The document discusses various aspects of ocular pharmacology including:
1) Drug delivery methods to the eye including topical drops, ointments, periocular and intraocular injections, and systemic administration.
2) Factors that influence drug penetration into ocular tissues including concentration, viscosity, lipid solubility, and molecular size.
3) Common classes of ocular drugs like antibiotics, antivirals, antifungals, glaucoma medications, anti-inflammatories, and their indications.
4) Side effects of long-term ocular steroid use and potential toxic effects of certain systemic drugs on ocular tissues.
PT PLN (Persero) is an electrical service provider in Indonesia. With a vision to be a "recognized as a growing, superior, and trusted world class company which is relying on Potensi Insani", PT PLN (Persero) is committed to electrify the entire archipelago. We believe that human potential is the greatest asset and our future, so we are investing heavily to get the future leader candidates who will develop PT PLN (Persero) became a World-class company and face the future business challenges.
Career opportunities in PT PLN (Persero) is very large because our business ranges from upstream to downstream, ranging from power plant, transmission to distribution to the customer and other supported services. Please join us.
The 2015 PT PLN (Persero) Open Recruitment Level Bachelor Degree / Diploma IV / Diploma III
Educational Qualifications
Possess Bachelor degree / Diploma IV graduate majoring in:
Electrical Engineering, Powerline, Electricity Power System (Code: S1 / ELE)
Power Low, Electronics, Instrument, Control (Code: S1 / ALE)
Mechanical Engineering (Code: S1 / MES)
Industrial Engineering (Code: S1 / IND)
Diploma III graduate majoring in:
Electrical Engineering, Powerline, Electricity Power System (Code: D.III / ELE)
Power Low, Electronics, Instrument, Control (Code: D.III / ALE)
Mechanical Engineering (Code: D.III / MES)
Civil Engineering (Code: D.III / SIP) (Makassar Only)
Marketing Management, Trade Administration, Business Administration, Office Administration (Code: D.III / MAN)
Qualifications
Not married and willing to not get married during Diklat Prajabatan
Born in 1989 or thereafter for Bachelor degree / Diploma 4 graduate
Born in 1991 or thereafter for Diploma 3 graduate
Minimum GPA 2.75 for S1/ELE, S1/MES, S1/ALE, S1/IND, D.III/ELE, D.III/ALE, D.III/MES, D.III/SIP positions
Minimum GPA 3.00 for D.III/MAN position
Required Documents
Application letter, addressed to: PT PLN (Persero) c.q. Kepala Divisi Pengembangan SDM dan Talenta
Curriculum vitae
Copy of birth certificate (if doesnt have yet, can be submitted on Interview)
Legalized copy of education diploma / Surat Keterangan Lulus
Legalized copy of latest education transcript
Copy of National Identity Card (KTP)
2 pieces 3x4 size recent colour photograph (write your name on back side)
For cross majors program graduate (Diploma III graduate continued to Bachelor degree / Diploma IV) please also submitted: legalized copy of Diploma 3 diploma and transcript
For last semester student who are currently completing the final project / thesis, are encourage to apply with the terms:
Will be graduated no later than November 2015
Attach Surat Keterangan Sedang Mengerjakan Tugas Akhir / Skripsi when applying
During the selection process, if there is a data mismatch, the applicant will be knocked out
Selecti
Skizoafentif tipe manik merupakan gangguan kejiwaan skizofrenia disertai gangguan afektif/perilaku manik. Perilaku manik menunjukkan perasaan gembira terus menerus dengan energi yang banyak, lama tidur pasien sedikit namun pasien tidak merasa lelahh. Pasien juga suka bermake up berlebihan atau berjalan-jalan/beraktivitas tanpa henti. Skizoafektif tipe manik dapat diobati. Terapi pada pasien skizoafektif juga memerlukan dukungan keluarga
PT PLN (Persero) is an electrical service provider in Indonesia. With a vision to be a "recognized as a growing, superior, and trusted world class company which is relying on Potensi Insani", PT PLN (Persero) is committed to electrify the entire archipelago. We believe that human potential is the greatest asset and our future, so we are investing heavily to get the future leader candidates who will develop PT PLN (Persero) became a World-class company and face the future business challenges.
Career opportunities in PT PLN (Persero) is very large because our business ranges from upstream to downstream, ranging from power plant, transmission to distribution to the customer and other supported services. Please join us.
