Eye anesthetics: Nursing pharmacology

Eye anesthetics: Nursing pharmacology

NSG1201

NSG1201

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Notes

EYE ANESTHETICS
DRUG NAME
proparacaine hydrochloride (Alcaine), tetracaine hydrochloride (Altacaine)
CLASS
Eye anesthetics
MECHANISM OF ACTION
Reversibly block sodium channels on the sensory neurons of the cornea and prevent the transmission of corneal sensation
INDICATIONS
  • Comprehensive eye exams
  • Brief ophthalmic procedures
ROUTE(S) OF ADMINISTRATION
  • Ophthalmic solution
SIDE EFFECTS
  • Loss of the corneal blink reflex
  • Blurred vision
  • Photophobia
  • Dryness and redness of the eyes
  • Stinging or burning sensation
CONTRAINDICATIONS AND CAUTIONS
  • None
NURSING CONSIDERATIONS
Assessment and monitoring
  • Prepare for procedure
    • Set up sterile field
    • Label all medications, separate intraocular medications
    • Verify correct eye for administration
  • Monitor pain level during and after procedure

Client education
  • Purpose of medication
  • May take time for effects to wear off
    • Wear eye protection
    • Avoid driving
  • Avoid scratching or rubbing affected eye
Author: Antonia Syrnioti, MD
Author: Ashley Mauldin, MSN, APRN, FNP-BC
Illustrator: Robyn Hughes, MScBMC

Transcript

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Ophthalmic or eye anesthetics are medications used to induce a temporary loss of corneal sensation, including pain, and can be used for various reasons in ophthalmology, such as during comprehensive eye exams, and during brief ophthalmic procedures, like removal of foreign objects or corneal sutures, as well as surgery for cataracts or glaucoma.

Now, commonly used eye anesthetics include proparacaine hydrochloride and tetracaine hydrochloride.

These medications are applied topically in the form of eye drops, and the way they work is by reversibly blocking sodium channels on the sensory neurons of the cornea. As a result, eye anesthetics prevent the transmission of corneal sensation.

Unfortunately, eye anesthetics can result in side effects, such as loss of the corneal blink reflex, and blurred vision.

In addition, clients may experience photophobia, dry, red eyes, and a stinging or burning sensation. There are no known contraindications for the use of eye anesthetics.

Alright, when preparing to assist with administering an eye anesthetic, start by assembling the sterile local anesthetic field.

Ensure that all medications are labeled with name, strength, amount, and expiration date, and that ocular solutions are separated from those not used intraocularly. Lastly, be sure to verify which eye has been prescribed the eye anesthetic.

Next, let your client know that the eye anesthetic will help decrease their pain and discomfort during the procedure.

Sources

  1. "Karch’s Focus on Nursing Pharmacology, 9th edition" LWW (2023)
  2. "Pharmacology: A Patient-Centered Nursing Process Approach, 9th edition" Elsevier Canada (2020)
  3. "Mosby’s 2023 Nursing Drug Reference, 36th edition" Mosby (2022)
  4. "Saunders Comprehensive Review for the NCLEX-RN, 9th Edition" Saunders (2022)
  5. "Mosby’s® Diagnostic and Laboratory Test Reference, 15th edition" Mosby (2020)
  6. "An Analysis of the Use of Proparacaine in Cataract Surgery" Cureus (2022)
  7. "Does Topical Proparacaine Improve Postoperative Comfort After Strabismus Surgery?" Clin Ophthalmol (2019)
  8. "Age and Sex Variation in the Duration of Action and Corneal Touch Threshold (CTT) following Instillation of 0.5% Topical Ophthalmic Proparacaine and Tetracaine Hydrochlorides" J Ophthalmol (2021)