Download Lecture 8

Lab#9 & 10
Eye Drops
Presentation to
students of health college
Sunday, May 22, 2010
by:
TA/ Mohammad AlMermesh, BSc., PGC,
Pharmaceutical Requirements:
Ophthalmic preparations requires:
• Sterility (by autoclave or bacterial filters)
• Preservations (e.g. benzalkonium chloride 0.004% – 0.01%)
• Isotonicity (0.9% NACL solution is isosmotic)
• Buffering (it affects solubility & stability of drugs)
To be continued
• Viscosity (by adding theckening agent e.g. methylcellulose 0.25%-1%)…
optimal viscosity is in the range 15-25 centipoise
• Ocular Bioavailability (affected by protein binding, drug metabolism, lacrimal
drainage and others such as physico-chemical properties (lipophilicity) &
product formulation)
• Ophthalmic preparation must be clear free from particulate matter (by visual
inspection, filtration & gentle shaking before use)
Indications of ophthalmic preparations:
• Anesthetics –e.g. proparacaine
• Antibiotics & antibacterial agents- e.g.
ofloxacin
• B-adrenergic blocking agents- e.g.
Timolol mleate
• Miotics and other Glaucoma agentse.g. Pilocarpine
• Antifungal agents- e.g. Amphotericin B
• Anti-inflammatory- e.g. Prednisolone
• Antiviral agents- e.g. Ganciclovir
• Mydriatics and cycloplegics –
e.g.Atropine or scopolamine
• Protectants & artificial tears –
carboxymethyl cellulose
• Astringents- e.g. Zinc sulfate
• Vasoconstrictors & ocular
decongestants - oxymetazoline
O.d……………………..right eye
O.s……………….………left eye
O.u……………………..each eye
O2..……………………both eyes
Vancomycin Eye Drops
Rx
Calculations
X 0.5
Vancomycin 500 mg hydrolyzed powder
WFI (water for injection,preservative free
Artificial tears eye drops solution
Prepare 15ml
• Storage: Rerigerator
• Package:15 ml artificial tears dropper bottle
2 vials
10 ml
20.8
1 vial
5ml
10.4 ml
Procedure:
1. Aseptically add 5 ml of preservative free water for injection to the vial
containing 500 mg vancomycin powder, shake well & wait for the powder
dissolution.
2. With a syringe a aseptically remove 4.6 ml from a 15 ml ophthalmic dropper
bottle of artificial tears
3. Withdraw 4-6 ml from the vancomycin vial and add them to the artificial
tears dropper, shake well to ensure mixing
Uses:
Vancomycin is an antibiotic which is used in the treatment
of serious staphylococall or other G+ve infections
(for methicillin resistant staphylo-coccus aureus MRSA)
Sig.: 2 gtt BID o.u for 1/52
Dose: 1-2 drops Bid o.u for 1/52
Stability: 10 days
Red label
Vancomycin Eye drops 31 mg/ml
Two drops to be installed in each eye twice daily
for seven days
Keep in Refrigerator
Expiry after two weeks
Name
Exp.Date
Amphotericin B Eye drops 5 mg/ml
Rx
Calculations
X 0.5
Amphotericin B Eye 50 mg vial
WFI (preservative)
Prepare 10 ml
• Storage: Refrigerator, protect from light and heat
• Package:10 ml, sterile plastic self-dropper
2 vials
20 ml
1 vial
10 ml
Procedure:
1. Within a laminar flow hood reconstitute Amphotericin B with 10 ml WFI,
shake and wait until complete dissolution of the drug.
2. Transfer the solution to a sterile bottle with dropper.
Uses:
It is antifungal antibiotic used for the treatment of fungal &
yeast ophthalmic infection and corneal ulceration
Sig.: 2 gtt BID o.u for 1/52 or u.d
Dose: 1-2 drops Bid for 7 days or u.d
Stability: 7 days
Red label
Amphotericin B Eye drops 5 mg/ml
Two drops to be installed in each eye twice daily
for one week or as directed
Keep in Refrigerator
Expiry after one week
Name
Date
Benzocaine Ear drops 1 % v/v
Rx
Calculations
X 0.1
Benzocaine
Phenazone (antipyrine)
Glycerol
Prepare 100 ml
ad
10 ml
50 gm
1000 ml
1 vial
5 gm
100 ml
Procedure:
1. Mix Benzocaine, Antipyrine & Glycerol together and mix well until you obtain
a clear solution
2. You can use gentle heat to dissolve these ingredients
Uses:
Analgesic, anesthetic
Role of each ingredient:
• Benzocain: Analgesic, anesthetic (active ingredient)
• Antipyrine: Solubilizing agent for benazocaine
• Glycerol: Vehicle
Sig.: 3 gtt a.s Tid or PRN
Dose: 2-4 drops Tid or PRN
Red label
Benzocaine Ear drops 1 % v/v
Three drops to be installed in the left ear three times
daily or when necessary
Name
Date
Phenol Glycerin Ear drops 16 % w/v
Rx
Calculations
X 0.1
Phenol
Glycerol
Prepare 100 ml
ad
160 gm
1000 ml
16 gm
100 ml
Procedure:
1. Dissolve the phenol in glycerol
2. Use gentle heat if necessary
Uses:
Disinfectant
Sig.: 1 gtt a.u Tid or u.d
Dose: 1-2 drops Tid for few days
Red label
Phenol glycerin Ear drops 16 % w/v
One drop to be installed in each ear three times
daily or as directed
Name
Date
Patient counseling
• Eye drops in multiple-application containers for normal use, should not be
used more than 4 weeks, in hospital after one week after first opening,
otherwise one single pack (outpatient, eye surgery, diagnostic dyes).
• A red eye, may be de to herpes simplex virus and a corticosteroid may
aggravate the condition.
• Steroid glaucoma may follow the use of corticosteroid eye preparations
• A steroid cataract may follow prolonged use e.g. 15 mg prednisolone daily
for several years.
• Antimuscarinics dilate the pupil and paralyse the ciliary muscle e.g, atropine
(Long Acting)
• Glaucoma can be treated by drugs that reduce intra-ocular pressure
• Beta-blockers should not be used in patients with asthma or a history of
obstructive airway disease unless no alternatives.
• Patient receiving prostaglandin analogues should be monitored for any
changes in eye coloration e.g. Latanoprost or Trovoprost eye drops
Thank You