In ophthalmic practice for the study of the fundus and other diagnostic procedures use Tropicamide. The drug is classified as a mydriatic. The popularity of conjunctival drops is due to their low cost, safety and clinical efficacy.
Record content:
- 1 Release form and composition of the drug
- 2 Pharmacological properties
- 3 Pharmacodynamics and pharmacokinetics
- 4 Indications for use
- 5 Contraindications
- 6 At what age can the drug be used?
- 7 Instructions for use, dosage
- 8 Side effects
- 9 Overdose
- 10 special instructions
- 11 Drug interactions
- 12 Analogs
- 13 Terms, conditions of storage and sale
- 14 Price
- 15 Video about the drug
Release form and composition of the drug
Ophthalmic medication for topical use is a clear liquid solution without color and pronounced odor. The drug composition is delivered to pharmacies in standard 5 ml vials made of soft polymer material of a medical grade.
It is chemically neutral, hypoallergenic and sterile. Each bottle is equipped with a tapered droplet dispenser, which ensures the accuracy of drug delivery into the ocular cavity. Ophthalmic medication is produced with an active ingredient concentration of 0.5 and 1%.
Tropicamide - eye drops, the price of which is available to a wide range of patients. Instructions for use are placed in the original cardboard box with the medicinal composition. Manufacturer - Polish pharmaceutical concern "Warsaw Pharmaceutical".
The main active component of eye drops has a similar name to the drug and belongs to the pharmacological group of muscarinic blockers acetylcholine receptors - physiological elements of the optical apparatus that transmit visual signals to the brain using heterotrimeric G-proteins. 1 ml of a 0.5% solution contains 5 mg of tropicamide.
The following auxiliary components are included in the drug formula:
| Chemical compound | Properties and purpose |
| Benzalkonium chloride | A special mixture of chloride compounds with pronounced bactericidal activity. The antiseptic component has virucidal, antiprotozoal, antifungal properties. |
| Sodium chloride | Chemically neutral saline solution. Easily penetrates the plasma envelope. Increases the volume of blood circulating in the eye capillaries, has a cleansing effect, normalizes osmotic pressure. |
| Hydrogen chloride | Potent monobasic acid of inorganic origin. A powerful bactericide, vigorously interacting with molecules of any metals, facilitates the evacuation of toxins from the intraocular space. |
| Disodium dihydrogenated edetate | An effective chelating agent that blocks physiological reactions that interfere with a diagnostic or surgical procedure. Reduces the level of intoxication of the visual apparatus, is used for poisoning with vapors of lead and mercury. |
| Distilled water | Chemically neutral and safe solvent for pharmacologically active components of the drug. |
The drug has a multifunctional, absolutely safe and well-balanced component composition.
Pharmacological properties
Tropicamide has mydriatic and anticholinergic effects. The pharmacologically active substance of the ophthalmic drug blocks the physiological activity of muscarinic cholinergic receptors in all functional systems of the body.
When applied topically by the conjunctival method, this property is manifested by an expansion of the pupil and an increase in intraocular pressure. The latter effect is weakly expressed in a single use for diagnostic purposes or during a surgical operation.
When a large dose is given and long-term treatment of ophthalmic diseases, tropicamide is absorbed through the lacrimal canals into the systemic circulation, affecting the entire body.
Muscarin is the main mediator of cholinergic receptors, which is temporarily inactivated by the main active ingredient of the drug. The mydriatic fixes the pupil in a dilated state, allowing diagnostic or surgical procedures to be performed.
The drug causes temporary paralysis of the ciliary muscle, which renders the visual mechanism immobile. The medicine has bacteriostatic properties, which make it possible to use it in the complex therapy of infectious and inflammatory diseases of the optic organ.
Pharmacodynamics and pharmacokinetics
Tropicamide - eye drops, the price of which is successfully combined with a therapeutic effect. The suppression of the physiological activity of the m-cholinergic receptors of the fibers of the ciliary muscle is of a short-term nature and provides the ophthalmologist with the opportunity to carry out the necessary procedures.
The drug paralyzes the circular muscle of the sphincter of the iris and disrupts the accommodative function of the optic organ. As a result, the optical system temporarily loses its ability to adapt to changes in external conditions and does not respond to the supply of a light flux or the introduction of a surgical instrument.
A sharp or slowly increasing irritation remains without a natural physiological response.
The biological accommodation mechanism involves:
- ciliary neuromuscular tissue;
- lens - the natural lens of the eyeball, located between the vitreous humor and the iris;
- Zinn's ligament - ciliary-lumbar sphincter formed by glycoprotein zonular fibers;
- choroid - the choroid of the optic organ, which feeds the retina and restores constantly disintegrating biochemically active substances that take part in the transfer of visual information.
The pharmacodynamic properties of Tropicamide are based on the ability to temporarily block the physiological activity of all these structures. The expansion of the pupil diameter is fixed after 6-9 minutes. after conjunctival administration of the medication once.
