx)
(be′si-flox′a-sin)
Besivance
ganciclovir (Rx)
(gan-sye′kloe-vir)
Zirgan
levofloxacin (Rx)
(lee-voh-floks′a-sin)
natamycin (Rx)
(nat-a-mye′sin)
Natacyn
ofloxacin (Rx)
(oh-flox′a-sin)
Ocuflox
silver nitrate 1% (Rx)
silver nitrate
sulfacetamide sodium (Rx)
(sul-fa-seet′a-mide)
Bleph-10
tobramycin (Rx)
(toe-bra-mye′sin)
Tobrasol, Tobrex
trifluridine (Rx)
(trye-floor′i-deen)
Viroptic
betaxolol (Rx)
(beh-tax′oh-lole)
Betoptic S
levobunolol (Rx)
(lee-voe-byoo′no-lole)
Betagen
metipranolol (Rx)
(met-ee-pran′oh-lole)
OptiPranolol
brinzolamide (Rx)
(brin-zoh′la-mide)
Azopt
(Direct-acting)
acetylcholine Rx)
(ah-see-til-koe′leen)
Miochol-E
carbachol (Rx)
(kar′ba-kole)
Isopto Carbachol
pilocarpine (Rx)
(pye-loe-kar′peen)
Isopto Carpine, Pilopine HS
echothiophate (Rx)
(ek-oh-thye′eh-fate)
Phospholine Iodide
fluocinolone (Rx)
(floo-oh-sin′oh-lone)
Retisert
fluorometholone (Rx)
(flure-oh-meth′oh-lone)
Flarex, FML, Liquifilm, FML Forte, FML S.O.P.
loteprednol (Rx)
(loe-tee-pred′nole)
Alrex, Lotemax
prednisolone (Rx)
(pred-niss′oh-lone)
Econopred, Omnipred, Pred Mild, Pred-Forte
rimexolone (Rx)
(ri-mex′a-lone)
Vexol
atropine (Rx)
(a′troe-peen)
Atropine Care, Isopto Atropine
cyclopentolate (Rx)
(sye-kloe-pen′toe-late)
Cyclogyl, Cylate
homatropine (Rx)
(home-a′troe-peen)
Isopto Homatropine
Phenylephrine (
OTC
)
(fen-ill-ef′rin)
Neofrin, Mydfrin
scopolamine (Rx)
(skoe-pol′a-meen)
Isopto Hyoscine
tropicamide (Rx)
(troe-pik′a-mide)
Mydral, Mydriacyl
diclofenac (Rx)
(dye-kloe′fen-ak)
flurbiprofen (Rx)
(flure-bih-proh′fen)
Ocufen
nepafenac (Rx)
(ne-pa-fen′ak)
Ilevro, Nevanac
apraclonidine (Rx)
(a-pra-klon′i-deen)
Iopidine
Lodoxamide
(loe-dox′a-mide)
Alomide
oxymetazoline (Rx)
(ox-i-meth′oh-leen)
Visine L.R.
tetrahydrozoline (
OTC
)
(tet-ra-hye-dro′zoe-leen)
Opticlear, Visine Original
travoprost (Rx)
(tra′voe-prost)
Travatan Z
unoprostone (Rx)
(un-oh-proe′stone)
Rescula
-Adrenergic blockers
Reduces production of aqueous humor by unknown mechanism
Ocular hypertension, chronic open-angle glaucoma
Decreases ion permeability by stabilizing neuronal membrane
Cataract extraction, tonometry, gonioscopy, removal of foreign objects, corneal suture removal, glaucoma surgery (ophthalmic); pruritus, sunburn, toothache, sore throat, cold sores, oral pain, rectal pain and irritation, control of gagging (topical)
Inhibits folic acid synthesis by preventing PABA use, which is necessary for bacterial growth
Uses:
Conjunctivitis, superficial eye infections, corneal ulcers, prophylaxis against infection after removal of foreign matter from the eye
Decreases inflammation, resulting in decreased pain, photophobia, hyperemia, cellular infiltration
Inflammation of eye, eyelids, conjunctiva, cornea; uveitis, iridocyclitis, allergic conditions, burns, foreign bodies, postoperatively in cataract
Converted to EPINEPHrine, which decreases aqueous production and increases outflow
Uses:
Open-angle glaucoma, ocular hypertension
Acts directly on cholinergic receptor sites; induces miosis, spasm of accommodation, fall in intraocular pressure, caused by stimulation of ciliary, pupillary sphincter muscles, which leads to pulling away of iris from filtration angle, resulting in increased outflow of aqueous humor
Uses:
Primary glaucoma, early stages of wide-angle glaucoma (less useful in advanced stages), chronic open-angle glaucoma, acute closed-angle glaucoma before emergency surgery; also neutralizes mydriatics used during eye exam; may be used alternately with mydriatics to break adhesions between iris and lens
Hypersensitivity
Precautions:
Pregnancy, breastfeeding, children, aphakia, hypersensitivity to carbonic anhydrase inhibitors, sulfonamides, thiazide diuretics, ocular inhibitors, hepatic/renal insufficiency
