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Ocular Pharmacology PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "Ocular Pharmacology” by Dr. Sonya Bennett.

This medical PowerPoint presentation is about ocular pharmacology, the study of drugs and their effects on the eyes and related structures. It involves the use of medications to treat various eye diseases and disorders, such as glaucoma, macular degeneration, and dry eye syndrome.

There are several categories of ocular drugs, including antibiotics, antivirals, anti-inflammatory agents, corticosteroids, immunosuppressants, and antiglaucoma agents. These drugs can be administered topically, orally, or intravenously, depending on the condition being treated and the severity of the disease.

Topical ocular medications are the most common form of treatment for ocular conditions. They are usually applied directly to the eye as eye drops or ointments. Topical medications have a lower risk of systemic side effects than oral medications, but they may cause local side effects such as irritation or burning sensation.

In addition to pharmacological treatments, there are also surgical and non-pharmacological interventions used in ocular therapy. For example, lasers can be used to treat conditions such as retinal detachment and glaucoma. Also, dietary supplements such as omega-3 fatty acids and vitamins can help improve eye health and reduce the risk of certain eye diseases.

Ocular pharmacology is an important field in medicine that helps to preserve and restore vision for people with eye diseases and disorders. It is critical for optometrists, ophthalmologists, and other healthcare professionals to have a thorough understanding of ocular pharmacology in order to provide the best possible care for their patients.

Tags : Ocular Pharmacology, glaucoma, macular degeneration, dry eye syndrome, Ophthalmology, Ophthalmology PowerPoint presentation

Published on : Jun 20, 2023 | Views : 1993 | Downloads : 3

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Slide 1-

Ocular Pharmacology Acute Eye Course Dr. Sonya Bennett
Slide 2-

Routes of Administration
Slide 3-

Overview delivery methods - eye drops, ointments, injections drug classifications case
Slide 4-

Eye drops most ocular medications are delivered topically - maximizes anterior segment concentrations and minimizes systemic toxicity drug gradient from tear reservoir to corneal and conjunctival epithelium forces passive absorption
Slide 5-

Eye drops Factors affecting absorption: drug concentration (limited by tonicity) and solubility (aqueous solution v’s suspension) viscosity (increased residence time)
Slide 6-

Eye drops lipid solubility: lipid rich epithelial cell membrane v’s water rich stroma pH and ionic charge - most eye drops are weak bases existing in both charged and uncharged forms enhancing absorption
Slide 7-

Eye drops Surfactants - preservatives used are surface-active agents that alter cell membranes in the cornea as well as bacteria, increasing drug permeability and preventing bacterial contamination
Slide 8-

Eye drops Reflex tearing: ocular irritation and secondary tearing wash out of the drug reservoir in the tears and reduce contact time with cornea. This occurs when drops are not isotonic, have non-physiological pH or contain irritants
Slide 9-

Eye drops Tissue binding: proteins in the tears and on the ocular surface may bind drug making the drug unavailable or creating a slow release reservoir. This may affect peak effect and duration of action as well as delayed local toxicity eg. ongoing toxic retinal effects of hydroxychloroquine even after discontinuation
Slide 10-

Eye ointments increases contact time of drug with ocular surface mixture of petrolatum and mineral oil water-soluble drugs are insolvent in the ointment and are present as microcrystals. The surface microcrystals dissolve in the tears, the rest are trapped until the ointment melts
Slide 11-

Eye ointments only drugs with high lipid solubility and some water solubility will get into both tears and corneal epithelium eg. chloramphenicol and tetracycline both achieve higher aqueous levels as ointment rather than drops
Slide 12-

Peri-ocular injections subconjunctival, subTenon’s and retrobulbar allow drugs to bypass the conjunctival/corneal epithelial barrier and reach therapeutic levels in the posterior segment eg anaesthetic agents, steroids, botulinum toxin
Slide 13-

Intraocular injections allow instant drug delivery at therapeutic concentrations to target site intracameral eg. antibiotics, viscoelastics, miochol intravitreal eg. triamcinolone, avastin
Slide 14-

