Basic Ocular Pharmacology for starters

1. OCULAR
PHARMACOLOGY

2. Role of the Lab Assistant in Health Care (Ocular !!!)
Ocular drug delivery in eyes
-Route of Administration
Ocular drug action in brief
- Classification of common ocular drugs and its use
Ocular Toxicity produced by drug
- Adverse reaction due to excessive usage of drugs
- Wrong drug administered to health care patients
Are you ready to know about….

3. ROLE of the LAB ASSISTANT
Recording Patient Case History
Patient Counseling
NEVER Work in Doubt!

4. PATIENT CASE HISTORY
Ocular Examination
Allergies
Ocular Drugs
Medications

5. VITAMIN SUPPLEMENTS
Now comes the drug….

6. CLASSIFICATIONS
Solutions – Ex: Eyedrops
Suspensions
Ointments

7. Pharmacodynamics
 It is the biological and therapeutic effect of the
drug (mechanism of action)
 If the drug is working at the receptor level, it can
be agonist or antagonist
 If the drug is working at the enzyme level, it can be
activator or inhibitor

8. Pharmacokinetics
To achieve a
therapeutic effect , a
drug must reach it's
site of action in
sufficient
concentration
“Do you know how
the stuff gets from
down there up to
her sore throat?”

9. Pharmacokinetics
 It is the absorption, distribution, metabolism, and
excretion of the drug (ADMET)
 A drug can be delivered to ocular tissue as:
 Locally:
 Eye drop
 Ointment
 Periocular injection
 Intraocular injection
 Systemically:
 Orally
 Intravenous
 Intramuscular

10. Drug Delivery in Eyes

12. Eye dropsEye Ointment
Intracameral

13. Drug Delivery in Eyes

14. Ophthalmic Drug Complications
 Giving people medications may seem routine, but there
are possible negative consequences.
 Not all people are tolerant of all medications. If given a
drug they can’t tolerate, a patient may have an allergic or
toxic reaction.
 As an eye technician administering drugs to people on a
daily basis, it’s important you understand and recognize
what is occurring if a patient does have a reaction.
 You also need to understand how drugs affect the eye.

15. Team Activity
Disease Dosage
forms
Route of
administration
 5 member in each group
 Consult with your clinicians
 Ask about details given below..
(atleast 5 drugs each )

16. To work without doubt !!!!!
 Anatomy of Eye
 Ocular Pathological
condition
 Drugs to be administered
before and after
diagnosis
 Brief knowledge about
drugs

17. Common ocular drugs
 Chemotherapeutics - Antibacterials (antibiotics),
Antivirals, Antifungal
 Autonomic Drugs – Miotics, Mydriatics and cycloplegics
 Ant glaucoma
 Anti-inflammatory agents- NSAIDS & Steroids
 Ocular Lubricants
 Ocular diagnostic drugs
 Local anesthetics

18. DIAGNOSTIC AGENTS
 Topical Anesthestics – Proparacaine, Tetracaine,Alcaine
 Mydriatics & Cycloplegics - Tropicamide, Phenylephrine,
Cyclogyl, Atropine, Homatropine, Scopalomine
 Dyes/Stains – Fluorescein, Rose Bengal, Lissamine Green
 Gonioscopic Solutions – Goniosol, Gonioscopic, Celluvisc

19. Accommodation

20. Eye Parasympathetic N.S. Sympathetic N.S.
Iris
radial muscle
circular muscle
No effect
Contraction (miosis)
M3
Contraction
(Mydriasis) α1
No effect
Ciliary muscle Contraction M3 Relaxation β2
Accommodation for near vision for far vision
Conjunctival
blood vessels
Conjunctival
Vasodilatation
Conjunctival
Vasoconstriction
Intraocular
pressure(IOP)
Decrease increase

21. Pupillary Muscles
Miosis (Constriction)
Mydriasis (Dilation)

22. Antibiotic
 Biotic means relating to, produced by, or
caused by living organisms
 The prefix anti "against" the referent of the stem
to which the prefix is affixed
 Penicillins
 Cephalosporins
 Sulfonamides
 Tetracyclines
 Chloramphenicol
 Aminoglycosides
 Fluoroquinolones
 Vancomycin
 macrolides

23. Antibiotic
 Used topically in prophylaxis (pre and postoperatively)
and treatment of ocular bacterial infections.
 Used orally for the treatment of preseptal cellulitis
e.g. amoxycillin with clavulonate, cefaclor
 Used intravenously for the treatment of orbital cellulitis
e.g. gentamicin, cephalosporin, vancomycin, flagyl
 Can be injected intravitreally for the treatment of
endophthalmitis.

24. Antibiotic
 Trachoma can be treated by topical and systemic
tetracycline or erythromycin, or systemic azithromycin.
 Bacterial keratitis (bacterial corneal ulcers) can be
treated by topical fortified penicillins, cephalosporins,
aminoglycosides, vancomycin, or fluoroquinolones.
 Bacterial conjunctivitis is usually self limited but topical
erythromycin, aminoglycosides, fluoroquinolones, or
chloramphenicol can be used

25. Antifungals
 Uses: fungal keratitis, fungal endophthalmitis
 Polyenes
 damage cell membrane of susceptible fungi
 e.g. amphotericin B, natamycin
 side effect: nephrotoxicity
 Imidazoles
 increase fungal cell membrane permeability
 e.g. miconazole, ketoconazole
 Flucytocine - act by inhibiting DNA synthesis

26. Antivirals
 Acyclovir
interact with viral thymidine kinase
(selective)
used in herpetic keratitis
 Trifluridine
more corneal penetration
can treat herpetic iritis
 Ganciclovir
used intravenously for CMV retinitis