The maximum paralyzing effect is achieved within 17-20 minutes. Its duration is about 1 hour. when using an ophthalmic solution with an active substance concentration of 0.5%.
With the use of 1% of the drug, the blockade of the structures involved in accommodation lasts 120 minutes. The biological optical system returns to its natural state after 5 hours. after drug administration.
The peak of paralysis of the accommodative function when using eye drops with an active substance concentration of 10 mg / 1 ml when injected twice with an interval of 5 minutes. registered after 25 minutes. Full restoration of the functionality of the eyeball is observed after 3 hours.
When instilled into the conjunctival sac, the active ingredients of the drug are able to overcome the hematological barrier and penetrate into the circulatory system in small quantities. They are eliminated through the urinary tract within 5 hours.
Indications for use
Ophthalmic solution 0.5% is used mainly for prophylactic purposes and combined therapy of inflammatory and infectious diseases of the optic organ.
It is prescribed to prevent the development of synechia of the iris covering - the fusion of the shell with the lens or cornea. Such drops are prescribed to suppress fungal and bacterial pathogenic microorganisms.
The drug in this dosage is used for:
- diagnostic examination of the fundus;
- complex therapy of keratitis - inflammation of the corneal element of the optical system;
- treatment of uveitis - a destructive pathology of the choroid and capillaries of the optic organ;
- carrying out ophthalmoscopy;
- determination of refractive ability - the refraction of light radiation;
- elimination of conjunctivitis.
Tropicamide - eye drops, which at a concentration of 1% of the active substance are prescribed when a strong and prolonged paralysis of the accommodative function is required. The low price allows the drug to be widely used in ophthalmic practice.
A solution of 1% is used for the following surgical operations:
- artificial lens implantation;
- laser vision correction;
- correction of defects of the vitreous body;
- retinal treatment;
- removal of glaucomatous opacities.
A short-acting anticholinergic drug is used for cycloplegic refraction - diagnostic a procedure that allows you to assess the state of the ciliary muscle and other functional elements of the eye in dynamics interactions.
Contraindications
The medication is not prescribed in case of an established allergy to the components included in the composition of the medicinal product.
Absolute contraindications include:
- biological intolerance to tropicamide;
- primary mixed and angle-closure glaucoma pathology;
- arrhythmia;
- steno- and tachycardia;
- thyrotoxicosis - an increased level of thyroid hormones;
- chronic endocrine disorders;
- diabetic nephropathy;
- arterial hypertension.
During pregnancy, the drug can only be used in exceptional cases. The teratogenic properties of tropicamide have not been established. Studies on laboratory animals have shown a negative effect of the active ingredients of an ophthalmic drug on intrauterine development.
The ability of tropicamide to be excreted in breast milk in small amounts is known. The lactation period is one of the absolute contraindications. There is no reliable scientific information about the effect of the drug on reproductive function and embryo growth.
At what age can the drug be used?
The use of tropicamide is allowed for children in the first year of life. For such patients, a 0.5% ophthalmic solution is used in a reduced dosage, under the supervision of a pediatrician and only when absolutely necessary.
Tropicamide can cause neurological damage in infants. A drug with a concentration of a pharmacologically active component of 1% is prescribed from the age of 12.
Tropicamide is quite toxic, which can negatively affect the development of the child. For underage patients, the medicine is used once. A course appointment for therapeutic purposes is possible only after prior consultation with a pediatrician.
Instructions for use, dosage
When using the drug for medicinal purposes, the daily rate and frequency of administration of the anticholinergic agent with mydriatic properties are calculated individually depending on clinical indications and age the patient.
For a short-term increase in the diameter of the pupil and the induction of accommodation paralysis, 1 drop of ophthalmic solution with an active substance content of 10 mg / 1 ml in each conjunctival sac twice with an interval of 5 min. If the drug is 0.5%, the dose is doubled.
Ophthalmoscopic examinations or surgical procedures begin after 10 minutes. after the instillation procedure. With an insufficient paralytic effect, a high intensity of the light flux used or the use of a drug to eliminate posterior synechia, Tropicamide is combined with Phenyledrine.
To measure the refractive ability of the optic organ conjunctivally, 1 drop of the drug is fed at a concentration of 1%. Six-fold instillation is performed at time intervals of 7-12 minutes. This provides stable accommodation paralysis and long-term fixation of the pupil in a dilated state.
Such an examination is carried out within 50 minutes. after the last instillation. For ophthalmic diagnostics and treatment of children under 6 years of age, 1 drop of Tropicamide 0.5% is fed into each eye. In complex therapy, the procedure is performed before bedtime. The duration of treatment is 7-14 days.
Side effects
Tropicamide - eye drops, the price of which is lower than the cost of many foreign analogues, but not inferior to them in efficiency and safety. The drug is characterized by side effects from various functional systems of the body.
Neurological disorders in children are manifested by psychotic symptoms, hyperexcitability, and headaches. After taking Tropicamide, vision deteriorates for a short time, intraocular pressure increases, and photosensitivity occurs.
