This document provides an overview of ocular pharmacology. It discusses ocular anatomy and physiology, pharmacokinetics of ocular drugs, routes of drug administration, therapeutic applications of drugs in ophthalmology including glaucoma treatment, antimicrobial agents, immunomodulatory drugs, and new drug delivery systems. Specific drug classes are explained in depth including prostaglandin analogs, beta blockers, alpha agonists, carbonic anhydrase inhibitors, and others for glaucoma treatment. Adverse effects and treatment approaches are also summarized.
OCULAR PHARMACOLOGY :
what is pharmacology ?
what is drug ?
what is pharmacokinetics & pharmacodynamics ?
what is drug half life period ?
what are the common drugs used in eye / ophthalmology ?
what is ADE ( adverse drug effect ) ?
Simple eye education for EHW, Ophthalmic eye student, school eye education & first - second year optometry students only .
OCULAR PHARMACOLOGY :
what is pharmacology ?
what is drug ?
what is pharmacokinetics & pharmacodynamics ?
what is drug half life period ?
what are the common drugs used in eye / ophthalmology ?
what is ADE ( adverse drug effect ) ?
Simple eye education for EHW, Ophthalmic eye student, school eye education & first - second year optometry students only .
Fungal infections of eye cause one of the most dangerious infections. Accurate diagnosis and proper institution of anti-fungal therapy is essential. Here we discuss the various anti-fungal agents available to be used in ophthalmology.
Ocular allergy are a group of external ocular conditions resulting from one or more types of hypersensitivity reactions to allergens.
Anti Allergic eye drops are liquid medicine used to treat symptoms of eye allergies.
Fungal infections of eye cause one of the most dangerious infections. Accurate diagnosis and proper institution of anti-fungal therapy is essential. Here we discuss the various anti-fungal agents available to be used in ophthalmology.
Ocular allergy are a group of external ocular conditions resulting from one or more types of hypersensitivity reactions to allergens.
Anti Allergic eye drops are liquid medicine used to treat symptoms of eye allergies.
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anatomy of optic nerve and its blood supply and clinical corelation
Presentation Layout: optic nerve anatomy
Embryology of optic nerve
Introduction
Parts of optic nerve
Blood supply
Clinical significance
For Further Reading
Wolff’s Anatomy of the eye and orbit by Bron, Tripathi and Tripathi
Anatomy and Physiology of eye by A.K. Khurana 2nd edition
Comprehensive Ophthalmology by A.K. Khurana 5th edition
AAO- Fundamentals & Principles of Ophthalmology : sec 2
Walsh and Hoyt’s Clinical Ophthalmology
Internet
Glaucoma and dgharia of bgf vfcvf vf .pptxmekulecture
Under normal conditions, only approximately 1 mL of the 125 mL of glomerular filtrate that is formed each minute is excreted in the urine.
The other 124 mL is reabsorbed in the tubules.
This means that the average output of urine is approximately 60 mL/hour… approximately 1.5L urine per day.
GLAUCOMA
,dignosis , types of glaucoma , risk factors oo glaucoma and treatment , the clasis of drugs that use in treatment of glaucoma.
prepared by : Hardi Sdiq
university of sullaimani
collage of pharmacy
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
1. Ocular Pharmacology
Guided By
Dr. V.M Motghare,
Prof. and Head
Department of pharmacology
G.M.C. Nagpur
& Dr . S.A. Pimpalkhute
Dr. Kundan Nivangune
JR3
2. Overview
Overview of ocular anatomy & Physiology
Pharmacokinetics & Toxicology of ocular therapeutic agents
Ocular Routes of Drug Administration
Therapeutic & Diagnostic applications of Drugs in Ophthalmology
Ophthalmic Effects of Selected Vitamin Deficiencies & Zinc Deficiency
Systemic Agents with Ocular Side Effects
New drug delivery systems in Ophthalmology
Conclusion
7. Pharmacokinetics of Ocular Drugs
Classical pharmacokinetic theory based on
systemically administered drugs does not fully
apply to all opthalmic drugs
Topical route – most commonly used
8. Absorption
Rate & extent of absorption of topically instilled
drugs depends upon –
1. Time the drug remains in the cul-de-sac &
precorneal tear film
“Drug penetration into the eye is
approximately 2. Elimination by linearly nasolacrimal related drainage
to its
concentration in the tear film.”
3. Drug binding to tear proteins
4. Drug metabolism by tear & tissue proteins
“”Drug penetration into the eye is approximately linearly related to
its concentration in the tear film.”
