Usage
This combination is primarily used in ophthalmology for the management of eye disorders, particularly cataracts. It aids in improving vision and may help prevent lenticular opacity. A secondary use, when other treatment options are unavailable, is to maintain fluid and electrolyte balance, especially in premature infants with respiratory distress syndrome.
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Pharmacological classification: Electrolyte replenisher, ophthalmic solution.
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Mechanism of Action: The exact mechanism for preventing cataract formation is not fully understood. However, each component contributes: Calcium Chloride maintains osmotic balance in the eye, Potassium Iodide may improve nutrient delivery to the lens, and Sodium Chloride regulates fluid balance and corneal edema. In systemic use, it replenishes lost fluids and minerals.
Alternate Names
Catarest, Catagon, CATACLEAR, CATAFLY, CATACT, Cateyeris, Catalens, NAYAREST. Other names may exist regionally.
How It Works
Pharmacodynamics: Primarily, each component exerts its effect by maintaining the proper electrolyte and fluid balance within the eye. This helps prevent or delay cataract formation. Systemically, the components maintain broader fluid and electrolyte balance crucial for cellular function.
Pharmacokinetics:
- Absorption: When administered as eye drops, absorption is primarily local to the eye. In IV administration, absorption is immediate and complete.
- Metabolism: These are inorganic salts; minimal metabolism occurs.
- Elimination: Primarily renal excretion for all components.
Mode of Action (Ophthalmic): Calcium chloride maintains osmotic balance, potassium iodide improves nutrient supply to the lens, and sodium chloride regulates fluid balance and corneal edema. The combination helps maintain lens clarity and intraocular pressure.
Receptor binding, enzyme inhibition, neurotransmitter modulation: Not applicable for this combination.
Elimination pathways: Primarily renal excretion for all components.
Dosage
Standard Dosage
Adults:
- Ophthalmic Solution: 1-2 drops instilled into the affected eye(s) 2-3 times per day, or as directed by the physician.
- Intravenous Infusion (for electrolyte replenishment): Dosage varies widely depending on the specific electrolyte imbalance being corrected. Refer to individual component dosing guidelines.
Children:
- Ophthalmic Solution: Safety and efficacy have not been specifically established in children. Use only under the guidance of a pediatric ophthalmologist.
- Intravenous Infusion (for electrolyte replenishment): Dosage is weight-based (e.g., for calcium chloride: Neonates, Infants, and Children: 10-20 mg/kg/dose (0.1-0.2 mL/kg/dose of 10% solution) IV over 10 minutes, repeating every 10-20 minutes as needed; Adolescents: 500-1000 mg/dose (5-10 mL of a 10% solution) IV over 10 minutes, repeating every 10-20 minutes as needed) and needs careful calculation and monitoring by a healthcare professional.
Special Cases:
- Elderly Patients: Dosage adjustments may be necessary based on renal function.
- Patients with Renal Impairment: Dose reduction may be required.
- Patients with Hepatic Dysfunction: No specific adjustments are typically needed.
- Patients with Comorbid Conditions: Close monitoring is advisable, especially in patients with cardiovascular disease, diabetes, or other relevant conditions.
Clinical Use Cases
- Intubation/Surgical Procedures/Mechanical Ventilation/ICU Use/Emergency Situations: Intravenous administration of this combination is typically not used in these settings, though individual components may be. Refer to individual component guidelines for relevant dosing.
Dosage Adjustments:
Dose modifications may be necessary based on renal/hepatic dysfunction, metabolic disorders, or other patient-specific factors.
Side Effects
Common Side Effects:
- Ophthalmic: Eye irritation, stinging sensation, temporary blurred vision, headache, bitter taste in mouth.
- IV Infusion: Flushing, nausea, vomiting, drowsiness, hypotension, chalky or metallic taste, sweating, tingling sensations.
Rare but Serious Side Effects:
- Ophthalmic: Allergic reactions (itching, swelling), severe eye pain.
- IV Infusion: Rapid IV administration: Vasodilation, hypotension, bradycardia, cardiac arrhythmia, syncope, cardiac arrest, hypercalcemia (lethargy, nausea, vomiting, coma), tissue irritation and necrosis.
Long-Term Effects: Generally, side effects are temporary. Long-term complications are rare with ophthalmic use. With IV infusions, chronic complications depend more on the underlying condition being treated.
Contraindications
- Known hypersensitivity to any component.
- Hyperkalemia, hypercalcemia (for IV infusions).
- Severe dry eye syndrome, corneal abrasions (for ophthalmic use, relative contraindication, use with caution).
- Thyroid disorders (for ophthalmic use, use with caution due to iodine content).
Drug Interactions
- Ophthalmic: Other ophthalmic medications (dorzolamide, timolol), antihistamines, antidepressants, iodine-containing supplements.
- IV Infusion: Cardiac glycosides (digoxin), diuretics (furosemide), certain antibiotics (tetracycline).
- Other potential interactions may exist, consult a comprehensive drug interaction database for detailed information.
Pregnancy and Breastfeeding
Safety not fully established for ophthalmic or IV use. Consult with physician. Data limited regarding fetal risks or breast milk excretion. Benefit should outweigh risk.
Drug Profile Summary
- Mechanism of Action: See above.
- Side Effects: See above.
- Contraindications: See above.
- Drug Interactions: See above.
- Pregnancy & Breastfeeding: Safety not established. Consult physician.
- Dosage: See above.
- Monitoring Parameters: For IV infusion, serum electrolyte levels, ECG, blood pressure, renal function. For ophthalmic solution, intraocular pressure, visual acuity.
Popular Combinations
Not applicable for this specific three-drug combination. Individual components may be part of other combinations.
Precautions
- General Precautions: Pre-screening for allergies, metabolic disorders, organ dysfunction.
- Specific Populations: See “Special Cases” under Dosage and “Pregnancy and Breastfeeding” sections.
- Lifestyle Considerations: For ophthalmic use, avoid driving immediately after application if blurred vision occurs.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Calcium Chloride + Potassium Iodide + Sodium Chloride?
A: See the Dosage section above, which outlines dosing for adults, children, and special populations for both ophthalmic and IV administration.
Q2: What are the primary uses of this combination?
A: Primarily used for eye disorders, particularly cataracts, and to maintain fluid and electrolyte balance, especially in premature infants with respiratory distress syndrome.
Q3: What is the mechanism of action?
A: Calcium Chloride maintains osmotic balance, Potassium Iodide may improve nutrient delivery to the lens, and Sodium Chloride regulates fluid balance and corneal edema.
Q4: Are there any significant drug interactions?
A: Yes. See the Drug Interactions section above.
Q5: Can this combination be used during pregnancy or breastfeeding?
A: Safety is not fully established. Consult with a physician.
Q6: What are the common side effects?
A: See the Side Effects section above for both ophthalmic and IV administration.
Q7: How is this combination administered?
A: As an ophthalmic solution (eye drops) or as an intravenous infusion.
Q8: Is this medication safe for long-term use?
A: Generally, side effects are temporary with ophthalmic use. Consult a physician for long-term IV use considerations.
Q9: What should I do if a dose is missed?
A: If you miss a dose of the eye drops, apply it as soon as you remember. If it is close to the next dose, skip the missed dose and continue your regular schedule. For intravenous administration, consult a physician.
