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    Common Drugs Use in Ophthalmology

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    ณัช เกษม
    This document provides information on common drugs used in ophthalmology, including their routes of administration, mechanisms of drug elimination, factors affecting drug penetration, and details on specific drug classes. It discusses topical anesthetics, mydriatics, antibiotics, antihistamines, mast cell stabilizers, corticosteroids, and artificial tears. The goal is to optimize treatment based on the severity and type of condition while minimizing potential complications.

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    Common Drugs Use in Ophthalmology

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    ณัช เกษม
    328 views40 pages
    This document provides information on common drugs used in ophthalmology, including their routes of administration, mechanisms of drug elimination, factors affecting drug penetration, and details on specific drug classes. It discusses topical anesthetics, mydriatics, antibiotics, antihistamines, mast cell stabilizers, corticosteroids, and artificial tears. The goal is to optimize treatment based on the severity and type of condition while minimizing potential complications.

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    This document provides information on common drugs used in ophthalmology, including their routes of administration, mechanisms of drug elimination, factors affecting drug penetration, and details on specific drug classes. It discusses topical anesthetics, mydriatics, antibiotics, antihistamines, mast cell stabilizers, corticosteroids, and artificial tears. The goal is to optimize treatment based on the severity and type of condition while minimizing potential complications.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    328 views40 pages

    Common Drugs Use in Ophthalmology

    Uploaded by

    ณัช เกษม
    This document provides information on common drugs used in ophthalmology, including their routes of administration, mechanisms of drug elimination, factors affecting drug penetration, and details on specific drug classes. It discusses topical anesthetics, mydriatics, antibiotics, antihistamines, mast cell stabilizers, corticosteroids, and artificial tears. The goal is to optimize treatment based on the severity and type of condition while minimizing potential complications.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 40
    At a glance
    Powered by AI
    The document discusses various ophthalmic drugs, their routes of administration, factors affecting drug penetration and absorption, and common preservatives used in eyedrops.

    The main routes of administration discussed are local (topical) and systemic. Local routes include topical, intravitreal, subconjunctival, subtenon, retrobulbar, and intracameral administration.

    Factors that determine the amount of drug penetration through the cornea include drug concentration, viscosity, lipid/water solubility, pH, surfactants, reflex tearing, and presence of preservatives.

    Common Drugs Use in

    Ophthalmology
    Rungroj Lertvithayasakul, MD
    Varintorn Chuckpaiwong, MD
    Department of Ophthalmology, Ramathibodi Hospital
    School of Medicine, Mahidol University

    Route of Administration

    Local

    Topical
    Intravitreous
    Subconjunctival
    Subtenon
    Retrobulbar
    Intracameral

    Systemic

    Blood aqueous barrier


    Blood retinal barrier

    Eyedrops
    50 l per drop

    Only 20 % of the administered


    drugs is retained
    One drop is enough.

    Volume of fluid held by


    cul-de-sac 7 10 l

    Drug eliminating mechanisms


    Lacrimal
    Lacrimalgland
    gland
    Tear production: 1.2 l /min
    Turn over rate 16 % per min
    Remaining

    4 min

    : 50 %

    10 min : 17 %

    Nasal
    Nasalcavity
    cavity

    Surface area of 150 - 200 cm 2


    ( 13 times of conjunctiva )
    200 times of cornea

    Drug eliminating mechanisms

    If the drug is
    irritating to the eye

    Dilution of drug
    Overflow drainage

    Improve ocular and decrease systemic


    absorption

    Digital pressure at medial canthal


    area

    Keep eyes closed for 5 min after


    taking drops

    Wait 10 minutes between drops

    Frequency ~ duration of action

    Order of using ~ pH

    Drug Penetration

    Precorneal
    Precornealarea
    area

    Cornea
    Cornea
    Anterior
    AnteriorSegment
    Segment

    Aqueous
    AqueousHumor
    Humor

    Drug Penetration
    Factors that determine the amount of medication
    to penetrate the cornea
    Drug concentration
    Viscosity
    Lipid/water solubility
    pH
    Surfactants
    Reflex tearing
    Preservative