CNS:
Headache
CV:
Hypertension, tachycardia, dysrhythmias
EENT:
Burning, stinging
GI:
Bitter taste
•
Ophth exams and intraocular pressure readings
•
Blood counts; hepatic, renal function tests and serum electrolytes during long-term treatment
•
Storage at room temperature away from light
•
Positive therapeutic response
•
Absence of increased intraocular pressure
•
How to instill drops
•
That product may cause burning, itching, blurring, dryness of eye area
Canada only Side effects:
italics
= common;
bold
= life-threatening 
Nurse Alert
azelastine (Rx)
(ay-zell′ah-steen)
Astelin
desoxyephedrine (
OTC
)
(des-oxy-e-fed′rin)
Vicks Vapor Inhaler
EPINEPHrine (
OTC
)
(ep-i-neff′rin)
Adrenalin
oxymetazoline (
OTC
)
(ox-i-met-az′oh-leen)
12-Hour Nasal, Afrin 12-Hour Original, Afrin 12-Hour Original Pump Mist, Afrin Severe Congestion with Menthol, Afrin Sinus with Vapornase, Afrin No-Drip 12-Hour, Afrin No-Drip 12-Hour Extra Moisturizing, Dristan, Mucinex Full Force, Mucinex Moisture Smart, Neo-Synephrine 12-Hour, Vicks Sinex
phenylephrine (
OTC
)
(fen-ill-eff′rin)
4-Way Fast Acting Nasal Spray, Neo-Synephrine
tetrahydrozoline (
OTC
)
(tet-ra-hye-dro′zoe-leen)
Tyzine
budesonide (Rx)
(byoo-des′oh-nide)
Rhinocort Aqua
fluticasone (Rx)
(floo-tic′a-son)
Flonase, Veramyst
triamcinolone (Rx)
(trye-am-sin′oh-lone)
Nasacort AQ
ketorolac (Rx)
(kee′toe-role′ak)
Sprix
Produces vasoconstriction (rapid, long acting) of arterioles, thereby decreasing fluid exudation, mucosal engorgement by stimulation of α-adrenergic receptors in vascular smooth muscle
Nasal congestion
Hypersensitivity to sympathomimetic amines
Precautions:
Pregnancy (C), children <6 yr, geriatric, diabetes, CV disease, hypertension, hyperthyroidism, increased intracranial pressure, prostatic hypertrophy, glaucoma
Calculator
• Adult and child >6 yr: 1-2
INH
in each nostril q2hr or less
• Adult and child
>
6 yr:
Apply with swab, drops, spray prn
• Adult and child
>
6 yr:
INSTILL
2-3 gtt or sprays to each nostril bid
• Child 2-6 yr:
I
NSTILL
2-3 gtt or sprays 0.025 sol bid, max 3 days
• Adult and child
>
12 yr:
2-3 drops/spray (0.25-0.5) in each nostril q3-4hr or less; or 2-3 drops/spray (1%) in each nostril q4hr or less
• Child 6-12 yr:
2-3 drops/spray (0.25%) in each nostril q3-4hr
• Infant
>
6 mo:
1-2 drops (0.16%) in each nostril q3hr
• Adult and child
>
6 yr:
2-4 drops (0.1%) q3-4hr prn or 3-4 sprays in each nostril q4hr prn
• Child 2-6 yr:
2-3 drops (0.05%) in each nostril q4-6hr prn
Available forms:
Nasal sol
•
Having patient tilt head back, squeeze bulb to create a vacuum, and draw correct amount of sol into dropper; insert 2 gtt of sol into nostril; repeat in other nostril
•
Store in light-resistant container; do not expose to high temperature or let sol come into contact with aluminum
•
For <4 consecutive days
•
Environmental humidification to decrease nasal congestion, dryness
CNS:
Anxiety, restlessness, tremors, weakness, insomnia, dizziness, fever, headache
EENT:
Irritation, burning, sneezing, stinging, dryness, rebound congestion
GI:
Nausea, vomiting, anorexia
INTEG:
Contact dermatitis
•
For redness, swelling, pain in nasal passages before and during treatment
•
For systemic absorption; hypertension, tachycardia; notify prescriber; systemic absorption occurs at high doses or after prolonged use
•
Therapeutic response: decreased nasal congestion
•
That stinging may occur for several applications; drying of mucosa may be decreased by environmental humidification
•
To notify prescriber if irregular pulse, insomnia, dizziness, or tremors occur
•
Proper administration to avoid systemic absorption
•
To rinse dropper with very hot water to prevent contamination