Actions and Uses of Ophthalmic Drugs (eBook)

A Textbook for Students and Practitioners

P. H. O'Connor Davies (Autor)

eBook Download: PDF

2013 | 2. Auflage
398 Seiten
Elsevier Science (Verlag)
978-1-4831-9220-8 (ISBN)

Infos

The Actions and Uses of Ophthalmic Drugs: A Textbook for Students and Practitioners, Second Edition provides pertinent information in relation to concepts in pharmacology, the formulation and application of ophthalmic drugs, and adverse ocular effects of systemic medication. This book discusses the preparations used in contact lens practice. Organized into 17 chapters, this edition begins with an overview of the primary systems of drug classification according to their actions or effects, or on the basis of their chemistry. This text then presents a detailed discussion on the actions and uses of ophthalmic autonomic drugs. Other chapters consider the structure and function of the involuntary nervous system in the orbital region. This book discusses as well the two main classifications of ophthalmic drugs, namely, therapeutic and diagnostic. The final chapter deals with the clinical significance of medication-induced ocular adverse effects. This book is a valuable resource for ophthalmologists, students, and practitioners.

Inhalt

Front Cover 1
The Actions and Uses of Ophthalmic Drugs: A Textbook for Students and Practitioners 4
Copyright Page 5
Table of Contents 12
Dedication 3
Foreword 6
Preface to the second edition 8
Preface to the first edition 10
Chapter 1. General pharmacological principles 14
Introduction 14
Sources of drugs 14
Drug nomenclature 15
Pharmacological classification 15
General pharmacological principles 16
Pharmacokinetics 16
Absorption 18
Distribution 19
Biotransformation 22
Excretion 23
Pharmacodynamics 23
Biological variations 
24 
Terminology 
24 
Mechanisms of drug action 
25 
Structure-activity relationship 
25 
Drug receptors 
25 
Sites of action 29
Factors modifying drug effects and dosage 
29 
Drug toxicity 
31 
Development and use of drugs 
31 
References 32
Chapter 2. Ocular autonomic innervation and neurohumoral transmission 33
Intra-ocular musculature 33
Parasympathetic innervation of the eye 33
Sphincter pupillae muscle 35
Dilatator pupillae muscle 35
Sympathetic innervation of the eye and orbit 35
Antagonistic action of sympatlietic and parasympathetic 37
Reciprocal innervation 38
Sensory innervation of the eye and orbit 38
Axonal conduction 39
Acetylcholine 48
Noradrenaline 51
Classification of drugs affecting the autonomic nervous system(autonomic drugs) 58
Parasympathomimetic drugs 58
Sympathomimetic drugs 59
Adrenergic receptor-blocking drugs 59
Adrenergic neurone-blocking drugs 60
Ganglion-blocking drugs 61
Ganglionic stimulating drugs 61
References 61
Chapter 3. Introduction to ophthalmic drugs—therapeutic and diagnostic 63
Therapeutic drugs 63
Diagnostic drugs 80
Pharmacological classification 
80 
Classification according to usage of ophthalmic diagnostic drugs thataffect the ocular autonomic nervous system 82
Choice of ophthalmic preparation 
84 
Eye lotions (Synonyms: collyr., collyrium 91
Ophthalmic lamellae and ophthalmic tablets 
92 
Ocuserts 
93 
Soft contact lens adjunctive medication 93
References 95
Chapter 4. Cycloplegics—Atropine 96
Advantages of cycloplegic refraction 96
Disadvantages of cycloplegic refraction 97
Necessity for cycloplegic refraction 97
Atropine 100
Source 100
Characters 100
Maximum therapeutic dose 101
Chemistr 101
Pharmacological actions 
101 
Mechanism of action 
102 
Time scale 
102 
Effects on intra-ocular circulation (Figure 2.1, Colour Plates III and IV) 103
Absorption, metabolism and excretion 104
