Phenylephrine + Tropicamide Pharmacology

Phenylephrine + Tropicamide

About Phenylephrine + Tropicamide
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Mechanism of Action of Phenylephrine + Tropicamide
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Pharmacokinets of Phenylephrine + Tropicamide
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Onset of Action for Phenylephrine + Tropicamide
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Duration of Action for Phenylephrine + Tropicamide
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Half Life of Phenylephrine + Tropicamide
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Side Effects of Phenylephrine + Tropicamide
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Contra-indications of Phenylephrine + Tropicamide
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Special Precautions while taking Phenylephrine + Tropicamide
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Pregnancy Related Information
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Old Age Related Information
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Breast Feeding Related Information
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Children Related Information
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Indications for Phenylephrine + Tropicamide
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Interactions for Phenylephrine + Tropicamide
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Typical Dosage for Phenylephrine + Tropicamide
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Schedule of Phenylephrine + Tropicamide
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Storage Requirements for Phenylephrine + Tropicamide
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Effects of Missed Dosage of Phenylephrine + Tropicamide
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Effects of Overdose of Phenylephrine + Tropicamide
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Phenylephrine

About Phenylephrine
An a1-adrenergic receptor agonist, Phenethylamine derivative, Decongestant, Antiglaucoma, Mydriatic.
Mechanism of Action of Phenylephrine
The drug exerts it`s pharmacological action by acting as a selective alpha-1 adrenergic agonist. It causes vasoconstriction and increases total peripheral resistance and raises blood pressure. It reduces intraocular tension by constricting ciliary body blood vessels and produce mydriasis (without cycloplegia). It exerts nasal decongestant action; by vasoconstrictory action on arterioles of nasal mucosa. It prolongs and localizes the action of anaesthetics due to it`s vasoconstrictory action on skin, mucous membrane, and viscera and thus slows the rate of absorption of local anaesthetics.
Pharmacokinets of Phenylephrine
Absorption: Variable depending up on the route of administration. Metabolism: Metabolized in the liver and intestine.
Onset of Action for Phenylephrine
Nasal: Rapid
Ophthalmic: Rapid
I.V.: Rapid
I.M.: Within 15 minutes
Duration of Action for Phenylephrine
Nasal: ? to 4 hours
Ophthalmic: 3 to 7 hours
I.V.: 15 to 20 minutes
I.M.: ? to 2 hours.


Half Life of Phenylephrine
N/A
Side Effects of Phenylephrine
1.Bradycardia
2.Arrhythmias
3.Hypertension
4.Tachycardia
5.Palpitations
6.Premature ventricular contractions
7.Pallor
8.Headache
9.Dizziness
10.Nervousness
11.Brow ache(with ophthalmic form)
12.Burning or stinging in eye
13.Blurred vision
14.Elevated intraocular pressure
15.Nausea
16.Episodes of asthma
17.Tachyphylaxis
18.Anaphylaxis


Contra-indications of Phenylephrine
1.Hypersensitivity to the drug
2.Hyperthyroidism
3.Ventricular tachycardia and severe hypertension (Injected form)
4.Angle closure glaucoma and in those who wear soft contact lenses(ophthalmic form)
Special Precautions while taking Phenylephrine
1.Coronary diseases
2.Advanced arteriosclerosis
3.Bradycardia
4.Partial heart block
5.Myocardial diseases
6.Atherosclerosis
7.Hypertension
8.Nasal and ophthalmic form use cautiously in type-1 diabetes mellitus

Pregnancy Related Information
Use with caution
Old Age Related Information
Use with caution
Breast Feeding Related Information
Use with caution
Children Related Information
Use with caution
Below age 6:contraindicated
Indications for Phenylephrine
1.Hypotension
2.Paroxysmal supra ventricular tachycardia
3.Maintain blood pressure during spinal and inhalation anaesthesia
4.Prolongation of spinal anaesthesia
5.Shock
6.Mydriasis(without cycloplegia)
7.Nasal congestion.
8.Cataract

