Details About Generic Salt ::  Carteolo

Main Medicine Class::    

(CAR-tee-oh-lahl HIGH-droe-KLOR-ide)
Ocupress
Class: Beta-adrenergic blocker

 

Drugs Class ::

 Action Blocks beta-receptors, primarily affecting cardiovascular system (decreases heart rate, cardiac contractility, and BP) and lungs (promotes bronchospasm). Ophthalmic use reduces IOP, probably by decreasing aqueous production.

Indications for Drugs ::

 Indications Management of hypertension. Ophthalmic preparation for control of intraocular hypertension and lowering of IOP in chronic open-angle glaucoma. Unlabeled use(s): Treatment of angina.

Drug Dose ::

 Route/Dosage

ADULTS: PO 2.5–10 mg qd.

OPHTHALMIC USE:

1 drop bid in affected eye(s). Consider concomitant therapy if IOP is not at satisfactory level.

Contraindication ::

 Contraindications Hypersensitivity to beta-blockers; persistently severe bradycardia; > first-degree atrioventricular block; CHF unless secondary to tachyarrhythmia treatable with beta-blockers; overt cardiac failure; sinus bradycardia; cardiogenic shock; bronchial asthma or bronchospasm, including severe COPD.

Drug Precautions ::

 Precautions

Pregnancy: Category C. Lactation: Excreted in breast milk. Children: Safety and efficacy not established. Cessation of therapy: Should be done gradually, over approximately 2 wk, with careful observation of patient and limited physical activity. CHF: Should be administered cautiously in patients with CHF treated with digitalis and diuretics. Diabetes mellitus: Drug may mask signs and symptoms of hypoglycemia (eg, tachycardia, blood pressure changes). May potentiate insulin-induced hypoglycemia. Peripheral vascular disease: Drug may precipitate or aggravate symptoms of arterial insufficiency. Renal and hepatic impairment: Requires dosage adjustment. Thyrotoxicosis: May mask clinical signs of developing or continuing hyperthyroidism (eg, tachycardia). Abrupt withdrawal may exacerbate symptoms of hyperthyroidism, including thyroid storm.

PATIENT CARE CONSIDERATIONS


Drug Side Effects ::

 Adverse Reactions

CV: Hypotension; bradycardia; CHF; cold extremities; first-, second-or third-degree atrioventricular block; arrhythmias; syncope. CNS: Insomnia; fatigue; dizziness; depression; lethargy; drowsiness; forgetfulness; headache. DERM: Rash; hives; alopecia. EENT: Dry eyes; blurred vision; tinnitus; slurred speech; dry mouth; sore throat. With ophthalmic use: eye discomfort or stinging; tearing; keratitis; drooping eyelids; visual disturbances; diplopia; ptosis. GI: Nausea; vomiting; diarrhea; constipation. GU: Impotence; painful, difficult or frequent urination. HEMA: Agranulocytosis; thrombocytopenic purpura. META: Hyperglycemia; hypoglycemia; unstable diabetes mellitus; hypercholesterolemia; hyperlipidemia; increased LDH. RESP: Bronchospasm; shortness of breath; wheezing. OTHER: Weight changes; fever; facial swelling; cramps; muscle weakness. Antinuclear antibodies may develop.

Drug Mode of Action ::  

 Action Blocks beta-receptors, primarily affecting cardiovascular system (decreases heart rate, cardiac contractility, and BP) and lungs (promotes bronchospasm). Ophthalmic use reduces IOP, probably by decreasing aqueous production.

Drug Interactions ::

 Interactions

Clonidine: May enhance or reverse antihypertensive effect; may cause potentially life-threatening increases in BP, especially on simultaneous discontinuation of both drugs. Epinephrine: May cause initial hypertensive episode followed by bradycardia. Ergot alkaloids: May cause peripheral ischemia with cold extremities. Peripheral gangrene possible. NSAIDs: May impair antihypertensive effect. Prazosin: May increase orthostatic hypotension. Systemic beta-blocker: When administered concomitantly with ophthalmic carteolol hydrochloride solution, may cause additive effects and toxicity. Theophyllines: May reduce elimination of theophylline. May cause pharmacologic antagonism, reducing effects of one or both drugs. Verapamil: May increase effects of both drugs.

Drug Assesment ::

 Assessment/Interventions

  • Obtain patient history, including drug history and any known allergies. Note history of CHF, asthma, diabetes, hypertension, or sensitivity to sulfite preservatives, which may be present in ophthalmic solution.
  • Determine baseline serum lipids and glucose before initiating treatment with systemic medication.
  • Perform measurements of IOP on regular basis to assess therapeutic effect of ophthalmic medication.
  • At end of drug regimen, taper dosage slowly under physician supervision to prevent rebound symptoms and adverse effects.
  • In patients with diabetes, monitor blood glucose and diabetic medications closely. Changes in diabetic medications may be required.
  • Monitor BP and pulse frequently when starting oral medication or when dosage is changed.
  • Note that ophthalmic solution may produce same adverse reactions as oral form because of absorption.
  • Be aware that systemic medication may mask signs of hyperthyroidism.
  • If signs of anaphylactic reaction are noted, withhold drug and notify physician.
  • Notify physician at first sign or symptom of CHF or unexplained respiratory problem.
  • Observe patient for signs of withdrawal syndrome: Hypertension, tachycardia, anxiety, angina, MI.
OVERDOSAGE: SIGNS & SYMPTOMS
  Bradycardia, cardiac failure, hypotension, bronchospasm, hypoglycemia

Drug Storage/Management ::

 Administration/Storage

  • For ophthalmic solution, pull out lower lid to create pocket, administer drop without touching eye, release lower lid, close eye, and apply gentle pressure on inner canthus of eye to avoid systemic absorption.
  • Store at room temperature.

Drug Notes ::

 Patient/Family Education

  • Instruct patient in proper method of instilling eye drops.
  • Teach patient how to monitor pulse before taking oral medication and to notify physician if pulse remains below 50 bpm after taking drug and fatigue and dizziness occur.
  • Instruct patient to inform physician of any scheduled surgery or dental work; dosage may need to be gradually tapered (and ophthalmic solution discontinued) before surgery or treatment.
  • Caution patient not to discontinue medication without consulting physician.
  • Instruct diabetic patient to monitor blood glucose closely because carteolol hydrochloride may mask signs of hypoglycemia.
  • Inform patient that ophthalmic solution may cause burning or stinging when first instilled in eye.
  • Instruct patient to report these symptoms to physician: CHF, dizziness, decreased pulse, confusion, shortness of breath, rash, or any unusual bleeding.
  • Advise patient that drug may cause drowsiness and to use caution while driving or performing other tasks requiring mental alertness.
  • Instruct patient not to take otc medications without consulting physician.

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