5. Diffusion across cornea & conjunctiva
9. Distribution
Transcorneal absorption
Accumulation in aqueous humor
Distribution to intraocular structures
Trabecular meshwork pathway
Distribution to systemic circulation
10. Distribution
Melanin binding of certain drugs –
- Ex:
1. Mydriatic effect of alpha adrenergic agonists
-- slower in onset - darkly pigmented irides compared
to those with lightly pigmented irides
2. Atropine’s mydriatic effect – long lasting in non-albino
rabbits than in albino rabbits
3. Accumulation of chloroquine in retinal pigment
epithelium – Bull’s eye maculopathy
11. Metabolism
Enzymatic biotransformation of ocular drugs-significant
Esterases – particular interest
Ex: Development of prodrugs for enhanced
ocular permeability
1. Dipivefrin hydrochloride
2. Latanoprost
12.
13. Ocular Routes of Drug Administration
Sr.N
o
Route Special Utility Limitations &
Precautions
1. Topical --Convenient
-- Economical
--Relatively safe
--Compliance
--Corneal & conjunctival
toxicity
--Nasal mucosal toxicity
--Systemic side effects from
nasolacrimal absorption
2. Subconjunctival,
sub-Tenon’s &
Retrobulbar
injections
-Anterior segment
infections
-Posterior uveitis
-Cystoid Macular
Edema (CME)
-Local Toxicity
-Globe perforation
-Optic nerve trauma
-Central retinal artery or
vein occlusion
3. Intraocular
Injections
Anterior segment
surgery or infections
-Corneal toxicity
-Relatively short duration of
action
4. Intravitreal
Immediate local effect Retinal toxicity
15. 1. Autonomic Drugs for Ophthalmic Use
2. Antimicrobial agents
3. Immunomodulatory & Antimitotic Drugs
4. Agents used to Assist in Ocular Diagnosis
5. Agents Used to treat Retinal
Neovascularization & Macular Degeneration
6. Drugs & Biological Agents Used in
Ophthalmic Surgery
16. Glaucoma
Definition:
Glaucoma is a chronic, progressive optic
neuropathy characterized by slow progressive
degeneration of the retinal ganglion cells and
the optic nerve axons leading to increased
deterioration of visual field.
• Parson’s.
17. History of Glaucoma
Hippocrates described "glaykoseis" as blindness
which occurs in the elderly.
The English ophthalmologist Banister - First to
establish the connection between increased
tension of the eyeball and glaucoma.
In 1862, Donders - High intraocular pressure
caused blindness and called the disease
"Glaukoma simplex.“
Drug treatment started in 1875 with the discovery
of pilocarpine.
18. Glaucoma…
IOP – Not an accurate indicator of disease
Ocular Hypertension - IOPs in mid to high 20s
with no optic nerve damage
Normal or low- tension Glaucoma – Progressive
glaucomatous optic nerve damage despite having
IOPs in normal range
19.
20. Types Of Glaucoma
Primary Glaucoma:
Primary open angle
glaucoma
Angle closure glaucoma
Secondary
Glaucomas
Congenital or
developmental
26. Mechanism of Action of β Blockers
Lower IOT by reducing aqueous formation
-- Down regulation of adenylylcyclase due to β2
receptor blockade in ciliary epithelium
-- Reduction in ocular blood flow
27. BETAXOLOL
Less efficacious than
Timolol
TIMOLOL
20-35% fall in IOT
within 1 hour & lasts for
12 hours
30% patients -
Additional medication
BETAXOLOL
Less efficacious than
Timolol
Protective effect on
retinal neurons by
blocking some calcium
channels & reducing
reducing Na2+/Ca2+
influx
28. Adverse Effects of Ocular β
Adrenergic blockers
Ocular
1. Stinging, redness &
dryness of eye
2. Corneal hypoesthesia
3. Allergic
blepharoconjunctivitis
4. Blurred vision
Systemic
1. Bronchospasm in
asthmatics & COPD
patients
2. Bradycardia &
accentuation of Heart
block
Minimization of systemic
adverse effects
29. Carbonic anhydrase Inhibitors
(CAI)
Topical CAI – Dorzolamide , Brinzolamide
MOA – Inhibit carbonic anhydrase (isoenzyme
II) on ciliary body epithelium → Reduces
formation of bicarbonate ions →
Reduces fluid transport → Reduces aqueous
formation → Decrease IOP
Use – Only as add on drug to topical β
blockers or PG analogs
Systemic CAI – Final medication option before
