Ophthalmic uses

Bacitracin given parenteraHy is sufftciendy nephrotoxic that it is rarely used in human medicine for other than topical indications (80). Thus safe and effective use, especially as the zinc salt, is limited almost completely to ointments, sprays, and solutions for skin and ophthalmic use in concentrations of 250 to 1000 units per milliliter. Bacitracin is only rarely skin sensitizing. As in the case of polymyxin, bacitracin is usually combined with other antibiotics to enlarge its spectmm of activity, or with corticoids or analgesics to reUeve pain or itching. 

D C Blue No. 9 (12) Indanthrene Blue Carbanthrene Blue Cl Vat Blue 6 [130-20-1] 69825 cotton and silk sutures (including those for ophthalmic use) only 2.5% (w/w) max dmgs in general... 

Most of the drug classifications used to treat ophthalmic conditions have been discussed in previous chapters. The following sections provide a short sum-maiy of these classifications and their implications in ophthalmic use. When appropriate the student is referred to the specific chapter where additional information can be found. The Summary Drug Table Select Ophthalmic Preparations provides examples of the drugs used to treat ophthalmic problems. 

The mast cell stabilizers currently for ophthalmic use are nedocromil and pemirolast. These drugp are used for the prevention of eye itching caused by allergic conjunctivitis. The mast cell stabilizers act by inhibiting the antigen-induced release of inflammatory mediators (eg, histamine) from human mast cells. 

Only preparations labeled asophthalmic are instilled in the eye. The nurse must check the label of the preparation carefully for the name of the drug, the percentage of the preparation, and a statement indicating that the preparation is for ophthalmic use. 

The plastic bottle and dispensing tip is made of low-density polyethylene (LDPE) resin, which provides the necessary flexibility and inertness. Because these components are in contact with the product during its shelf life, they must be carefully chosen and tested for their suitability for ophthalmic use. In addition to stability studies on the product in the container over a range of normal and accelerated temperatures, the plastic resins must pass the USP biological and chemical tests for... 

In an attempt to formulate an anhydrous, but water-soluble, semisolid base for potential ophthalmic use, five bases were studied [279]. The nonaqueous portion of the base was either glycerin or polyethylene glycols in high concentrations. The matrix used to form the phases included silica, Gantrez AN-139, and Carbopol 940. Eye irritation results were not reported, but the authors studied representative bases from that research report and found them to be quite irritating in rabbit eyes. The irritation is believed to be primarily due to the high concentration of the polyols used as vehicles. 

In addition to the various advice included in the development pharmaceutics guidelines there is also a specific guideline on plastic primary packaging materials (3AQ10a, adopted February 1994), which describes general requirements for all plastic containers but pays particular attention to those for parenteral and ophthalmic use. 

For nonparenteral/ophthalmic use the plastics should meet the requirements of relevant EU food use legislation, and if the material has not been so approved then toxicology data will be required. If the container is to be used for ophthalmic or parenteral products then compliance with the relevant requirements of the Ph Eur or other relevant member state pharmacopeial requirements will be required or appropriate additional data provided. 

Where polymers, etc., are approved for food use, the available toxicology data should be provided. Additional information is required on the source of the polymer, its conversion, and the manufacturers involved for parenteral and ophthalmic uses. 

Hypersensitivity to any component monotherapy in primary bacterial infections such as impetigo, paronychia, erysipelas, cellulitis, angular cheilitis, erythrasma (clobetasol), treatment of rosacea, perioral dermatitis, or acne use on the face, groin, or axilla (very high or high potency agents) ophthalmic use. 

Systemic -adrenergic blocker-associated reactions - Consider potential effects with ophthalmic use. The following adverse reactions have occurred with each individual agent ... 

Pharmacology Brinzolamide and dorzolamide are carbonic anhydrase inhibitors formulated for topical ophthalmic use. 

Lactation It is not known whether ciprofloxacin, norfloxacin, or ofloxacin appears in breast milk following ophthalmic use. Exercise caution when administering ciprofloxacin to a nursing mother. 

A large number of (3-blockers are on the market in the United States. Of these, propranolol, a nonselective (3-antagonist, was the first to be introduced and is the prototypical drug with which the others are compared. Metoprolol was the hrst (3i-selective drug and timolol the hrst (3-blocker approved for ophthalmic use. 

Idoxuridine is marketed strictly for topical ophthalmic use, and systemic exposure is insignificant. However, after oral dosing, the drug is rapidly metabolized and excreted. It tends not to accumulate in body tissues. 

D. Acyclovir is in pregnancy category B animal studies have shown no evidence of harm to the fetus, but no large, controlled studies of human outcomes have been performed. Cidofovir may be used to treat HSV that is resistant to acyclovir however, it is embryotoxic and teratogenic, and Ms. Doe should avoid it. Docosanol is used for cold sores and is not indicated for ophthalmic use. Fomivirsen is effective against CMV retinitis, not HSV keratitis. Ribavirin is indicated for RSV infection and is also mutagenic, teratogenic, and embryotoxic. 

Biocompatibility test scheme adjusted for FCLs for ophthalmic use... 

An exception is the ophthalmic use of PFCLs (see Table 1) like perfluorooctane (PFO) and perfluorodecalin (PFD). Since the introduction of PFCLs into VR surgery in the 80s [6-8], more than 2 million patients have been treated with PFCLs intra-operatively. In addition, animal studies with at least 3 months exposure have been published [9-11]. This experience based on the high number of well-documented patient cases and the consolidated findings on the effects of a longterm treatment opens the possibility of an exemplary discussion of opportunities and drawbacks of the use of highly fluorinated liquids. 

The different PFCLs used as interoperative tools can be categorised as a group of compounds with more or less uniform behaviour. On the contrary, the partially fluorinated species have to be regarded as individuals each. This is due to the hybrid character of these compounds, which combine the behaviours of alkanes and perfluoroalkanes. Especially, the toxicological behaviour cannot be optimised by simple modifications of the degree of fluorination. If the two molecule parts are combined in the right balance, the cytotoxic behaviour of the alkyl chain can be overcompensated by the inert perfluorinated part of the compound. But each compound should be tested individually to ensure its suitability as a candidate for ophthalmic use. 

Be alert for signs of bleeding, which may also occur with ophthalmic use if systemic absorption occurs... 

Contraindications Not for ophthalmic use hypersensitivity to oxiconazole or any other azole fungals... 

It is nonselective agent with no local anaesthetic activity and having excellent ocular hypotensive effect preferred for ophthalmic use. It is useful in chronic wide-angle and aphakic glaucoma. Levobunolol and betaxolol are other agents used as ophthalmic preparation used in glaucoma. 

Until recently, the topical ophthalmic use of some interesting and promising either lipophilic or macromolecular therapeutic substances has been limited clinically because of their restrictive physicochemical properties, which has exhibited poor ocular bioavailability. It is possible... 

An area where CDs have a significant therapeutic benefit is in the solubilization of drugs intended for ophthalmic use. Corneal permeability favors moderately lipophilic drugs. These compounds often have a low aqueous solubility. Thus, the CDs are being extensively exploited for their usefulness in increasing the solubility of insoluble and poorly soluble drugs and keeping them at the corneal barrier. 

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