Actions and Uses of Ophthalmic Drugs (eBook)

Front Cover 1
The Actions and Uses of Ophthalmic Drugs 4
Copyright Page 5
Table of Contents 10
Foreword 6
Preface to the third edition 7
Preface to the first edition 8
Chapter 1. General pharmacological principles 12
Introduction 12
Sources of drugs 12
Drug nomenclature 13
Pharmacological classification 13
General pharmacological principles 14
References 28
Chapter 2. Ocular autonomic innervation and neurohumoral transmission 29
Intra-ocular musculature 29
Parasympathetic innervation of the eye (Colour Plate I) 29
Sympathetic innervation of the eye and orbit (Colour Plate I) 31
Sensory innervation of the eye and orbit (Colour Plate I) 33
Neurohumoral transmission in the autonomic nervous system (Figure 2.2) 34
Autonomic drugs 54
Denervation supersensitivity 59
References 59
Chapter 3. Basic microbiology 61
Bacteria 61
Chlamydiae 68
Fungi 68
Micro-organisms and disease 69
Microbiology of the eye 70
Some common ocular pathogens 70
Antimicrobial agents 75
Hygiene in practice 79
References 80
Further reading 81
Chapter 4. Introduction to ophthalmic drugs 82
Dosage forms for ophthalmic use 83
Drug classification 92
References 93
Chapter 5. Cycloplegics 95
Ideal properties of cycloplegics 95
Advantages of cycloplegic refraction 95
Disadvantages of cycloplegic refraction 97
Precycloplegic examination 97
Cycloplegic examination 97
Choice of cycloplegic 100
Atropine 102
Cyclopentolate 111
Tropicamide (Bistropamide) 115
Other cycloplegics 116
Adverse effects of cycloplegics 118
References 119
Chapter 6. Mydriatics 122
Ideal properties of mydriatics 122
Indications 122
Contra-indications 124
Mode of action 125
Antimuscarinic mydriatics 127
Sympathomimetic mydriatics 129
Antimuscarinic or sympathomimetic 134
Mixed mydriatics 134
Mydriatics for Horner's syndrome 135
Adverse effects of mydriatics 135
References 137
Chapter 7. Miotics 139
Ideal properties 139
Indications for use 139
Advantages 141
Disadvantages 141
Mode of action 141
Parasympathomimetic miotics 141
Pilocarpine 142
Carbachol 144
Acetylcholine chloride + mannitol 144
Bethanecol chloride 145
Methacholine chloride 145
Anticholinesterases 145
Physostigmine (eserine) 146
Irreversible anticholinesterases 149
Dyflos (DFP) or di-isopropylfluorophosphonate (Isofluorophate, UPS) 149
Ecothiopate iodide (Ecothiophate iodide USP) (Phospholine Iodide) 149
Alpha-blocking agents 150
Choice of miotic 150
Mixed miotics 151
Miotics for Adie's pupil 152
Adverse reactions to miotics 152
References 153
Chapter 8. Local anaesthetics 155
Ideal properties 155
Indications for use 155
Advantages 156
Disadvantages 157
Mode of action 157
Choice of topical anaesthetic 157
Proxymetacaine hydrochloride (Proparacaine Hydrochloride, USP) (Ophthaine: Alcaine, Canada, USA: Ophthetic, Australia, Canada, 
158 
Oxybuprocaine hydrochloride (benoxinate hydrochloride) (Novesine, Australia, South Africa Dorsacaine, USA)
Lignocaine hydrochloride (Lidocaine Hydrochloride, Eur. P., USP) 
159 
Amethocaine hydrochloride (Tetracaine Hydrochloride Eur. P., 
159 
Adverse reactions to local anaesthetics 160
References 161
Chapter 9. Stains 163
Ideal properties 164
Fluorescein sodium 164
Rose bengal (Colour Plate VI) 168
Mixtures of fluorescein and rose bengal 169
Other stains 169
Methylene blue 170
References 170
Chapter 10. Anti-infective agents 171
Ideal properties for anti-infective agents 172
Sulphacetamide sodium (Albucid Acetopt, Optamide, Australia
Mafenide proprionate (p-aminomethylbenzenesulphonamide proprionate alpha-aniino-p-toluene sulphonamide proprionate) (Sulfomyl)
Dibromopropamidine isethionate (Brolene) 174
Propamidine isethionate 174
Framycetin 174
Adverse reactions 175
References 175
Chapter 11. Miscellaneous agents 176
Agents used in the treatment of inflammation 176
Vasoconstrictors 176
Antihistamines 178
Non-steroidal anti-inflammatory drugs (NSAIDs) 178
Irrigating and emollient drops 180
Normal saline 180
Oily drops 181
Artificial tears 181
References 181
Chapter 12. Contact lens solutions 182
Disinfecting and soaking solutions 183
Daily cleaning agents 188
Wetting solutions 188
In use comfort drops 189
Protein remover tablets (Figure 12.4) 190
References 191
Chapter 13. Ocular first aid 194
Equipment 195
Common ocular emergencies 196
References 200
Chapter 14. Legal aspects 201
General Sale List (GSL)—section 51 202
Pharmacy Medicines (P)—section 52 202
Prescription Only Medicines (POM)—section 58 202
Sale and supply of contact lens solutions 203
Acts of Parliament and statutory instruments 208
Chapter 15. Drugs used in ophthalmology—anti-infectives 209
Routes of administration 209
Antibacterial agents 210
Antifungal agents 213
Antiviral drugs 215
References 217
Chapter 16. Drugs used in ophthalmology— anti-inflammatory agents 219
Corticosteroids 220
Sodium cromoglycate (cromolyn sodium) 221
Chapter 17. Drugs used in ophthalmology—anti-glaucoma drugs 222
Systemic treatments 224
Topical treatments 224
Mixtures of agents 229
Future developments 229
References 229
Chapter 18. Adverse ocular reactions to drug therapy 232
Adverse ocular effects of drugs 235
Drugs acting on the alimentary tract 236
Drugs acting on the cardiovascular system 237
Drugs acting on the respiratory system 239
Drugs acting on the central nervous system 241
Drugs used in the treatment of infections 244
Drugs acting on the endocrine system 247
Anti-inflammatory drugs 249
Drugs acting on the blood 250
References 250
Appendix 252
Index 256