CYCLOPENTOLATE HYDROCHLORIDE

(sye-kloe-pen'toe-late)

Ak-Pentolate, Cyclogyl, Pentalair
Classifications: eye preparation; cycloplegic; mydriatic;
Therapeutic: eye preparation; mydriatic
Pregnancy Category: C

Availability

0.5%, 1%, 2% ophth solution

Action

Tertiary amine antimuscarinic compound with systemic side effects and CNS toxicity, similar to those of atropine. Acts by blocking response of iris sphincter muscle, and muscle of accommodation in the ciliary body to cholinergic stimulation.

Therapeutic Effect

Results in dilation and paralysis of accommodation of the eyes.

Uses

Induction of cycloplegia or mydriasis for ophthalmic diagnostic procedures.

Contraindications

Narrow angle glaucoma, excessively increased intraocular pressure; pregnancy (category C), lactation; children with a history of epilepsy.

Cautious Use

Elderly patients, brain damage (in children), Down's syndrome, spastic paralysis in children, blue-eyed individuals; infants; seizure disorders.

Route & Dosage

Cycloplegia or Mydriasis
Adult: Topical 1 drop of 1% solution in eye 40–50 min before procedure, followed by 1 drop in 5 min; may need 2% solution in patients with darkly pigmented eyes.
Child: Topical 1 drop of 0.5–1% solution in eye 40–50 min before procedure, followed by 1 drop in 5 min; may need 2% solution in patients with darkly pigmented eyes.

Administration

Topical

Clarify with physician which strength (1% or 2%) should be used.
Ask patient to remove soft contact lenses prior to installation of drops.

Adverse Effects (≥1%)

Body as a Whole: Flushing, fever. CNS: Drowsiness dysarthria, disorientation, ataxia, hallucinations, hyperkinesis, psychosis, seizures. CV: Sinus tachycardia, hypotension. GI: Dry mouth, abdominal distention in infants. Skin: Rash, contact urticaria. Special Senses: Burning, stinging, transient increases in intraocular pressure, irritation, punctate keratitis, blurred vision, hyperemia, synechiae, conjunctivitis, photophobia. Urogenital: Urinary retention.

Interactions

Drug: May interfere with the ocular antihypertensive effects of carbachol, pilocarpine, physostigmine.

Pharmacokinetics

Peak: 15–60 min. Duration: 24 h.

Nursing Implications

Assessment & Drug Effects

Monitor cardiac status especially with preexisting heart disease.

Patient & Family Education

Do not touch the dropper to any surface, including your skin or eyes.
Exercise caution when driving or engaging in other potentially hazardous activities as cyclopentolate ophthalmic may cause blurred vision. If you experience blurred vision, avoid these activities.
Protect your eyes when in bright light. Cyclopentolate ophthalmic may cause increased light sensitivity.
Do not wear soft contact lenses when the eyedrops are being inserted.
Report immediately any of the following: difficulty breathing, swelling of your lips, tongue, face or hives; palpitations; and unusual behavior.

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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