    Form

    Solution and suspension


    Ointment
    Gel

    Solution and Suspension


    Most commonly used
    Advantages
    - Easily instilled
    - Less interfere to vision
    - Fewer potential complications
    Disadvantages
    - Short ocular contact time
    - Imprecise and inconsistent delivery
    - Frequent contamination
    - Possibilities of ocular injury with the dropper tip

    Suspensions
    Must be re-suspended by shaking to provide
    an accurate dosage of drug

    Ointment

    Consist of petrolatum and mineral oil


    Increase contact time
    Disturb vision

    Gel

    Polymer-based aqueous gels

    Drug release occurs by diffusion and by erosion


    of the gel surface

    Techniques of Instillation

    Eye ointment

    Eye drop

    Eye ointment

    Packaging

    The outer surface


    dimensions of the tip
    affects drop size

    Packaging
    Standard colors for drug labeling and bottle cap
    Yellow, Blue
    Red
    Green
    Orange
    Brown or tan
    Gray
    Pink

    B blocker
    Mydriatics and cycloplegics
    Miotics
    Carbonic anhydrase inhibitors
    Anti-infective agents
    NSAIDS
    Steroids

    Commonly used drugs

    Anesthesia
    Topical

    Cornea, conjunctiva
    Irritate 15 sec
    Duration 15 min
    For FB removal, IOP measurement, etc.
    Complications : toxic to epithelium

    Tetracaine hydrochloride (Tetracaine) 0.5%


    Benoxinate hydrochloride (Novesine) 0.4%

    Anesthesia
    Local

    Including akinesia
    For surgery
    Complications: overdose, systemic absorption
    (respiratory distress, seizure)

    Lidocaine hydrochloride (Xylocaine) 1-2 % 1-2 hr


    Bupivacaine hydrochloride (Marcaine) 0.25-0.5%
    5-7 hr

    Mydriatics
    I. Sympathomimetics

    Stimulate dilator muscle


    Complications: AACG, vasoconstriction
    For retinal examination, surgery

    Phenylephrine hydrochloride (Neosynephrine)


    10% 2-3 hr

    Mydriatics
    II. Parasympatholytics / Cycloplegics

    Inhibit constrictor m.and ciliary m. contraction


    Complications: AACG, flushing
    For ciliary spasm, refraction in children, retinal exam
    Atropine sulfate 1% 2 wk
    Scopolamine hydrobromide 0.25% 3-5 d
    Homatropine hydrobromide 1-2% 1-3 d
    Cyclopentolate hydrochloride (Cyclogyl) 1% 24 hr
    Tropicamide (Mydriacyl) 0.5-1% 4-5 hr

    Mydriatics and Cycloplegics

    Atropine sulfate

    Cyclopentolate HCl

    Tropicamide

    Phenylephrine HCl


    40
    1


    45
    3

    Antibiotics

    Antibiotics
    Consider
    Severity and progression
    Suspected organism & Sensitivity
    Location & Penetration
    Toxicity
    Frequency and concentration


    18
    3

    Antibiotics: Combination

    Polymyxin B
    Gramicidin
    Neomycin

    Antibiotics

    Antibacterial

    Antifungal

    Antiviral

    Anti parasitic


    30

    1

    Antihistamine

    Vasoconstrictors
    Phenylephrine HCl

    Pheniramine maleate

    Naphazoline HCl

    Antazoline HCl

    Tetrahydrozoline HCl

    Antazoline HCl
    + Tetrahydrozoline HCl
    Pheniramine maleate
    + Naphazoline HCl


    7
    2 1

    Mast-cell stabilizer

    Cromolyn sodium

    Lodoxamide

    Olopatadine HCl


    40

    dexoph

    Corticosteroid

    Anti-inflammation
    Suppress immune system and tissue reaction
    Precaution in treatment of infection especially
    viral and fungal infection
    Dexamethazone 0.1%
    Prednisolone acetate 0.5%, 1%
    Fluorometholone 0.1%

    Corticosteroids

    Prednisolone ( 0.5, 1% )

    Dexamethasone ( 0.1%)

    Fluorometholone ( 0.1 %)

    Corticosteroids
    Side effects
    Glaucoma
    Cataract
    Exacerbation of infection
    Ptosis
    Scleral melting

    Artificial Tear

    Supplement
    Increase contact time
    For dry eye, CL wearer
    Frequency of usage ~ severity
    Preserve VS non preserve

    Artificial tears

    The end

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