Tropicamide

Tropicamide

Tropicamide is a topical antimuscarinic medication that is used to reduce the particle size of the pupil of the eye to inhibit visual accommodation for diagnostic and therapeutic procedures. It has a marked effect on pupillary size and a marked effect on visual accommodation for a short duration of time.

Uses for

Tropicamide is used to reduce pupil size for diagnostic procedures like ophthalmoscopy, endothelial specular microscopy, fundus photography, and tonography. Its use also includes therapeutic management of acute angle-closure glaucoma and sympathetic ophthalmia.

Brand Name	Tropicamide
Type
Weight
Generic	Tropicamide
Manufacturer
Available in	English বাংলা

Mechanism of Action

Tropicamide binds to muscarinic acetylcholine receptors on the iris sphincter muscle resulting in a decrease in the muscle's contractility. This results in mydriasis (dilation) and cycloplegia (paralysis of accommodation). Tropicamide is also believed to decrease intraocular pressure.

How Long Does It Take to Work?

Tropicamide begins to take effect within 30 minutes and can last for up to 8 hours.

Absorption

Tropicamide is rapidly absorbed through the corneal and conjunctival epithelium. It is also absorbed through the ciliary body and iris.

Route of Elimination

Tropicamide is metabolized in the liver and excreted through the kidneys.

Dosage

For refraction: instill 1 or 2 drops in the eye(s), repeated in 5 minutes. If patient is not seen within 20 to 30 minutes, an additional drop may be instilled to prolong mydriatic effect.

For examination of the fundus: instill 1 drop 15 to 20 minutes prior to examination.

The recommended dose of tropicamide is one drop of a 0.5% or 1% solution into the conjunctival sac of the affected eye. The strength and amount of medicinal product must be specified when prescribing and/or dispensing tropicamide.

Administration

Tropicamide is administered via topical ophthalmic route. It should not come into contact with the eye lids and conjunctivae.

Side Effects

The most common reported side effects from tropicamide use are burning, stinging, discomfort or a feeling of foreign body sensation in the eyes, blurred vision, myopia, conjunctival hyperemia, decrease in intraocular pressure, transient ischemic optic neuropathy, ciliary block glaucoma, circumpapillary telengiectasia, purulent conjunctivitis, cystoid macular edema, and keratitis. It can also cause systemic effects on the cardiovascular system, such as tachycardia and hypertension.

Toxicity

Tropicamide is not known to be toxic at therapeutic doses. In case of accidental ingestion, the effects may include blurred vision, drowsiness, insomnia, loss of appetite, nausea, vomiting and increased salivation and bronchial secretions.

Precaution

Patients should be monitored for signs and symptoms of systemic side effects such as hypertension and tachycardia, especially in those with a history of cardiovascular disease. Long-term use of tropicamide may increase the risk of cataracts so patients should be monitored for any changes in vision. It should not be used in patients with known hypersensitivity to anticholinergics.

Interaction

Tropicamide may interact with other medications, including anticonvulsants, antidepressants, antiarrhythmics, digitalis glycosides, narcotics, orphenadrine, quinidine, and sedatives. It may also interact with antihistamines, antimuscarinics, and para-aminobenzoic acid.

Disease Interactions

Tropicamide should be used with caution in patients with angle-closure glaucoma, congestive heart failure, urinary retention, arrhythmias, and bronchial asthma. It may exacerbate narrow angle glaucoma in some patients.

Drug Interactions

Tropicamide may interact with other ophthalmic products such as mydriatics, miotics, adrenergics, anti-inflammatory agents, and antiglaucoma agents. It may also interact with medications used to treat neurological disorders, cardiovascular disorders, and gastrointestinal disorders.

Food Interactions

Tropicamide should not be taken with food, as it can impair absorption.

Pregnancy Use

Tropicamide should be used during pregnancy only if clearly needed. The safety and efficacy of the drug in pregnant women has not been established.

Lactation Use

Tropicamide is excreted in the breast milk, and should not be used during lactation.

Acute Overdose

Acute overdose of tropicamide may cause tachycardia, hypertension, and CNS disturbances, although the effects are usually mild. Treatment is symptomatic and supportive.

Contraindication

Tropicamide is contraindicated in patients with narrow angle glaucoma, hypersensitivity to anticholinergics, and in patients with a history of peptic ulcer disease, bladder neck obstruction, or hiatal hernia.

Use Direction

Tropicamide should be administered as one drop of the appropriate concentration into the conjunctival sac of the affected eye three to four times daily. It should not be used for more than 2 weeks without consulting a physician.

Storage Condition

Tropicamide should be stored at room temperature between 15° C and 30° C. Protect from light and moisture and keep away from children.

Volume of Distribution

The volume of distribution for tropicamide is approximately 10-15L/kg.

Half Life

The elimination half-life of tropicamide is approximately 1.6 hours.

Clearance

The clearance of tropicamide is approximately 35-60 mL/min/kg.

See in details version Tropicamide also Tropicamide in bangla

Some Frequently Asked Questions About Tropicamide