Administration 104
Directions given to parents 104
Supply of atropine sulphate^ to ophthalmic opticians 106
Pre-cycloplegic examinations: careful history and symptoms 107
Cycloplegic examination 107
Objective checking of the cylinder axis 109
Interpretation of refractive results under cycloplegia 109
Subjective verification 110
The prescription 111
Tonus allowance 112
Refractive errors and atropine cycloplegia 113
Myopia 114
Hypermetropia 115
Previous prescription 118
Oculo-motor balance 118
Strabismus 120
Latent and manifest error 120
Binocular balancing techniques 121
Bichromatic tests 122
Advantages of atropine cycloplegia 123
Disadvantages of atropine cycloplegia 123
Precautions 124
Further uses of atropine 125
References 126
Chapter 5. other cycloplegics—Homatropine,Cyclopentolate, Tropicamide andLachesine 127
Homatropine 127
Ophthalmic preparations 128
Mechanism of action and effects 129
Suitable cases 130
Disadvantages and contra-indications 131
Mechanism of action and effects 133
Adverse effects 139
Recommended dosage for cycloplegic refraction 140
Medical uses 141
Summary 141
Tropicamide (Bístropamide 142
Lachesine 143
References 144
Chapter 6. Mydriatics 145
Indications 145
Contra-indications 146
Antimuscarinic mydriatics 148
Homatropine hydrobromide† 0.25 per cent, or 0.5 per centeyedrops 149
Cyclopentolate hydrochloride 0.1 † per cent eyedrops 150
Eucatropine (Euphthalmin) 5 and 10 per cent eyedrops (P) 151
Sympathomimetic mydriatics 151
Phenylephrine eyedrops (P) 154
Precautions and contra-indications 157
Medical provocative tests 160
Other sympathomimetic drugs that cause mydriasis 161
Cocaine (CD. POM) 161
Colour Plate Section 162
Adrenaline (epinephrine) 171
References 175
Chapter 7. Miotics 177
Physostigmine (eserine) 177
Properties 178
Mechanism of action 179
Ophthalmic preparations 179
Precautions 
183 
Physostigmine in glaucoma 183
Pilocarpine 186
Mechanism of action 186
Precautions 189
Pilocarpine in glaucoma 189
Miotics in the treatment of strabismus 191
References 192
Chapter 8. Miscellaneous drugs 197
Cycloplegics and mydriatics 197
Dibutoline sulphate 198
Miotics 200
Dyflos (DFP) or di-isopropylfluorophosphonate (Isoflurophate, USP) 202
Carbachol (Doryl Carcholin)
Methacholine chloride 205
Acetylcholine chloride -h mannitol (Miochol) 205
Thymoxamine hydrochloride^ (Opilon) 206
Other miscellaneous drugs 206
Guanethidine (Ismelin) 207
Morphine and barbiturates 207
Nicotine 208
References 211
Chapter 9. Local anaesthetics, staining agents,conjunctival decongestants and anti-infectivepreparations 212
Topical local anaesthetics 212
Cocaine hydrochloride 213
Block anaesthesia 219
Staining agents 219
Rose bengal 223
Alcian blue 223
Conjunctival decongestants 224
Propamidine isethionate 230
References 230
Chapter 10. Poisoning with ophthalmic drugs 232
Precautionary measures 232
Symptoms and signs of poisoning by belladonna alkaloids 233
Symptoms and signs of poisoning by physostigmine andpilocarpine 236
Symptoms and signs of poisoning with local anaesthetics 237
Symptoms and signs of poisoning witli organophosphorouscompounds 238
Symptoms and signs of poisoning by nicotine 239
References 240
Chapter 11. Sterility in eye preparations 241
Antimicrobial substances 241
Bacteria 244
Fungi 244
Types of bacterial cell 245
Spore formation 246
Gram-positive 246
Gram-negative 247
Bacteriology of the conjunctiva and cornea 247
Criteria for ideal eyedrops 249
References 253
Chapter 12. Contact lens preparations 254
Normal saline eyedrops (sterile) 254
Sodium bicarbonate eyedrops (sterile) 255
Eye lotions 255
Liquid paraffin eyedrops (also known as Parolein eyedrops) 256
