Nurses Compass
Drug Guide
Trifluridine
Classification
Therapeutic: Antiviral (Ophthalmic)
Pharmacological: Nucleoside analogue
FDA Approved Indications
- Treatment of herpetic keratitis
Mechanism of Action
Trifluridine is a nucleoside analogue that inhibits viral DNA synthesis by interfering with viral DNA polymerase, thus preventing viral replication.
Dosage and Administration
Adult: 1 drop in the affected eye every 2 hours while awake for up to 7 days, then reduce frequency as directed by physician.
Pediatric: Use as directed by a healthcare provider; safety and effectiveness have not established specifically in children.
Geriatric: No specific adjustments necessary; consider assessment of renal and hepatic function.
Renal Impairment: Use with caution; no specific dosage adjustments established.
Hepatic Impairment: Use with caution; monitor accordingly.
Pharmacokinetics
Absorption: Minimal systemic absorption due to topical ophthalmic application.
Distribution: Limited systemic distribution.
Metabolism: Metabolized locally in ocular tissues; systemic metabolism not significant.
Excretion: Excreted primarily through ocular tissues; negligible systemic excretion.
Half Life: N/A for topical application; systemic half-life not applicable.
Contraindications
- Hypersensitivity to trifluridine or any components of the formulation.
Precautions
- Use with caution in patients with corneal epithelial defects. Ophthalmic use only; avoid contact with other tissues.
- Monitor for signs of increased intraocular pressure or local irritation.
Adverse Reactions - Common
- Transient ocular irritation (Common)
- Conjunctival hyperemia (Common)
Adverse Reactions - Serious
- Corneal toxicity or epithelial defects (Rare)
- Allergic reactions, including edema and eyelid swelling (Rare)
Drug-Drug Interactions
- None well characterized; use cautiously with other topical ocular medications.
Drug-Food Interactions
- None significant.
Drug-Herb Interactions
- None established.
Nursing Implications
Assessment: Assess ocular condition and response to therapy, monitor for signs of toxicity or adverse reactions.
Diagnoses:
- Risk for corneal damage
- Impaired visual acuity
Implementation: Administer ophthalmic solution as prescribed; instruct patient on proper instillation technique; maintain strict aseptic technique.
Evaluation: Evaluate therapeutic response and monitor for adverse effects.
Patient/Family Teaching
- Use medication exactly as prescribed.
- Avoid touching the tip of the dropper to any surface.
- Report any signs of ocular irritation, pain, or vision changes.
- Follow-up appointments are necessary for monitoring.
Special Considerations
Black Box Warnings:
- None currently issued.
Genetic Factors: Not applicable.
Lab Test Interference: No known interference with lab tests.
Overdose Management
Signs/Symptoms: Ocular irritation, redness, or worsening of symptoms.
Treatment: Discontinue use; supportive care; ocular irrigation if necessary; consult ophthalmology.
Storage and Handling
Storage: Store at room temperature, 15°C to 25°C (59°F to 77°F).
Stability: Stable under recommended storage conditions; discard after the expiration date.