Atropine involvement in Myopia
Atropine is a non-selective muscarinic antagonist used to slow progression of myopia through several mechanisms and is known for its cycloplegic traits1, 2. Atropine acts in different ways to treat, mostly, myopic children by preventing accommodation thereby reducing the progression. It also has been known to affect the release of the dopamine neurotransmitter which has an influence on the retina and its signals sent along the optic tract1. Growth Hormone (GH) is also affected by high levels of atropine in the bloodstream and it affects the growth of the eye itself as GH secretion from the pituitary gland is inhibited in relation to excess levels of Atropine1.
Atropine drops acts as a cycloplegic to dilate the
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A dosage of 2 drops a day for 7 days a week is often prescribed4.
Short term side effects of higher dose treatment (1%) include blurry vision at near, photophobia, visual discomfort, mydriasis, allergic conjunctivitis as well as systemic conditions such as headaches and increased heart rate1,2,3 and 4. Side effects of the lower dose treatment (0.1-0.5%) are less pronounced and more tolerated. Studies involving patients prescribed with lower dosage treatments showed lower rates of progression of Myopia compared to patients prescribed with the higher dose treatments1.
Long term side effects are currently unknown but case studies have shown that there is an increase in risk for ultraviolet (UV) retinal damage as well as cataract formation due to the prolonged dilation of the patients’ pupils. Resent research also shows that within one year of treatment, there has been a reduction in the progression of 81% in myopic children and the effects of the treatment control does not continue after the first year3. A study showed that patients prescribed with the lower dosage treatment showed sign of myopic regression or “rebound” after two years of
Three (3) drops, three (3) times a day for three (3) days starting the day before the study.
The records have been reviewed. The member is an adult male with a birth date of 05/16/1973. He has a diagnosis of bilateral degenerative myopia. His treating provider, Amy Camarota, OD, recommended treatment options on 03/18/2016, one of which was scleral lenses, which the member opted and paid for on 04/01/2016.
For adults and children 12 years of age and older, the recommended dosage is 0.63 mg three times daily, given every 6 to 8 hours (maximum 1.25 mg three times a day).
2 times daily with water after meals and 4 capsules each time. No, we recommend you take at least 4 capsules per serving.
Redux may cause potential drowsiness and fatigue. It is also potent with the consumption of alcohol or any drugs. The dosage should
Headaches, Blurred vision or any vision problems, Earaches , Nosebleeds, Sore throats, Difficulty swallowing, Any lumps in head or neck area.
Melinda, I also have the same concern when it comes to side effects and furthermore allergies. This issue can definetely be drawback as it can contribute to non-complience and perhaps even life threathening related to allergies. I think it would be difficult to determine which drug could be the trigger for such reactions. If I was to be the health care provider prescribing this pill I would take into consideration, if the patient had taken any of this drugs separatly prior, to make an assessment if weather it would be a good candidate for the polypill.
Generally adverse effects of nifurtimox or benznidazole are lower in children than in adult. There are two adverse effects of benznidazole i.e. allergic dermitis and peripheral neuropathy. Allergic dermitis occur within 8-10 days after treatment starts and there is no need to reduce dose in most patients. While sensitive neuropathy result in last part of treatment and affect mainly lower parts of limbs. The treatment should stopped in this case. Rare adverse effects includes leucopenia, weight loss, vomiting, insomnia, and nausea 26, 28.
At the end of the study 205 patients (73.2%) reported a minimum of one adverse effect, like diarrhea or nausea (Table 2) (Berende et al., 2016). Nine people had a serious adverse effect and 19 had a bad enough side effect that they discontinued with the study (Table 2) (Berende et al., 2016). In the end though most of the patients made it throughout the whole study.
2. Based on the information provided by GlaxoSmithKline, the symptoms of confusion and disorientation in this patient have been reported with use of Augmentin XR. Other adverse effects on the central nervous system include: behavioral changes, agitation, insomnia, anxiety, agitation, and convulsions. These patient’s symptoms could possibly be an adverse effect of augmentin XR.
2000mg/day. If doses >2000mg/day are required, give in 3 divided doses (not to exceed 2500mg/day)
The Lumigan group contained 90 patients. The Cosopt group consisted of 87 patients. The baseline characteristics of the study was patients in the age range of 29 to 88 years old with a mean age of 60 and 64 years old, 73% white, 62% women, and 40% with brown irides3. There was no statistically significant difference in mean intraocular pressure at baseline. Both groups instilled one drop in each eye in the morning between 7 AM – 9 AM and in the evening between 7 PM and 9 PM3. In order for the study to remain blinded the medications were put in color coded bottles for morning and evening3. Since Lumigan is only dosed once a day the lumigan group’s evening dose bottle was a placebo. Intraocular pressure, the primary endpoint, was measured during six visits which were pre-study, baseline, week 1, and months 1-33. Intraocular pressure was measured at 8 AM and 10 AM at all visits and also 4 PM and 8 PM at baseline and month 3 visit. The safety endpoints studied were conjunctival hyperemia, ocular burning and stinging, and taste
As with any medication out there, 5-FU has side effects that may or may not subside. According to MedlinePlus, some of the common symptoms include: loss of appetite, unusual fatigue, dizziness, headache, hair loss, dry and cracked skin, vision changes, sensitivity to light, redness, pain, swelling or burning at the injection sight and confusion. However, some more serious side effects are sores in the mouth and or throat, diarrhea, vomiting, fever, chills, nosebleeds, and chest pains (Fluorouracil Injection: MedlinePlus Drug Information). Any side effect that interferes with the quality of life of the patient should be mentioned to the doctor immediately, to assess whether the current treatment is appropriate and if the medication has been
Adverse reactions to this medication are migraine, speech disorders, rhinitis, sinusitis, hyperglycemia, elevated liver function, elevated serum creatinine level, pancytopenia, bronchitis, dyspnea, toxic epidermal necrolysis, anaphylaxis, elevated creatine kinase, generalized pain, and infection. Nursing considerations with this medication is to have the patient swallow the whole tablet and not to chew. Watch for aspiration while watching the patient take the medication. Educate the patient about the medication and inform them to notify a physician if bleeding
There are a number of studies that have been done investigating the effectiveness of the patching in children considering the age and the duration of patching. One large trial that investigated the patching in the mentioned groups of subjects is The Pediatric Eye disease Investigator Group. They investigated the effectiveness of 6 hours vs 2 hours of daily patching in 189 children with moderated amblyopia (20/40 to 20/80) and the average visual acuity improvement in both of the group was 2.4 lines (A randomized trial of patching regimens for treatment of moderate amblyopia in children.(the pediatric eye disease investigator group).2003) . However, the trial did not provide details about the binocularity improvement such as stereopsis in the studied subjects. Even though, patching improves the visual acuity as we addressed above, the compliance is low. Because putting a patch in front children eyes prevents them from being engaged with the surrounding social activities such as playing and reading and that has at least a negative psychological effect (Searle, Norman, Harrad, & Vedhara, 2002)