The circulatory system reacts to the absorption of active ingredients of the ophthalmic solution by arterial hypertension. In elderly patients, while using the drug, signs of heart failure are observed. In chronic respiratory diseases, breathing difficulties and partial suppression of the functions of the pulmonary organ are possible.
With individual intolerance to the components of the medicinal composition and congenital tendency to anaphylactic reactions of the immediate type of tendency are possible:
- allergic skin rash;
- dry mouth;
- itching and burning in the eyes;
- profuse lacrimation.
Usually, such negative phenomena disappear on their own after adaptation of the body to a new complex of chemicals and do not require treatment cancellation. If side effects continue for more than a day, therapy should be interrupted and a compatible analogue should be found.
Overdose
With the local application of an ophthalmic solution in the recommended and pharmacologically reasonable volumes, the symptoms of drug intoxication are not recorded.
If the established dose is regularly exceeded, the following may occur:
- local irritation;
- hyperemia;
- edema of the conjunctival membrane;
- disorientation in space;
- visual hallucinations;
- ataxia;
- migraine;
Apathy and drowsiness are observed. Paranoid reactions, increased body temperature and blood pressure are possible.
A significant overdose and ingestion of the drug is fraught with:
- dizziness;
- vomiting;
- violation of the stool;
- dyspeptic symptoms;
- bronchospasm;
When such symptoms appear, they wash the eyes with warm water, take activated charcoal or other adsorbent. Physostigmine and Diazepam are used for therapeutic control of nervous excitability. In a hospital, hypoxic conditions and acidosis are corrected.
special instructions
Benzalkonium chloride serves as a preservative for the medicinal formula of Tropicamide. It tends to settle on the surface of soft contact lenses. It is undesirable to use them in the course of treatment with an ophthalmic solution.
This limitation does not apply to rigid optics. Such contact lenses are removed before instillation and installed no earlier than 15 minutes later. after the procedure.
To reduce the likelihood of systemic absorption of the ophthalmic solution after administration of the drug in the conjunctival sac should be lightly massaged on the skin folds in the area instillation.
When treating with a medication that causes both mydriasis and accommodation paralysis, extreme caution should be exercised in driving vehicles and performing work with dangerous mechanisms.
Tropicamide - eye drops, the price of which is low, which makes it possible to actively use them for the treatment of various ophthalmic diseases. In premature and debilitated babies, the drug can cause systemic anticholinergic effects.
They increase with each use of the drug. It is possible to neutralize such an effect without reducing the clinical efficacy of the drug by diluting the drops with 0.9% sodium chloride in a 1: 1 ratio.
Drug interactions
Mutual enhancement of pharmacological properties was established with the simultaneous use of Tropicamide with:
- anticholinergics;
- inhibitors of histamine H1 receptors;
- antidepressants of the tricyclic group;
- phenothiazines;
- Quinidine;
- antiarrhythmic drugs with membrane stabilizing action;
- psychoactive drugs based on benzodiazepine;
- monoamine oxidase blockers;
- antipsychotic drugs.
Paralysis of the structures involved in the accommodative mechanism is significantly enhanced when eye drops are combined with sympathomimetic drugs and is weakened when taken in parallel with parasympathomimetic drugs.
The cross-use of Tropicamide with nitrate-containing drugs provokes an increase in intraocular pressure. A similar effect is obtained by combining eye drops with Disopyridamide, alkalizing agents, glucocorticosteroid drugs, Galaperidol.
Analogs
A popular substitute for Tropicamide is Atropine, which is a natural alkoloid with pronounced mydriatic and anticholinergic properties.
Among other analogs, the following are in demand:
- Midax - an anticholinergic drug that blocks the physiological functions of the sphincter of the iris and ciliary muscles, causing the state of mydriasis of the pupil.
- Cycloptic - ophthalmic solution based on cyclopentolate.
- Midriacil - Belgian m-cholinomimetic used for therapeutic and diagnostic purposes.
- Cyclomed - a medication with a large list of contraindications. Used only as directed by a physician.
-
Medrimax - an alpha-adrenergic agonist of a non-selective type based on phenylephrine.
Midrimax eye drops
Unitropic, Midrum, Midriaticum have a similar pharmacological mechanism of action to Tropicamide.
Terms, conditions of storage and sale
Eye drops with an intact bottle tightness are suitable for use within 36 months from the date of production. The opened drug must be used as directed for 4 weeks.
Ophthalmic medicine belongs to the category of potent medicines and is sold in pharmacies only with a prescription. It should be stored in its original packaging in a place protected from sunlight at temperatures up to + 25 ° C.
Price
The therapeutic and diagnostic drug Tropicamide in the capital's pharmacies costs about 160 rubles. Eye drops can be purchased from commercial online resources for a little cost. In regional pharmacies, the price of an ophthalmic solution is slightly lower than in Moscow.
Video about the drug
Tropicamide is a pharmacy drug or medicine:
