LabLab#9 & 10#9 & 10 Eye Drops Eye Drops

Presentation tostudents of health college

Sunday, May 22, 2010

by:TA/ Mohammad Al-Mermesh, 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)

• 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)

To be continued

Indications of ophthalmic preparations:

• Anesthetics –e.g. proparacaine • Antibiotics & antibacterial agents- e.g. ofloxacin • Antifungal agents- e.g. Amphotericin B

• Anti-inflammatory- e.g. Prednisolone

• Antiviral agents- e.g. Ganciclovir • Astringents- e.g. Zinc sulfate

• B-adrenergic blocking agents- e.g. Timolol mleate • Miotics and other Glaucoma agents- e.g. Pilocarpine • Mydriatics and cycloplegics – e.g.Atropine or scopolamine • Protectants & artificial tears – carboxymethyl cellulose

• Vasoconstrictors & ocular decongestants - oxymetazoline

O.d……………………..right eyeO.s……………….………left eyeO.u……………………..each eyeO2..……………………both eyes

Rx

Vancomycin 500 mg hydrolyzed powder 2 vialsWFI (water for injection,preservative free 10 ml Artificial tears eye drops solution 20.8

Prepare 15ml

Calculations

X 0.5

1 vial

5ml

10.4 ml

• Storage: Rerigerator

Vancomycin Eye Drops

• Package:15 ml artificial tears dropper bottle

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 Vancomycin is an antibiotic which is used in the treatment of serious staphylococall or the treatment of serious staphylococall or other G+ve infectionsother G+ve infections(for methicillin resistant staphylo-coccus (for methicillin resistant staphylo-coccus aureus MRSA)aureus MRSA)Sig.: 2 gtt BID o.u for 1/52 2 gtt BID o.u for 1/52

Dose: 1-2 drops Bid o.u for 1/521-2 drops Bid o.u for 1/52

Stability: 10 days10 days

Vancomycin Eye drops 31 mg/mlVancomycin Eye drops 31 mg/mlTwo drops to be installed in each eye twice daily Two drops to be installed in each eye twice daily for seven days for seven days Keep in Refrigerator Keep in Refrigerator Expiry after two weeksExpiry after two weeks

Name Exp.Date

Red label

Rx

Amphotericin B Eye 50 mg vial 2 vials

WFI (preservative) 20 ml

Prepare 10 ml

Calculations

X 0.5

1 vial

10 ml

Amphotericin B Eye drops 5 mg/ml

• Storage: Refrigerator, protect from light and heat

• Package:10 ml, sterile plastic self-dropper

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 It is antifungal antibiotic used for the treatment of fungal & yeast ophthalmic treatment of fungal & yeast ophthalmic infection and corneal ulceration infection and corneal ulceration

Sig.: 2 gtt BID o.u for 1/52 or u.d2 gtt BID o.u for 1/52 or u.d

Dose: 1-2 drops Bid for 7 days or u.d1-2 drops Bid for 7 days or u.d

Stability: 7 days7 days

Amphotericin B Eye drops 5 mg/mlAmphotericin B Eye drops 5 mg/mlTwo drops to be installed in each eye twice daily Two drops to be installed in each eye twice daily for one week or as directed for one week or as directed Keep in Refrigerator Keep in Refrigerator Expiry after one weekExpiry after one week

Name Date

Red label

Rx

Benzocaine 10 mlPhenazone (antipyrine) 50 gmGlycerol ad 1000 ml

Prepare 100 ml

Calculations

X 0.1

1 vial

5 gm

100 ml

Benzocaine Ear drops 1 % v/v

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, anestheticAnalgesic, anesthetic

Sig.: 3 gtt a.s Tid or PRN3 gtt a.s Tid or PRN

Dose: 2-4 drops Tid or PRN2-4 drops Tid or PRN

Role of each ingredient:

• Benzocain: Analgesic, anesthetic (active ingredient)• Antipyrine: Solubilizing agent for benazocaine

• Glycerol: Vehicle

Benzocaine Ear drops 1 % v/vBenzocaine Ear drops 1 % v/vThree drops to be installed in the left ear three timesThree drops to be installed in the left ear three times daily or when necessarydaily or when necessary

Name Date

Red label

Rx

Phenol 160 gmGlycerol ad 1000 ml

Prepare 100 ml

Calculations

X 0.1

16 gm

100 ml

Phenol Glycerin Ear drops 16 % w/v

Procedure:

1. Dissolve the phenol in glycerol

2. Use gentle heat if necessary

Uses:

Disinfectant Disinfectant

Sig.: 1 gtt a.u Tid or u.d1 gtt a.u Tid or u.d

Dose: 1-2 drops Tid for few days1-2 drops Tid for few days

Phenol glycerin Ear drops 16 % w/vPhenol glycerin Ear drops 16 % w/vOne drop to be installed in each ear three timesOne drop to be installed in each ear three times daily or as directeddaily or as directedName Date

Red label

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 YouThank You