The 2015 PT PLN (Persero) Open Recruitment Level Bachelor Degree / Diploma IV / Diploma III
Educational Qualifications
Possess Bachelor degree / Diploma IV graduate majoring in:
Electrical Engineering, Powerline, Electricity Power System (Code: S1 / ELE)
Power Low, Electronics, Instrument, Control (Code: S1 / ALE)
Mechanical Engineering (Code: S1 / MES)
Industrial Engineering (Code: S1 / IND)
Diploma III graduate majoring in:
Electrical Engineering, Powerline, Electricity Power System (Code: D.III / ELE)
Power Low, Electronics, Instrument, Control (Code: D.III / ALE)
Mechanical Engineering (Code: D.III / MES)
Civil Engineering (Code: D.III / SIP) (Makassar Only)
Marketing Management, Trade Administration, Business Administration, Office Administration (Code: D.III / MAN)
Qualifications
Not married and willing to not get married during Diklat Prajabatan
Born in 1989 or thereafter for Bachelor degree / Diploma 4 graduate
Born in 1991 or thereafter for Diploma 3 graduate
Minimum GPA 2.75 for S1/ELE, S1/MES, S1/ALE, S1/IND, D.III/ELE, D.III/ALE, D.III/MES, D.III/SIP positions
Minimum GPA 3.00 for D.III/MAN position
Required Documents
Application letter, addressed to: PT PLN (Persero) c.q. Kepala Divisi Pengembangan SDM dan Talenta
Curriculum vitae
Copy of birth certificate (if doesnt have yet, can be submitted on Interview)
Legalized copy of education diploma / Surat Keterangan Lulus
Legalized copy of latest education transcript
Copy of National Identity Card (KTP)
2 pieces 3x4 size recent colour photograph (write your name on back side)
For cross majors program graduate (Diploma III graduate continued to Bachelor degree / Diploma IV) please also submitted: legalized copy of Diploma 3 diploma and transcript
For last semester student who are currently completing the final project / thesis, are encourage to apply with the terms:
Will be graduated no later than November 2015
Attach Surat Keterangan Sedang Mengerjakan Tugas Akhir / Skripsi when applying
During the selection process, if there is a data mismatch, the applicant will be knocked out
Selecti
Skizoafentif tipe manik merupakan gangguan kejiwaan skizofrenia disertai gangguan afektif/perilaku manik. Perilaku manik menunjukkan perasaan gembira terus menerus dengan energi yang banyak, lama tidur pasien sedikit namun pasien tidak merasa lelahh. Pasien juga suka bermake up berlebihan atau berjalan-jalan/beraktivitas tanpa henti. Skizoafektif tipe manik dapat diobati. Terapi pada pasien skizoafektif juga memerlukan dukungan keluarga
This ppt is for pharmacology students of MBBS UG&PG and other healthcare persons who needs basic science like BDS, Nursing Ayurveda unani homeopathy etc.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
Francesca Gottschalk - How can education support child empowerment.pptxEduSkills OECD
Francesca Gottschalk from the OECD’s Centre for Educational Research and Innovation presents at the Ask an Expert Webinar: How can education support child empowerment?
This slide is special for master students (MIBS & MIFB) in UUM. Also useful for readers who are interested in the topic of contemporary Islamic banking.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
Executive Directors Chat Leveraging AI for Diversity, Equity, and InclusionTechSoup
Let’s explore the intersection of technology and equity in the final session of our DEI series. Discover how AI tools, like ChatGPT, can be used to support and enhance your nonprofit's DEI initiatives. Participants will gain insights into practical AI applications and get tips for leveraging technology to advance their DEI goals.
Normal Labour/ Stages of Labour/ Mechanism of LabourWasim Ak
Normal labor is also termed spontaneous labor, defined as the natural physiological process through which the fetus, placenta, and membranes are expelled from the uterus through the birth canal at term (37 to 42 weeks
2. Farmakodinamik
• efek biologis dan terapi obat (mekanisme kerja)
• Sebagian besar obat bekerja dengan mengikat
makromolekul, seperti neurotransmiter, reseptor
hormon atau enzim
• Jika obat tersebut bekerja pada tingkat reseptor,
itu bisa berupa agonis atau antagonis
• Jika obat tersebut bekerja pada tingkat enzim,
itu bisa menjadi aktivator atau inhibitor
3. Farmakokinetik
• Proses absorbsi, distribusi, metabolism, dan ekskresi obat/zat
• Obat dapat didistribusikan ke jaringan mata sebagai:
• Obat lokal
• Tetes mata
• Ointment
• Injeksi periocular
• Injeksi intraocular
• Sistemik
• Oral
• Intravena
4. Drug Delivery in Eyes
Topical Periocular Intraocular Systemic
drop
ointment
gel
Soft contact lens
Subconj.
