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timolol maleate Nursing Considerations & Management

Drug Name
Generic Name : timolol maleate Brand Name: Apo-Timol (CAN), Apo-Timop (CAN), Betimol, Blocadren, Gen-Timolol (CAN), Novo-Timol (CAN), Nu-Timolol (CAN), Timoptic, Timoptic-XE Classification: Beta-adrenergic obstructer, Antihypertensive, Antiglaucoma garbage Pregnancy Category C 
Dosage & Route
Available frames : Tablets—5, 10, 20 mg; ophthalmic disconnection, gel—0.25%, 0.5%
ADULTS
Oral
  • Hypertension: Initially, 10 mg bid. Acception dosage at 1-wk intervals to a completion of 60 mg/day disjoined into two doses, as needed. Usual subsistence dose is 20–40 mg/day loving in two disjoined doses.
  • Prevention of reinfarction in MI (long-term prophylaxis in unrepinings who survived the intelligent sight): 10 mg bid PO amid 1–4 wk of infarction.
  • Migraine: 10 mg PO bid; during subsistence, the 20 mg/day may be loving as a uncompounded dose. May be acceptiond to a completion of 30 mg/day in disjoined doses or decreased to 10 mg/day. Eradicate if satisfactory reply is not obtained succeeding 6–8 wk.
Ophthalmic
  • Initially, 1 faint of 0.25% disconnection bid into the improbable eye or eyes. Adjust dosage on account of reply to 1 faint of 0.5% disconnection bid or 1 faint of 0.25% disconnection daily. When replacing other agents, gain exexchange fragmentarily and state dosage. One faint in the improbable eye each waking (Istalol).
PEDIATRIC PATIENTS
  • Safety and effectiveness not orderly.
Therapeutic actions
  • Timolol is a non-selective β-adrenergic receptor obstructer which does not possess forcible immanent sympathomimetic, plain myocardial depressant or persomal anesthetic ghost. It decreases intrapalpable exigency by reducing aqueous temper shape or acception outflow.
Indications
  • Hypertension, used remaining or in coalition delay other antihypertensives, in-particular thiazide-type diuretics
  • Prevention of reinfarction in MI unrepinings who are hemodynamically stable
  • Prophylaxis of migraine
  • Ophthalmic disconnection: Reduction of IOP in constant open-angle glaucoma, some unrepinings delay induced glaucoma, aphakic unrepinings delay glaucoma palpable hypertension
Adverse goods
  • Fatigue, indifference of extremities, paresthesia, GI symptoms, peel balanceventuresome, alopecia, dry bunghole, bradycardia. Ophthalmic use: Blurred prospect, persistent, intense, palpable irritation, decreased corneal sensitivity, visual disturbances, diplopia, ptosis, cystoid macular edema, pseudopemphigoid, choroidal separation forthcoming sublimation surgery. Systemic aridity delay systemic goods may appear.
  • Potentially Fatal: Kernel insufficiency, kernel obstruct, bronchospasm, respiratory insufficiency.
Contraindications
  • Present or truth of bronchial asthma, COPD, give or truth of bronchospastic sickness, sinus bradycardia, 2nd and 3rd rank kernel obstruct, open kernel insufficiency, cardiogenic disgust. Pregnancy.
Nursing considerations
Assessment
  • History: Sinus bradycardia, second- or third-rank kernel obstruct, cardiogenic disgust, CHF, asthma, COPD, pregnancy, lactation, diabetes or thyrotoxicosis
  • Physical: Weight, peel requisite, neurologic standing, P, BP, ECG, respiratory standing, renal and thyroid power, lineage and urine glucose
Interventions
  • WARNING: Do not eradicate garbage abruptly succeeding long-term therapy (hypersensitivity to catecholamines may possess exposed, causing exacerbation of angina, MI, and ventricular arrhythmias). Taper garbage fragmentarily balance 2 wk delay monitoring.
  • Consult delay surgeon about delaydrawal if unrepining is to experience surgery (refusal is controversial).
Teaching points
  • Do not plug preliminary this garbage probable instructed to do so by your heartiness circumspection provider.
  • Avoid driving or exposed activities if dizziness or contradiction appears.
  • If using ophthalmic frame, control eye faints unexceptionably to minimize systemic aridity.
  • Report inaptitude existing, shade cough, swelling of extremities, late pulse, laziness, dip, balanceventuresome, heat, thin throat.

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