Question

​A client has been prescribed timolol eye drops. What are three (3) possible adverse effects of this medication and nursing interventions/client education related to these effects? Why would a client have timolol eye drops prescribed? Write the steps on "Administering eye drops" from the beginning including washing hands.

What are the classification and Therapeutic Drug Levels of the following

Aminophyllin

Carbamazephine

Digoxin

Gentamycin

Lidocaine

Magnesium Sulfate

Phenobarbital

Phenytoin

Salicyate

Theophyllin

Tobramycin

What is a peak and Trough levels

Answer 1

1) Timolo eye drops are used to reduce intraocular pressure by decreasing sympathetic impulses and decreasing aqueous humor production without affecting accomadation or pupil size.These medication are used to treat glaucoma.

Adverse effects are:Ocular irritation

Visual disturbances

Bradycardia

Hypotension

Bronchospasm

Interventions: a. Monitor vital signs especially blood pressure and pulse.

b. Monitor shortness of breath

c. Assess for risk of injry

d. Monitor intake and output

e.Instruct the client to notify the HCP if shortness of breath occurs

f.Instruct the client not to discontinue the medication abruptly.

g. Instruct the client to change the postion slowly because of potential for orthostatic hypotension.

Steps on administering eye drops:

a. Wash hands

b. Put gloves on.

c.Check the name ,strength ,amd expiry date of the medication

d.Instruct the client to tilt the head backward,open the eyes, and look up

e.Pul the lower eye lid down aganist the cheek bone

f. Hold the bottle like a pencil with thw tip upward

g. Holding the bottle gently rest the wrist of the hand on the clients cheek

h.Squeeze the bottle gently to allow the drop to fall on the conjuctival sac

i. Instruct the client to close the eyes gently and not to squeeze the eye shut

j,Wait 3 to 5 minutes before instilling the another eye drops.

k.Do not allow the medication bottle ,dropper to ccome in contact withe eyelid .

l.To prevent systemic absorption of the medication apply gentle pressure with a clean tissue to the client nasolacrimal duct for 30 to 60 seconds.

2) Classification and therapeutic drug levels:

A. Aminophyllin:Classification is Methylxanthine

Therapeutic level:10 to 20 mcg/ml

B.Carbamazephine:Classification:Anticonvulsants

Therapeutic level:4 to 12 mcg/ml

C.Digoxin:Classification: Cardiac glycosides

Therapeutic level:0.5 to 2ng/ml

D.Gentamycin: classification:Aminoglycoside antibiotic

Therapeutic level:0.5 to 2 microgram/ml trough level

5 to 10 microgram/ml peak level

E.Lidocaine: classification:Local anesthetics

Therapeutic level:1.5 to 5 mcg/ml

F.Magnesium sulfate:Classification:Anticonvulsants,cardiovascular drugs

Therapeutic level:3.5 to 7 mEq/l

GPhenobarbital:Classification:Barbiturate anticonvulsants

Therapeutic level:15 to 40 mcg/ml

H. Phenytoin:ClassificationAnticonvulsants:

Therapeutic level:10 to 20 mcg/ml

I .Salicyate:Classification:Aspirin

Therapeutic level:15 to 30 mg/dl

J Theophyllin:Classification:Methylxanthines

Therapeutic level:5 to 15 mcg/ml

K. Tobramycin:Classification:Aminoglycoside antibiotics

Therapeutic level:4 to 6 mcg/ml

3) Peak level:It is defined as the excessive drug congregation in the clients blood stream and th trough level just opposite of peak level that is Lowest drug concentration.