Subtenon
Peribulbar
Retrobulbar
Intracameral
Intravitreal
oral
intravenous
Intramuscular
5. Faktor-faktor yang mempengaruhi penetrasi
obat lokal ke dalam jaringan mata
• Konsentrasi dan kelarutan obat
• semakin tinggi konsentrasinya, semakin baik
penetrasi mis. pilocarpine 1-4%
• Kekentalan
• penambahan metilselulosa dan polivinil alkohol
meningkatkan penetrasi obat dengan meningk-
atkan waktu kontak dengan kornea dan meng-
ubah epitel kornea
• Kelarutan terhadap lemak
• membran sel epitel banyak mengandung lipid,
sehingga semakin tinggi kelarutan dalam lemak
maka semakin penetrasi semakin baik
6. • Surfaktan
• bahan pengawet yang digunakan dalam sediaan okular mengubah
membran sel dalam kornea dan meningkatkan permeabilitas obat
mis. benzylkonium dan thiomersal
• pH
• pH normal air mata adalah 7,4 dan jika pH obat jauh berbeda,
ini akan menyebabkan reflek pengeluaran air mata
• Tonisitas
• ketika obat alkaloid dimasukkan ke dalam media yang relatif al-
kaloid, proporsi bentuk tidak bermuatan akan meningkat, sehin-
gga lebih banyak penetrasi
• Berat dan ukuran molekul
Faktor-faktor yang mempengaruhi penetrasi
obat lokal ke dalam jaringan mata
7. TOPICAL
Drop (Gutta)- simplest and more convenient
mainly for day time use
1 drop=50 microlitre
Conjuctival sac capacity=7-13 micro liter
so, even 1 drop is more than enough
Method
hold the skin below the lower eye lid
pull it forward slightly
INSTALL 1 drop
measures to increase drop absorption:
-wait 5-10 minutes between drops
-compress lacrimal sac
-keep lids closed for 5 minutes after instillation
8. Ointments
Increase the contact time of ocular medication to ocular surface thus
better effect
It has the disadvantage of vision blurring
The drug has to be high lipid soluble with some water solubility to h
ave the maximum effect as ointment
9. Peri-ocular injections
They reach behind iris-lens diaphragm
better than topical application
E.g. subconjunctival, subtenon, peribu-
lbar, or retrobulbar
This route bypass the conjunctival and
corneal epithelium which is good for dr
ugs with low lipid solubility (e.g. penicil-
lins)
Also steroid and local anesthetics can
be applied this way
10. Periocular
Subconjunctival - To achieve higher concentration
Drugs which can’t penetrate cornea due to large size
Penetrate via sclera
Subtenon— ant. Subtenon– disease ant to the Lens
Post Subtenon– disease posterior to the lens
Retrobulbar-Optic neuritis
Papillitis
Posterior uveitis
Anesthesia
Peribulbar-- anesthesia
11. Intraocular injections
Intracameral or intravitreal
E.g.
– Intracameral acetylcholine (
miochol) during cataract su
rgery
– Intravitreal antibiotics in
cases of endophthalmitis
– Intravitreal steroid in
macular edema
12. Sustained-release devices
These are devices that deliver
an adequate supply of medicat
ion at a steady-state level
E.g.
– Ocusert delivering pilocarpine
– Timoptic XE delivering timolol
– Ganciclovir sustained-release i
ntraocular device
– Collagen shields
13. Common ocular drugs
Antibacterials (antibiotics)
Antivirals
Antifungal
Mydriatics and cycloplegics
Antiglaucoma
Anti-inflammatory agents
Ocular Lubricants
Ocular diagnostic drugs
Local anesthetics
Ocular Toxicology
Corticosteroids
NSAID
15. Antibiotics
Used topically in prophylaxis (pre and postop
eratively) and treatment of ocular bacterial in
fections.
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 intravitrally for the treatment
of endophthalmitis
16. Specific antibiotic for almost each organisms
Sulfonamiodes- Chlamydial infections like TRACHOMA
INCLUSION CONJUNCTIVITIS
TOXOPLAMOSIS
Bacterial cell wall syntheis inhibitors-
Penicillin
Cephalosporins
I) first generation- gm + cocci eg cephazolone
ii) second generation Gm –and antistaphylococcal cefuroxime
iii) Third generation Gm – bacilli --ceftriaxones
17. Side effects- allergic reaction
neutropenia
thrombocytopenia
Amino glycosides
mainly against gm negative bacilli
Bacterial protein synthesis inhibitors
Gentamycin—0.3% eye drop
Tobramycin- Pseudomonas 1% eye drop
Neomycin—0.3-0.5% eye drop
18. Tetracycline
Inhibit protein synthesis
active against both gm+ and gm -, some fungi and Chlamydia
Chloromphenicol
Broad spectrum ,bacteriostatic, gm+/gm-, Chlamydia
0.5% Eye drop, ointment
19. Antibiotics
Trachoma can be treated by topi
cal and systemic tetracycline or e
rythromycin, or systemic azithro
mycin.
