DORZOLAMIDE HYDROCHLORIDE

DORZOLAMIDE HYDROCHLORIDe
(dor-zol'a-mide)
Trusopt
Classifications: eye preparation; carbonic anhydrase inhibitor;
Therapeutic: carbonic anhydrase inhibitor

Prototype: Acetazolamide
Pregnancy Category: C

Availability

2% ophthalmic solution

Action

Dorzolamide is a sulfonamide and inhibits carbonic anhydrase in the eye, thus reducing the rate of aqueous humor formation with subsequent lowering of IOP. Elevated IOP is a major risk factor in the pathogenesis of optic nerve damage and visual field loss due to glaucoma.

Therapeutic Effect

Lowers IOP in glaucoma or ocular hypertension.

Uses

Elevated intraocular pressure in patients with ocular hypertension or open-angle glaucoma.

Contraindications

Previous hypersensitivity to dorzolamide; pregnancy (category C).

Cautious Use

History of hypersensitivity to other carbonic anhydrase inhibitors, sulfonamides, or thiazide diuretics; ocular infection or inflammation; recent ocular surgery; moderate-to-severe renal or hepatic insufficiency; angle-closure glaucoma; concomitant use of oral carbonic anhydrase inhibitors; older adults, corneal abrasion.

Route & Dosage

Glaucoma, Ocular Hypertension
Adult/Child: Ophthalmic 1 drop in affected eye t.i.d.

Administration

Instillation
  • Apply gentle pressure to lacrimal sac during and immediately following drug instillation for about 1 min to lessen degree of systemic absorption.
  • Administer at least 10 min apart, if another ophthalmic drug is being used concurrently.
  • Store at 15°–30° C (59°–86° F).

Adverse Effects (≥1%)

CNS: Headache. GI: Bitter taste, nausea. Special Senses: Transient burning or stinging, transient blurred vision, superficial punctate keratitis, tearing, dryness, photophobia, ocular allergic reaction. Skin: Rash.

Pharmacokinetics

Absorption: Some systemic absorption from topical instillation. Onset: 2 h. Duration: 8–12 h. Distribution: Distributes into red blood cells. Elimination: In urine. Half-Life: RBC elimination about 4 mo.

Nursing Implications

Assessment & Drug Effects

  • Inquire about previous hypersensitivity to sulfonamides prior to therapy.
  • Withhold drug and notify physician if S&S of local or systemic hypersensitivity occur (see Appendix F).
  • Withhold the drug and notify the physician if ocular irritation occurs.
  • Lab tests: Monitor CBC, serum electrolytes, and renal and liver function tests periodically with long-term therapy.

Patient & Family Education

  • Learn proper technique for applying eyedrops.
  • Do not allow tip of drug dispenser to come in contact with the eye.
  • Discontinue drug and report to physician: ocular irritation, infection, or S&S of systemic hypersensitivity occur (see Appendix F).

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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