timolol Flashcards
generic name
timolol
trade name (4)
-Timoptic,
-Blocadren,
-Betimol,
-Istalol
therapeutic class
-Antihypertensives (treats high blood pressure)
-Vascular headache suppressant (vasoconstriction)
pharmacological class
-Beta blockers (management of hypertension)
indication
-Managing hypertension (may be used alongside other antihypertensive drugs)
-Prevention of myocardial infarction
-Prevention of migraine headaches
action
Blocks stimulation of beta1 & beta2 adrenergic receptor sites
Blockage of beta1 in the heart -> reduced heart rate and contractility = lower BP
Blockage of beta2 in vascular and bronchial smooth muscle, and the uterus -> vasoconstriction, bronchoconstriction, and uterine constriction.
Ophthalmic beta blockers decrease production of aqueous humor
Blockage of beta2 -> decreased activation of adenylate cyclase -> decreased cyclic adenosine monophosphate (cAMP) -> decreased production of aqueous humour
desired effect
-decreased production of aqueous humour in the eyes, = decreased intraocular pressure (prevention of glaucoma)
contraindication
-Geriatrics may have an increased sensitivity to beta blockers (lower initial dose is recommended)
critical side effects (life threatening)
life threatening:
-Heart failure
-Arrhythmias
-Bradycardia
-Pulmonary edema
-Anaphylaxis (rare)
critical side effects (Adverse reactions)
-conjunctivitis,
decreased visual acuity,
-ocular burning,
-rash,
-delirium in geriatric clients**
critical side effects (common)
fatigue/weakness
Why is miki taking this med
-To regulate eye pressure by decreasing production of aqueous humor thus decreasing intraocular pressure
-To maintain eye health and prevent development of glaucoma (geriatrics are more susceptible)
-Client was already prescribed timoptic before but did not refill their prescription
what are some side effects miki has experienced?
-backpain
-insomnia
-depression
-memory loss
-increased risk of falls due to blurred vision
(least severe side effects)
what is important to know about this client in relation to this medication
**Be aware of medication ramipril = lowers BP, but if timolol is admin systemically accidentally = can cause bradycardia = DIZZINESS (due to low BP from ramipril)
-Miki is an older adult which may increase her sensitivity to timoptic, a beta blocker.
A LOWER INITIAL DOSE is recommended
-adherence to the med is essential: miki’s age is a risk factor & history of stroke = ocular vascular dysregulation
nursing actions (6)
-May cause orthostatic hypertension if pressure is not applied on the inner conjunctiva
-monitor BP before and after admin
-assess for orthostatic hypotension = when sitting client up
-assess fluid overload (edema, fatigue, weight gain)
-monitor prescription refills = for adherence
-monitor signs of overdose (bradycardia, severe dizziness or fainting, severe drowsiness, dyspnea, bluish fingernails or palms. seizures).
what does miki need to know about the med
-helps lower eye pressure, maintains eye health and prevents the development of eye problems
-needs to ADHERE to the medication dosage and administration schedule
-Medication may increase sensitivity to cold
-Change positions slowly to minimize orthostatic hypotension
-May cause drowsiness or dizziness, avoid driving or activities that require alertness
-May experience blurry vision when the medication is first applied
if you have multiple PO meds and eye drops to admin to a client, when do you admin the eye drops? and WHY
eye drops are last
causes blurriness to the eyes. better to have the client be able to see the PO meds first before administering eyedrops