Interactions for Phenylephrine
May interact with systemically administered MAOIs.
Typical Dosage for Phenylephrine
I.M. or S.C.: 2 to 5mg. Then if required; give doses up to 10mg.
Slow I.V. injection: 0.1 to 0.5mg. Then if required; repeat after 15 minutes.
I.V. infusion: Starts with 0.18mg/minute. Then adjust the dosage up to 0.03 to 0.06mg/minute based on patient`s response.
Nasal congestion: Apply 2 to 3 drops or 1 to 2 sprays of 0.25% to 1% solution instilled in each nostril.
Mydriasis (without cycloplegia): Instill 1 to 2drops 2.5% or 10% solution in eye. Repeated if required.
Prolongation of spinal anaesthesia: 2 to 5mg added to anaesthetic solution.
Schedule of Phenylephrine
N/A
Storage Requirements for Phenylephrine
Store at controlled room temperature at range of 15 to 30 degree C. in a well closed container. Protect from light.
Effects of Missed Dosage of Phenylephrine
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Phenylephrine
Discontinue the drug and give supportive and symptomatic treatment. Closely monitor vital signs. Use atropine sulfate to block reflex Bradycardia. Treat excessive hypertension with phentolamine. Treat cardiac arrhythmia with propranolol. Treat excessive mydriatic effect with levodopa.

Tropicamide

About Tropicamide
Anticholinergic (muscarinic blocker), Ophthalmic Agent, Mydriatic, cycloplegic.
Mechanism of Action of Tropicamide
Tropicamide is a muscarinic receptor blocker. It nonselectively inhibits the muscarinic actions of Acetylcholine. Tropicamide blocks the muscarinic receptors in the muscles of the eye which are involved in controlling the pupil size and the shape of the lens. Tropicamide blocks the cholinergic nerves supplying the smooth muscles of iris and produces Mydriasis. It also causes paralysis of ciliary muscle and produces a tightening of the suspensory ligament and results in flattening of the lens and a consequent increase in focal length. Because of paralysis of muscle cannot constrict the pupils for viewing near object or prevents the eye from accommodating for near vision (Cycloplegia).
Tropicamide is given as eye drops to dilate the pupil and relax the lens so that eye examinations can be carried out thoroughly. It is often used to aid eye examinations in young children.
Pharmacokinets of Tropicamide
Absorption: Tropicamide is readily absorbed after ophthalmic use.
Onset of Action for Tropicamide
15 - 30 minutes
Duration of Action for Tropicamide
3 - 8 hours
Half Life of Tropicamide
N/A
Side Effects of Tropicamide
1. Photophobia
2. Irritation
3. Contact dermatitis
4. Blurring
5. Mydriasis
6. Tachycardia
7. Aiaxia
8. Pain
9. Lacrimation (hyperemia)
10. Increased intraocular pressure
Contra-indications of Tropicamide
1. Hypersensitivity to Tropicamide and other belladonna alkaloids
2. Aangle closure glaucoma
Special Precautions while taking Tropicamide
1. Avoid the use of medicament if any allergic reactions occur
2. Any work that require good vision like driving vehicle, operating machine
3. Wear sun glasses
4. Raised intraocular pressure
5. Avoid use of soft contact lens
Pregnancy Related Information
Use with caution
Old Age Related Information
Use with caution
Breast Feeding Related Information
Use with caution
Children Related Information
Use with caution
Indications for Tropicamide
1. Dilating the pupil to aid examination of the eye
2. Cycloplegic refraction
Interactions for Tropicamide
N/A
Typical Dosage for Tropicamide
Adult and children
Tropicamide 0.5% and 1 % eye drops are available.
Eye drop: Instill 1-2 drop 15 - 20 minutes before procedure
Schedule of Tropicamide
N/A
Storage Requirements for Tropicamide
Store in a cool dry place in a tightly closed container. Protect from heat and light. Keep out of the reach of children. Discard the drug 1 month after opening.
Effects of Missed Dosage of Tropicamide
Instill the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Tropicamide
A topical ocular overdose of an ophthalmic product containing Tropicamide may be flushed from the eye with warm tap water.

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