Bacterial keratitis (bacterial corn
eal ulcers) can be treated by topi
cal fortified penicillins, cephalosp
orins, aminoglycosides, vancomy
cin, or fluoroquinolones.
Bacterial conjunctivitis is usuall
y self limited but topical erythro
mycin, aminoglycosides, fluoroqu
inolones, or chloramphenicol can
be used
20. Antivirals
Acyclovir
3% oinment 5 times-10-14 days
800mg oral 5 times 10-14 days
intravenous for Herpes zoster retinitis
Others
Idoxuridine
Vidarabine
Cytarabine
Triflurothymidine
Gancyclovir
INDICATIONS
HZ keratitis
Viral uveitis
21. ANTIFUNGAL
INDICATIONS
Fungal corneal ulcer
Fungal retinitis/ Endophthalmitis
Commonly used drugs are
Polyenes
– damage cell membrane of susceptible fungi
– e.g. amphotericin B, natamycin, nystatin
– side effect: nephrotoxicity
Imidazoles
– increase fungal cell membrane permeability
– e.g. miconazole, ketoconazole,fluconazile
Flucytocine
– act by inhibiting DNA synthesis
22. Mydriatics and cycloplegics
Dilate the pupil, ciliary muscle paralysis
CLASSIFICATION
Short acting- Tropicamide (4-6 hours)
Intermediate- homatropine ( 24 hours)
Long acting- atropine (2 weeks)
Indications
corneal ulcer
uveitis
cycloplegic refraction
24. Carbonic anhydrase inhibitors
Systemic topical
acetazoamide Dorzolamide
brinzolamide
Mechanism of action---- reduce aqueous humour formation
Side effect
Paresthesiae
Frequent urination
GI disturbances
Hypokalamia
25. Hyperosmotic agent--- iv mannitol
when IOP is very high 60-70
Prostaglandins
Latanoprost (0.005% eye drop)
increased aqueous out flow
Reduced IOP
Side effect– conjunctival redness, iris and periocular pigmentation
hypertrichosis, darkening of iris
35. Ocular diagnostic drugs
Fluorescein dye
– Available as drops or strip
s
– Uses: stain corneal abrasio
ns, applanation tonometry,
detecting wound leak, NL
D obstruction, fluorescein
angiography
– Caution:
• stains soft contact lens
• Fluorescein drops can be
contaminated by Pseudo
monas sp.
36. Ocular diagnostic drugs
Rose bengal stain
– Stains devitalized epithelium
– Uses: severe dry eye, herpetic keratitis
37. Local anesthetics
topical
– E.g. propacaine, tetracaine
– Uses: applanation tonometry, goniscopy, re
moval of corneal foreign bodies, removal of
sutures, examination of patients who cannot
open eyes because of pain
– Adverse effects: toxic to corneal epithelium,
allergic reaction rarely
40. Complications of topical administration
Mechanical injury from the bottl
e e.g. corneal abrasion
Pigmentation: epinephrine-
adrenochrome
Ocular damage: e.g. topical anes
thetics, benzylkonium
Hypersensitivity: e.g. atropine, ne
omycin, gentamicin
Systemic effect: topical phenylep
hrine can increase BP
41. Amiodarone
A cardiac arrhythmia drug
Causes optic neuropathy (mild decreased vision, visual fie
ld defects, bilateral optic disc swelling)
Also causes corneal vortex keratopathy (corneal verticillat
a) which is whorl-shaped pigmented deposits in the corn
eal epithelium
42. Digitalis
• A cardiac failure drug
• Causes chromatopsia (objects appear
yellow) with overdose
43. Chloroquines
• E.g. chloroquine,
hydroxychloroquine
• Used in malaria, rheumatoid
arthritis, SLE
• Cause vortex keratopathy
(corneal verticillata) which is
usually asymptomatic but can
present with glare and
photophobia
• Also cause retinopathy (bull’s
eye maculopathy)
44. Chorpromazine
• A psychiatric drug
• Causes corneal punctate epithelial
opacities, lens surface opacities
• Rarely symptomatic
• Reversible with drug discontinuation
45. Ethambutol
• An anti-TB drug
• Causes a dose-related optic neuropathy
• Usually reversible but occasionally
permanent visual damage might occur