resorting to laser or incisional surgical treatment
30. Adrenergic Agonists
Dipivefrine
Prodrug of Adrenaline
Reduces aqueous
production
Augments uveoscleral
outflow
Ocular burning
Infrequently used for
add on therapy
Apraclonidine
Selective α2 agonist
Highly ionized at
physiological pH
Do not cross BBB
Reduces aqueous
production
Enhance uveoscleral
outflow
31. Topical Miotics
Historically important in open angle glaucoma
MOA - Ciliary muscle contraction
-Increase drainage through trabecular
meshwork
Drugs----Pilocarpine
Less useful drugs – Numerous side effects &
three to four times a day dosing
32. Stepped Medical Approach to
Treatment of Open Angle Glaucoma
Start monotherapy with Latanoprost or topical β
blocker
If target i.o.t. not attained, either change over to
alternative drug or use both the above
concurrently
Brimonidine/dorzolamide – Use only when there
are contraindications to PG analogs/ β blockers
or to supplement their action
Oral acetazolamide/Topical miotics – Last resort
43. Topical Antibacterial Agents
Commercially Available for Ophthalmic
Use
Azithromycin 1% solution H Conjunctivitis
Ciprofloxacin
0.3% solution;
H
hydrochloride
0.3% ointment
D-RCD
-Conjunctivitis
-Keratitis
-Keratoconjunctivitis
-Corneal Ulcers
-Blepharitis
-Dacryocystitis
Erythromycin 0.5% ointment H -Superficial Ocular Infections
involving cornea or conjunctiva
Gatifloxacin 0.3% solution H Conjunctivitis
H- Hypersensitivity ; D-RCD – Drug Related Corneal Deposits
44. Topical Antibacterial Agents Commercially
Available for Ophthalmic Use…..
Gentamicin
sulfate
0.3%
solution
H Conjunctivitis, Keratitis
Levofloxacin 0.5% H Conjunctivitis
Levofloxacin 1.5% H Corneal Ulcers
Moxifloxacin 0.5%
solution
H Conjunctivitis
Ofloxacin 0.3%
solution
H Conjunctivitis
Corneal Ulcers
Tobramycin
sulfate
0.3%
solution
0.3%
ointment
H External infections of the eye
49. Therapeutic Uses of Topical
Glucocorticoids
1. Significant ocular allergy
2. Anterior uveitis
3. Postoperative inflammation following
refractive, corneal & intraocular surgery
4. To reduce potential scarring of surgical site
(After Glaucoma filtering surgery )
55. Therapeutic Uses
1. In Glaucoma surgery, to improve success of
filtration surgery by limiting postoperative wound-healing
process.
2. In corneal surgery, topical mitomycin – To reduce
risk of scarring after excision of pterygium
3. Conjunctival papilloma & conjunctival tumours –
Interferon alpha- 2b
4. Uveitis & uveitic cystoid macular edema –
Intraocular Methotrexate
56. Immunomodulatory Agent
Topical Cyclosporine
– Approved for the treatment of chronic dry eye
associated with inflammation
-Decreases inflammatory markers in lacrimal gland &
increases tear production
57. Agents used to Assist in Ocular
Diagnosis
Fluorescein dye - Epithelial defects of cornea
& conjunctiva and aqueous
humor leakage
- IOP measurement
Mydriatrics - Dilated fundoscopic
Examination
58. Agents Used to treat Retinal
Neovascularization & Macular Degeneration
1. Verteporfin
2. Pegaptanib
3. Bevacizumab
4. Ranibizumab
78. LACRISERT
- Hydroxypropyl cellulose ophthalmic insert
(LACRISERT)
Patients with dry eyes (keratitis sicca)
A substitute for artificial tears
Placed in the conjunctival sac and softens within 1
h and completely dissolves within 14 to 18 h
Stabilizes and thickens the precorneal tear film and
prolongs the tear film break-up time
80. Ocusert
Pilocarpine, a parasympathomimetic agent for
glaucoma
Acts on target organs in the iris, ciliary body and
trabecular meshwork
Carrier for pilocarpine : alginic acid in core of
Ocusert
White annular border : titanium dioxide (pigment)
(easy for patient to visualize)
81.
82. Contd… Advantages
1) Drug application convenient (Once a week)
2) Stabilization of Diurnal variation in IOT.
3) Guard against dangerously high IOT due to
irregularly instilled drops.
Disadvantages
1) Foreign body sensation
2) Difficulty in retention of device
3) Increased cost
4) Detailed instruction.