Ophthalmic Corticosteroids
Mahahalagang Punto
- Ang dexamethasone at prednisolone ay pangunahing topical agents para sa ocular inflammatory conditions.
- Ang prolonged therapy ay maaaring magtaas ng IOP at glaucoma risk at maaaring magdulot ng cataract o optic-nerve damage.
- Contraindicated ang ocular corticosteroids sa active viral, fungal, at piling mycobacterial eye infections.
- Ang dexamethasone formulations ay maaaring may sulfites na puwedeng mag-trigger ng severe reactions sa sulfite-sensitive clients.
- Dapat idiin sa teaching ang pag-iwas sa contamination, ligtas na paglalakad kapag pansamantalang malabo ang paningin, at taper plans na ayon sa utos ng prescriber.
Class Overview
Pinipigil ng topical ocular corticosteroids ang inflammatory responses mula sa allergic, chemical, immune, o postoperative causes. Karaniwang ginagamit ang mga ito para sa conjunctivitis, iritis, uveitis, at piling burn o trauma pathways kapag na-exclude ang infection contraindications.
Mga Karaniwang Ahente at Tipikal na Dosing
| Drug | Typical Adult Ophthalmic Dosing Pattern | Notes |
|---|---|---|
| Dexamethasone (drops/ointment/insert formulations) | Initial high-frequency dosing (often q1h daytime, q2h nighttime), then taper by response | More potent and longer duration than prednisolone |
| Prednisolone sodium phosphate 1% | 1-2 drops q1h while awake and q2h at night initially, then taper to q4h and then 3-4 times daily | Duration varies from days to weeks by response |
Adverse Effects at Contraindications
- Blurred vision, photophobia, ocular irritation/dryness
- Increased IOP at glaucoma risk (lalo na sa prolonged use)
- Panganib ng cataract formation at optic-nerve injury
- Panganib ng secondary infection at paglala ng umiiral na ocular infection
Contraindication examples:
- Acute superficial herpes simplex keratitis
- Fungal ocular disease
- Acute infectious varicella-stage eye disease
- Viral corneal/conjunctival disease
- Ocular tuberculosis
- Advanced glaucoma
Nursing Assessment at Interventions
- Suriin ang therapeutic response: nabawasang pain, redness, at irritation.
- Bantayan ang warning signs: tumitinding pain, drainage, persistent blurred vision, headache, o light sensitivity.
- Tiyakin ang ligtas na paglalakad at kapaligiran habang pansamantalang malabo ang paningin.
- I-verify ang tamang administration technique at contamination prevention.
- Para sa treatment na mas mahaba sa humigit-kumulang 10 days, tiyaking may routine IOP monitoring.
Client Education
- Sundin nang eksakto ang taper instructions; ang biglaan o sobrang bilis na pagbabawas ay maaaring magdulot ng rebound problems.
- I-report agad ang severe fatigue, dizziness, visual change, infection signs, o paglala ng sintomas.
- Gumamit ng sunglasses para sa photophobia kapag nasa labas kung kailangan.
- Iwasan ang contact lenses nang hindi bababa sa humigit-kumulang 15 minutes pagkatapos ng instillation.
- Iwasan ang pagmamaneho o hazardous activities hanggang luminaw ang paningin.
Related Concepts
- Pagbibigay ng ophthalmic medication - Route technique at contamination prevention.
- Ophthalmic antibiotics - Combination anti-infective pathways at contamination-control overlap.
- Ophthalmic immunosuppressants - Steroid-sparing at concurrent immunomodulator safety context.
- Ophthalmic nonsteroidal anti-inflammatories - Additive delayed-healing risk kapag pinagsabay.