Common Eye Drop Use in Opthalmology

Antibacterial/ antifungalFluroquinolonesCiprofloxacinAminoglycosidesGentamycinOthersChloramphenicolAntifungal NatamycinAmphotericin B

FucithalmicBd dosea/biotic agains Staph, Strep, Neisseria, Haemophylus, Moraxella, & CorynebacteriaIndications bacterial eye infections caused by susceptible organism in conjunctivitis, blepharitis, sty, keratitis, dacrocystitis & in connection with removal of FBCI known to have hypersensitivitiesSE transient stinging, very low allergenic potential

GentamycinGenta eye drops recommended dose 4Hly, severe infection 2hlyAminoglycoside with bactericidal action. Inhibits protein synthesis in susceptible bacteria. Active against a wide range of gram ve organism eg. E coli, P aeroginosa, Proteus spp, also some gram +ve org eg. StaphIndication superf bacterial infections of the conjunctiva, cornea, eyelids, tear pharitis, blepharoconjunctivitis, keratitis, keratoconjunctivitis, episcleritis, dacrocystitis, corneal ulcers, eyes & infected eye socketsCI Sensitivity to any of the componentSE hypersensitivity reactions

CloramphenicolActive against common bacterial eye pathology staph aureusStreptococciE coliHaemophilusklebsiellaFor ocular infection: conjuctiva, corneaCI: known hypersensitivitySE: bone marrow hypoplasia/ aplastic anemia, stinging, itching

GlaucomaAlpha-adrenergic agonist Brimonidine titrate (alphagan-P) bd-tdsBeta-adrenergic antagonistBetaxolol 0.5% (betoptic) BdTimolol maleate 0.5% BdCarbonic anhydrase InhibitorDorzolamide 2% (Trusopt)MioticsPilocarpine hydrocloride ProstaglandinLatanoprost 0.005% (xalatan)SymphatomimeticEpinephrine 0.5,1,2% bd

Alpha-adrenergic agonistEg: Brimonidine titrate (alphagan-P) Usual dose: bd-tdsMechanism: inhibits aqueus secretion, posibble increase uveoscleral outflowSide effect: allergy, mydriasis, dry mouth, dry eye, hypotension, lethargyContraindication: Monoamine oxidase inhibitor

Beta-adrenergic antagonistEg: Betaxolol 0.5% (betoptic), Timolol maleate 0.5% Usual dose: BdMechanism: decreased aqueous humor productionSide effect: blurred vision, corneal anesthesia, SPK, bradycardia, heart block, bronchospasmContraindication: asthma, severe COAD, bradycardia, heart block, CCF

Betaxolol 0.5% (Betoptic)

A cardioselective (beta-1-adrenergic) receptor blocking agentIndication effective in lowering IOP and may be used in pts with chronic open-angle glaucoma and ocular HPTCI Hypersensitivity to the component, sinus brady, greater than a 1st degree AV block, cardiogenic shock or pts with overt cardiac failureSE transient ocular discomfort, blurred vision, corneal punctate keratitis, dryness of eye, etc

TimololTimolol maleateBeta 1 and beta 2 adrenergic receptor blocking agent Reducing elevated and normal IOP whether or not accompanied by glaucomaExact mechanism not been clearly definedIndication elevated IOP in patients with ocular HPT or open angle glaucomaCI pts with B. asthma, severe COPD, sinus bradycardia, 2nd or 3rd degree AV block, cardiac failure, cardiogenic shock, hypersensitivity to any component of the productSE local irritation, bronchoC in elderly pts with COPD

Carbonic anhydrase InhibitorEg: Dorzolamide 2% (Trusopt)Usual dose: Bd-tdsDecreased aqueous production in cilliary bodySide effect: bitter taste, diuresis, GI upset,aplastic anaemia, Stevens-Johnson syndromeContraindication: Sulfa allergy, hyponatremia, hypokalemia, renal stone

MioticsEg: Pilocarpine hydrocloride (Isopto Carpine) solution 0.25%-8%Usual dose: bd-qidIncreased trabecular outflowSide effect:Contraindication:

Pilocarpine HydrochlorideIsopto carpineDirect acting cholinergic parasympathomimetic agent which acts through direct stimulation of muscarinic neuro receptors & smooth muscle such as the iris and secretory glandsContraction of iris spincter > Increase tension on scleral spur and opening of TM spaces to facilitate outflow of aqueusIndications to control IOP as a miotic (parasympathomimetic)CI acute iritis, known to have hypersensitivity, pupillary block glaucomaSE transient stinging & burning, ciliary spasm, conjunctival vasc congestion, temporal/supraorbital headache and induced myopia may occur

ProstaglandinEg: Latanoprost 0.005% (xalatan)Increased uveoscleral outflowSide effect: blurred vision, eyelid redness,cme,ant uveitis, myalgiaContraindication: pregnancy, inflammatory condition

Symphatomimetic

Mydfrin 2.5%Phenylephrine hydrochlorideAn alpha receptor sympathetic agonist used in local ocular disorder bcoz of its vasoC & mydriatic action.Indication as a vasoC, decongestant & mydriatic in a variety of ophtalmic conditions & procedures, pupillary dilatation in uveitis, ophtlmic surgical procedures & for refraction without cyclopegiaCI pts with anatomically narrow angles or narrow angle glaucoma, LBW infants, elderly adult with severe arteriosclerotic cardiavascular or cerebrovasc disease, disturbed corneal epithelial barrier during intraocular op preocedures & known to have hypersensitivitiesSE marked increased BP, cardiovasc reactions, syncope, MI, tachy, arrhytmia and fatal subarachnoid hhage

Anti-InflammatoryNSAIDSKetorolac acular 0.5%AntihistaminesCromolyn sodiumCorticosteroidsFluoromethalone 0.1,0.25,%BetnesolCombination steroid and antibiotic maxitrolBetnesol N

AcularKetorolac tromethamineIs a NSAID (analgesic, anti-inflammatory & anti-pyretic), action by the ability to inhibit prostaglandin biosynthesisIndication short term relief of ocular itching d/t seasonal allergic conjunctivitis, prophylaxis and reduction of inflammation and associated symptoms following ocular surgeryCI known to have hypersensitivity, avoid at late pregnancySE transient stinging and burning in instillation, ocular irritation, allergic reactions, superf ocular infections & superficial keratitis

MaxitrolDexamethasone, neomycin, polymyxin B sulfateCorticoids suppress the inflammatory response to a variety of agentsIndication ocular inflammation when concurrent use of an antimicrobial is judged necessary,supress inflammatory responseCI epithelial herpes simplex keratitis, vaccinia, varicella, and many other viral diseases of the cornea & conjunctiva. Mycobacterial infection of the eye. Fungal diseases of ocular structures. Known to have hypersensitivities.SE allergic sensitizations, elevation of IOP, optic nerve damage, posterior subcapsular cataract formation & delayed wound healing

LubricatingSolcoseryl eye-gel3-4 times /dayContain benzalkonium choride as preservativePromote healingtreatment of disorders & injuries affecting the cornea & conjunctiva of the eyeCI any persons known to have hypersensitivity to its ingredientsSE Stinging may occasionally occur briefly on admin

Dacrolux /artificial tearsRelieves the eye dry symptom by reestablishing the tear filmIndications cases requiring additional lubrication as symptomatic relief of dryness of the eye d/t the use of contact lenses, dust, smogCI known to have hypersensitivitySE none are known

Isopto-Atropine

Potent parasympatholytic agentIndication for the production of mydriasis & cyclopegia. - For refraction or - for iris dilation desire in acute inflammatory conditions of the iris & uveal tract (tds)CI pts with glaucoma or a tendency toward glaucomaSE - local irritation resulting in congestion, edema, eczema, & follicular conjunctivitis

Homatropine HydrobromideIsopto HomatropineAnticholinergicModerate Long acting mydriatic and cyclopegic for cycloplegic refractionTreatment of inflammotory condition of uveal tract (3-4hly)CI: primary glaucoma eg: narrow angleSE: transient stinging and burning