Ophthalmic administration

Counsel patients about glaucoma, drug therapy options, ophthalmic administration techniques, and the importance of adherence to the prescribed regimen. 

Pharmacokinetics Not significantly absorbed following topical or ophthalmic administration. 

Pharmacokinetics Well absorbed from fhe G1 fracf. Minimal absorption after ophthalmic administration. Protein binding 50%-60% (oral). Metabolized in liver. Primarily excreted in urine. Removed by hemodialysis. Half-life 12-22 hr (half-life is increased in the elderly and patients with impaired renal function). Ophthalmic Systemic absorption may occur. 

Contraindications Hypersensitivity to ciprofloxacin or other quinolones for ophthalmic administration vaccinia, varicella, epithelial herpes simplex, keratitis, mycobacterial infection, fungal disease of ocular structure, use after uncomplicated removal of a foreign body... 

Completely absorbed from the G1 tract penetrates cornea after ophthalmic administration (may be systemically absorbed). Protein binding greater than 99%. Widely distributed. Metabolized in the liver. Primarily excreted in urine. Minimally removed by hemodialysis. Half-life 1.2-2 hr. 

Ocular hypertension and open-angle glaucoma are well-known adverse effects of ophthalmic administration of glucocorticoids (SEDA-17, 449). 

Trifluridine Viroptic Local (ophthalmic] administration for treatment of herpes simplex keratitis and keratoconjunctivitis... 

Ciprofloxacin is commercially available as the monohydrate phase of its hydrochloride salt, and has been formulated for oral and ophthalmic administration. The compound has also been developed as the lactate salt for use in intravenous administration [3]. 

Sterile Injectable Pellet Implant Solution or Ointment for Ophthalmic Administration Inhalation Products Oral Dosage Forms... 

Topical and Ophthalmic Preparations Appearance (clarity, color, and especially homogeneity), odor, pH, resuspendability, consistency, particle size, weight loss (of more importance if plastic containers are used). Sterility and preservative levels also must be considered if the product is intended for ophthalmic administration. 

Cyclodextrins are a group of cyclic oligosaccharides consisting of a hydrophilic outer surface of six to eight glucose imits incorporating lipid-soluble drugs in their center. They are soluble in water and are often used to improve solubility, stability, or irritability of various compounds. They have demonstrated increased ocular bioavailability and have been studied for potential ophthalmic administration. 

All routes of drug administration can affect ocular structures and functions. OADRs have been associated with topical ophthalmic administrations as well as local injections. Systemically, oral drug administration has been implicated most frequently in the development of OADRs. However, parenteral as well as inhaled or nasally applied drugs have also produced OADRs. Topical application to the skin, particularly if it is abraded or burned, may result in sufficient systemic absorption to lead to ocular side effects. Dermatologic use of antibiotics has resulted in ocular hypersensitivity reactions. 

The oral route is typically the preferred route for medication administration to pediatric patients. Other routes may be used, if the patient cannot take a medication orally because of vomiting, being unable to swallow, or the medication is imavailable for oral use. In addition, for specific problems it may be better to deliver the medication directly to the area being treated, for example, inhalation, ophthalmic administration, or otic administration. 

Tetracycline hydrochloride is al.so available in ointments for topical and ophthalmic administration. A topical solution is used for the management of acne vulgaris. 

Note Systemic adverse effects have been reported following ophthalmic administration... 

Among the quaternary ammonium organophosphorus compounds, only echothiophate is useful clinically (limited to ophthalmic administration). It is not volatile and does not readily penetrate the skin. 

Genta, 1., Conti, B., Perugini, R, Pavanetto, F, Spadaro, A., Puglisi, G. (1997). Bioadhesive microspheres for ophthalmic administration of acyclovir, Pham PhajTnoco/.,49, 737-742. 

I. Genta, B. Conti, P. Perugini, E Pavanetto, A. Spadaro, and G. Puglisi, Bioadhesive microspheres for ophthalmic administration of acyclovir, J. Pharm. Pharmacol, 49,737-742,1997. 

Dyflos and sarin (Fig. 16.10) are extremely active and have serious side effects, thus limiting their use to local ophthalmic administration for the treatment of glaucoma. The binding of these agents is irreversible and a new enzyme is needed in order for the cells to restore ACh hydrolysing capacity. 

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