Hard (rigid, hydrophobic, poly methyl methacrylate (PMMA)) contactlens cleaning solutions 256
Hard contact lens wetting solutions 258
Hard contact lens soaking (storage) solutions 262
Artificial tears/re-wetting 265
Multifunctional solutions 266
Solutions for use with hydrophobic and semi-hydrophilic lenses otherthan those of PMMA 267
Antimicrobial preservatives used in contact lens solutions 267
Benzalkonium chloride 269
Cetrimide 271
Chlorbutol {Synonym: chlorbutanol) 272
Organic mercurial antimicrobial preservative agents 272
Phenylmercuric acetate or nitrate 273
Chlorhexidine acetate or gluconate 274
Viscosity-increasing and wetting agents 275
Chelating agents 276
pH of commonly used hard contact lens solutions 277
Wetting solutions 277
Soaking solutions 277
Combined wetting-soaking solutions 277
Combined wetting-cleaning solutions 278
Hydrophilic (soft) lens care preparations 278
Cleaning solutions and methods 279
Disinfection systems 281
Rejuvenating systems 286
Legislation and contact lens preparations 288
References 288
Chapter 13. Ocular first aid and emergencies 291
Records 291
Equipment 292
Maintenance of equipment 296
Removal of ocular foreign bodies 298
Superficial foreign bodies 300
Embedded foreign bodies 301
Acid burns of the eye 303
Lime and alkali burns 304
Fainting 306
Heart-lung resuscitation 306
Circulation restored 307
References 308
Chapter 14. Use and preparation of eyedrops, eyelotions and eye ointments{The Pharmaceutical Codex, 1979 BP, 1980)
Eyedrops 309
Domiciliary use 310
Hospital wards and out-patient departments 310
Operating theatres 310
Preparation of eyedrops 311
Containers 311
Labelling 312
Quantities for domiciliary use 312
The ophthalmic optician's consulting rooms 313
Methods of sterilization 313
Standard 313
Methods 313
Eye ointments 314
Preparation 314
Quantity 315
Labelling 315
Preparation 316
Labelling 316
References 316
Chapter 15. Ophthalmie formulary 317
Eyedrops (guttae), eye lotions (collyria) and eye ointments(oculenta) 317
Eyedrops 318
Eye lotions 325
References 328
Chapter 16. Medicines legislation and the ophthalmicoptician 329
Summary 329
Parts I and II 330
The Statutory Instruments 1977/1978 331
Parts IV–VII 335
Emergency treatment and supply 336
Labelling by ophthalmic opticians 337
Legislation and contact lens preparations 339
References 340
Chapter 17. Adverse ocular reactions from drug therapyand drug interactions 341
Questioning the patient with respect to medically prescribed substances or self-medication 343
Suspected adverse ocular reactions from medication 344
Drugs affecting the ANS 346
Drugs affecting the CNS 349
Cardiovascular drugs 358
Anti-infective drugs 363
Antirheumatic drugs 371
Antihistamines 373
Antidiabetics 374
Drugs used in neuromuscular disorders 375
Drugs used in myasthenia gravis 
376 
Oxytocics 376
Inorganic halides 377
Heavy metals 377
Vitamins 378
Summary 379
Ophthalmic and systemic drug interactions 379
Drug interactions between sympathomimetic mydriatics and tricyclic antidepressants 380
Drug interactions between anticholinergic mydriatics and tricyclic antidepressants 381
Drug interactions between sympathomimetic mydriatics and monoamine oxidase inhibitors 381
Drug interactions between sympathomimetic mydriatics and antihypertensive agents 382
Summary 384
References 385
Index 388

Produkt-Details

• Erscheint lt. Verlag: 22.10.2013
• Sprache: englisch
• Themenwelt: Medizin / Pharmazie ► Gesundheitsfachberufe
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Pharmakologie / Pharmakotherapie
• Themenwelt: Studium ► 2. Studienabschnitt (Klinik) ► Pharmakologie / Toxikologie
• ISBN-10: 1-4831-9220-2 / 1483192202
• ISBN-13: 978-1-4831-9220-8 / 9781483192208