Download Loteprednol etabonate

Loteprednol
etabonate
(lo h -te h- PRE D- no h l)
CLASSIFICATION(S):
Glucocorticoid
PREGNANCY CATEGORY: C
Rx: Alrex, Lotemax.
SEE ALSO CORTICOSTEROIDS,
CHAPTER 2.
USES
Alrex (0.2% Suspension): Temporary
relief of seasonal allergic conjunctivitis.
Lotemax (0.5% Suspension): (1)
Steroid-responsive inflammatory conditions of the palpebral and bulbar conjunctiva, cornea, and anterior segment
of the globe (e.g., allergic conjunctivitis,
superficial punctuate keratitis, herpes
zoster keratitis, acne rosacea, iritis), cyclitis, certain infective conjunctivitis. (2)
Treatment of postoperative inflammation after ocular surgery.
ACTION/KINETICS
Action
Rapidly metabolized to inactive compounds by eye esterases. After ocular
use, minimal amounts are absorbed.
CONTRAINDICATIONS
Bacterial, fungal, or viral eye infections.
SPECIAL CONCERNS
• Use with caution with cataracts, diabetes mellitus, glaucoma, intraocular
hypertension, use beyond 10 days.
• Safety and efficacy not determined in
children.
SIDE EFFECTS
Most Common
Blurred vision, discharge, burning on instillation, dry eyes.
Ophthalmic: Increased IOP, thinning of
sclera or cornea, blurred vision, discharge, dry eyes, burning on instillation.
HOW SUPPLIED
Ophthalmic Suspension: 0.2% (Alrex),
0.5% (Lotemax).
DOSAGE
• ALREX OPHTHALMIC SUSPENSION,
0.2%
Seasonal allergic conjunctivitis.
1 gtt in the affected eye(s) 4 times per
day.
C = see color insert
H = Herbal
• LOTEMAX OPHTHALMIC SUSPENSION, 0.5%
Steroid-responsive disease.
1–2 gtt into the conjunctival sac of the
affected eye 4 times per day. For the
first week, dose may be increased to 1
gtt every hour. Do not discontinue prematurely. Re-evaluate if client does not
improve after 2 days.
Postoperative inflammation.
1–2 gtt into the conjunctival sac of the
operated eye(s) 4 times per day beginning 24 hr after surgery and continuing
for 2 weeks.
NURSING CONSIDERATIONS
ADMINISTRATION/STORAGE
Store upright from 15–25°C (59–77°F).
Do not freeze.
ASSESSMENT
1. Note indications for therapy, symptoms, clinical presentation, and related
factors (triggers).
2. Assess for any viral diseases of the
cornea and conjunctiva including epithelial herpes simplex, keratitis (dendritic keratitis), vaccinia, and varicella, and
also for mycobacterial infection of the
eye and fungal diseases of ocular structures; precludes drug therapy. Document ophthalmic findings.
CLIENT/FAMILY TEACHING
1. Used to reduce eye inflammation.
Shake well before use; instill as
directed.
2. Wash hands, do not allow dropper to
touch eye. Tilt head back looking up;
pull lower eyelid down and instill prescribed number of drops. Close eye for
1 to 2 min, apply gentle pressure to
bridge of nose for 1 to 3 min. Do not
rub eye or touch top of dropper bottle
to eye, fingers, or other surface.
3. If more than 1 topical eye drug used,
give at least 5 min apart administering
the ointment last. May experience temporary stinging or burning; report if
bothersome or if eye/eyelid inflammation noted.
4. Contact lenses may continue to be
worn if the drug is used to treat lensassociated giant papillary conjunctivitis.
Remove lens prior to each instillation;
reinsert 10–15 min later.
IV = Intravenous
E = sound alike drug
5. When used for steroid responsive
disease, do not discontinue therapy
prematurely.
6. Report if symptoms do not improve
or worsen after 2 days of treatment
Bold Italic = life threatening side effect
7. Keep all F/U to assess response or for
adverse SE.
OUTCOMES/EVALUATE
앗 Eye irritation, inflammation, and allergic S&S
■ = black box warning
W = Available in Canada