Ophthalmic Nonsteroidal Anti-inflammatories
Mahahalagang Punto
- Ang topical ocular NSAIDs ay nagpapababa ng postoperative eye inflammation, sakit, at photophobia.
- Ang pangunahing agents ay diclofenac at ketorolac ophthalmic solutions.
- Kabilang sa major safety risks ang delayed healing, ocular bleeding, at corneal epithelial injury kapag matagal ang paggamit.
- Ang kasabay na paggamit ng ophthalmic corticosteroids ay maaaring lalo pang magpaantala ng healing.
- Maaaring bawasan ng ocular NSAIDs ang therapeutic effect ng latanoprost.
Class Overview
Ang ocular NSAIDs ay humahadlang sa cyclooxygenase at nagpapababa ng prostaglandin synthesis sa ocular surface. Pangunahing ginagamit ang mga ito pagkatapos ng cataract extraction at corneal refractive procedures, at sa piling allergic-pruritus pathways (ketorolac).
Common Agents and Typical Dosing
| Drug | Typical Adult Ophthalmic Dosing | Common Indications |
|---|---|---|
| Diclofenac 0.1% | 1 drop QID starting 24 hours after cataract surgery for about 2 weeks; refractive surgery: 1-2 drops pre-op, immediate post-op, then QID for up to 3 days | Postoperative inflammation, postoperative pain, photophobia |
| Ketorolac 0.5% | 1 drop QID starting 24 hours after cataract/refractive surgery for about 2 weeks; seasonal allergic conjunctivitis: 1 drop QID | Postoperative inflammation/pain, ocular pruritus |
Adverse Effects and Contraindications
- Burning/stinging, blurred vision, itching, lacrimation
- Delay in wound healing and keratitis risk
- Ocular bleeding risk kabilang ang hyphema sa susceptible clients
- Corneal epithelial breakdown, thinning, ulceration, o perforation risk kapag matagal ang therapy
- Contraindicated sa severe NSAID o aspirin hypersensitivity
Mas malamang ang higher-risk corneal complications sa clients na may corneal denervation, dry-eye syndrome, diabetes, o rheumatoid arthritis, lalo na kapag lumampas sa humigit-kumulang 14 araw ang paggamot.
Nursing Assessment and Interventions
- Tayahin ang baseline at interval visual acuity.
- Bantayan ang ocular bleeding, facial edema, lumalalang sakit, at corneal-injury cues.
- Kailangan ang return-demonstration ng drop technique at contamination prevention.
- Magbigay ng pansamantalang fall-risk support kung naaapektuhan ng blurred vision ang kaligtasan sa paglakad.
- Kung lumitaw ang corneal epithelial breakdown, ihinto ang topical NSAID at mag-escalate agad.
Drug and Care Interactions
- Concurrent ophthalmic corticosteroids: mas mataas na delayed-healing risk
- Latanoprost: posibleng nabawasang latanoprost therapeutic effect
- Anticoagulants/antiplatelet pathways: additive bleeding risk context
Client Education
- Basahing mabuti ang labels upang maiwasan ang look-alike/sound-alike errors (halimbawa ketorolac vs magkakahawig ang pangalan na nonophthalmic products).
- Iulat agad ang red eye, foreign-body sensation, lumalalang sakit, photophobia, o nabawasang paningin.
- Huwag magmaneho o gumamit ng mapanganib na kagamitan hanggang luminaw ang paningin pagkatapos ng instillation.
- Iwasang makontamina ang dropper tip sa pagdikit nito sa mata, balat, o ibang surfaces.
Related Concepts
- Pagbibigay ng ophthalmic medication - Sterile no-touch instillation at route safety.
- Ophthalmic corticosteroids - Karaniwang kaparehang class na may additive healing-risk concerns.
- Ophthalmic antibiotics - Postoperative anti-infective overlap at technique reinforcement.
- Pagtatasa ng mata, visual acuity, at karaniwang abnormalidad - Reassessment ng vision change sa ocular drug therapy.