Generic Name

Tropicamide

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Classification

FDA Approved Indications

• Diagnostic pupil dilation for eye examinations
• Cycloplegia during ocular examinations

Mechanism of Action

Tropicamide blocks the parasympathetic muscarinic receptors on the iris sphincter pupillae muscle and ciliary body, resulting in pupil dilation (mydriasis) and paralysis of accommodation (cycloplegia).

Dosage and Administration

Adult: Administer 0.5% to 1% eye drops in the conjunctival sac 15-20 minutes before the procedure, repeating as needed up to 2 doses.

Pediatric: Dosing is similar; typically 0.5% to 1% eye drops, with careful monitoring for side effects.

Geriatric: Same as adult dosing, but caution in patients with cardiac or other systemic conditions.

Renal Impairment: No specific dose adjustment recommended; use with caution.

Hepatic Impairment: No specific data; use cautiously.

Pharmacokinetics

Absorption: Topically applied in ocular tissues with minimal systemic absorption.

Distribution: Primarily confined to ocular tissues; minimal plasma levels.

Metabolism: Metabolized locally within ocular tissues; systemic metabolism is minimal.

Excretion: Minimal systemic absorption; any absorbed drug excreted via renal route.

Half Life: Approximately 0.5 to 1 hour in ocular tissues; systemic half-life not well defined due to minimal absorption.

Contraindications

• Allergy to tropicamide or other anticholinergic drugs
• Narrow-angle glaucoma

Precautions

• Use with caution in patients with cardiovascular diseases, myasthenia gravis, or urinary retention; use in children under 6 months is generally avoided due to risk of systemic absorption and side effects.

Adverse Reactions - Common

• Transient stinging or burning sensation in the eye (Common)
• Blurred vision (Common)

Adverse Reactions - Serious

• Allergic reactions including rash, swelling, difficulty breathing (Rare)
• Elevated intraocular pressure in susceptible individuals (Rare)

Drug-Drug Interactions

• Other anticholinergic medications may enhance effects.
• Caution with medications that affect cardiovascular system.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Patient/Family Teaching

• Avoid touching the dropper or contaminating the eye drops.
• Expect temporary effects such as stinging, blurred vision, and photophobia.
• Report any signs of allergic reactions or adverse effects.

Special Considerations

Black Box Warnings:

• None currently

Genetic Factors: Genetic variations are not well characterized affecting this drug.

Lab Test Interference: May interfere with intraocular pressure measurements temporarily.

Overdose Management

Signs/Symptoms: Systemic anticholinergic effects such as dry mouth, urinary retention, tachycardia, hallucinations, and agitation.

Treatment: Supportive care, decontamination if ingested, and symptomatic treatment.

Storage and Handling

Storage: Store at room temperature, away from light and moisture.

Stability: Stable until the expiration date on the packaging.