Systemic drug getting into eye from systemic circulation limited by tight junctions in vascular endothelium of retinal vessels, and non-pigmented epithelium of ciliary body drugs with higher lipid solubility pass through blood-ocular barrier more readily
Slide 15-

Systemic extent of drug bound to plasma proteins also effects access of drug into eye - only unbound form can pass blood-ocular barrier bolus administration exceeds the capacity of a drug to bind to plasma proteins and so leads to higher intraocular drug levels than with slow IV drip
Slide 16-

Sustained release devices devices available for steroid, gancyclovir delivery within vitreous cavity
Slide 17-

Classes of Drugs
Slide 18-

Cholinergics Muscarinic Nicotinic
Slide 19-

Adrenergic agents direct acting eg.phenylephrine indirect acting eg. brimonidine agonists eg dipivefrin
Slide 20-

Beta-blockers important to be aware of side effect profile before administering
Slide 21-

Carbonic anhydrase inhibitors dorzolamide, brinzolamide, acetazolamide
Slide 22-

Osmotic agents glycerol, mannitol
Slide 23-

NSAIDs topical, oral
Slide 24-

Steroids prevent or suppress local hyperthermia, vascular congestion, oedema, pain of inflammatory responses.... and late inflammatory responses such as capillary and fibroblast proliferation, collagen deposition and scarring
Slide 25-

Antivirals acyclovir, gancyclovir, foscarnet
Slide 26-

Local anaesthetics oxybuprocain, alacaine, tetracaine lignocaine, bupivacaine
Slide 27-

so many..... pick one drug per week and learn its indications, contraindications, actions, side effects
Slide 28-

Case AJ
Slide 29-

Presentation 48 yr old man with five year history of low grade anterior uveitis OD VA 6/5 IOP 38mmHg on cosopt BD, brimonidine BD, pred forte QID
Slide 30-

Case AJ
Slide 31-

clear cornea quiet anterior chamber larger area of iris transillumination open drainage angle, though surface appeared irregular clear lens disc 0.7, full HVF, healthy macula
Slide 32-

Questions What other IOP lowering drops are safe to use? Is the steroid having an effect on the IOP? Should I give him Diamox tablets? Can he be controlled medically? the roller coaster ride starts.....
Slide 33-

Choice of IOP lowering agents potential for exacerbation of uveitis (and CMO) with hypotensive lipids and brimonidine
Slide 34-

ppt slide no 34 content not found
Slide 35-

Choice of IOP lowering agents Order of introduction of agents that I use: timolol, brinzolamide, brimonidine, latanoprost speed of effect of drops important? yes want fast response hypotensive lipids can lower IOP sooner than initially thought (days not weeks)
Slide 36-

Choice of IOP lowering agents theoretically using topical NSAIDs may reduce the effectivity of hypotensive lipids, though clinical evidence lacking
Slide 37-

Choice of IOP lowering agents Diamox long list of side effects, interaction with cyclopsorin and folic acid antagonists in chronic uveitis, ciliary body aqueous production can be reduced, and so may be exquisitely sensitive to CAIs (oral or topical)
Slide 38-

Is it a Steroid Response? not often evident as to if it is directly related to steroids or attributable to uveitis more likely in younger patient need to treat uveitis adequately or the IOP can elevate due to trabeculitis or increased aqueous viscosity balancing act!
Slide 39-

Treating steroid response reduce the steroid as much uveitis allows choice of steroid: prednisone, dexamethasone, fluoromethalone
Slide 40-

Progress reduced the pred forte quickly and added diamox IOP reduced so came off diamox several weeks later IOP bounced up again so latanoprost added excellent response initially but after a couple of months IOP back up at 42mmHg
Slide 41-

Progress Added diamox and increased pred forte reduced pred forte but IOP didn’t lower enough to stop diamox..... time for a trabeculectomy (after 5 months)
Slide 42-

Progress Trab with MMC - IOP 12 mmHg Phaco/PCIOl with IOL and Morcher implants to block iris defects VA 6/6 IOP 14
Slide 43-

Thank you!