DORZOLAMIDE HYDROCHLORIDe (dor-zol'a-mide)
Trusopt Classifications: eye preparation; carbonic anhydrase inhibitor; Therapeutic: carbonic anhydrase inhibitor Prototype: Acetazolamide Pregnancy Category: C
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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.
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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: 812 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).