OCULAR DRUGSOCULAR DRUGS

Gitalisa AndayaniGitalisa Andayani

Department of Ophthalmology, Department of Ophthalmology, FKUI/RSCM JakartaFKUI/RSCM Jakarta

Rabu, 5 Maret 2008Rabu, 5 Maret 2008

Ocular drugsOcular drugsTopical anestheticsTopical anestheticsAnti-allergy dan decongestantAnti-allergy dan decongestantAntibacteria (antibiotics)Antibacteria (antibiotics)AntifungalAntifungalAnti-inflammatoryAnti-inflammatory - corticosteroids- corticosteroids

- non-steroid (NSAID)- non-steroid (NSAID)AntivirusAntivirusArtificial tearsArtificial tearsGlaucoma drugsGlaucoma drugsPupil dilators (midriatics and cycloplegics)Pupil dilators (midriatics and cycloplegics)

Preparation of Eye DrugsPreparation of Eye Drugs5 ml, 15 ml eyedrop bottles5 ml, 15 ml eyedrop bottles

mini/monodosemini/monodose

Eye gelEye gel

Eye ointmentEye ointment

Intravitreal injectionIntravitreal injection

Subconjunctival injectionSubconjunctival injection

Subtenon injection Subtenon injection

Application of topical eye drugsApplication of topical eye drugs

Applying eyedrops/eyegel

Applying eye ointment

AnestheticsAnesthetics

- Propacain HCl 0.5%- Propacain HCl 0.5%

- Tetracain HCl (- Tetracain HCl (Pantocain 0.5%, 2%Pantocain 0.5%, 2%) )

Anti-allergy dan decongestantsAnti-allergy dan decongestants

Anti-allergy:Anti-allergy:

- Sodium chromoglycate (- Sodium chromoglycate (ConverConver))

- Lodoxamide tromethamine (- Lodoxamide tromethamine (AlomideAlomide))

- Kalium pemirolast (- Kalium pemirolast (AlegysalAlegysal))

- Pheniramine maleate (in - Pheniramine maleate (in Vasacon-A/Naphcon-AVasacon-A/Naphcon-A))

Vasoconstrictor (reduce redness):Vasoconstrictor (reduce redness):

- Naphazoline HCl- Naphazoline HCl

- Oxymetazoline HCl (- Oxymetazoline HCl (VisineVisine), etc), etc

Antibiotics (Antibacteria) Antibiotics (Antibacteria) – with/without steroids – with/without steroids / vasoconstrictors/ vasoconstrictors

Types: Types: Aminoglicosides: Aminoglicosides: - Neomicin (frequently combined with- Neomicin (frequently combined with

polimixin-B and gramicidin, egpolimixin-B and gramicidin, eg Xitrol, Polydex, PolidemisinXitrol, Polydex, Polidemisin, , StatrolStatrol))- Gentamicin sulphate (- Gentamicin sulphate (Garamycin, Garamycin, Timact Timact))- Tobramisin sulphate (- Tobramisin sulphate (Tobro, TobrexTobro, Tobrex))

Bacitrasin (now seldomly used)Bacitrasin (now seldomly used)ErithromicinErithromicinPolimixin-BPolimixin-BQuinolones :Quinolones : - Ciprofloxacin (- Ciprofloxacin (Baquinor, CiloxBaquinor, Cilox))

- Norfloxacin- Norfloxacin- Ofloxacin (- Ofloxacin (Tarivid, FloxaTarivid, Floxa))- Gatifloxacin (- Gatifloxacin (GifloxGiflox))- Levofloxacin - Levofloxacin (LFX)(LFX)

Antibiotics (Antibacteria) Antibiotics (Antibacteria) with/without steroids / with/without steroids / vasoconstrictorsvasoconstrictors

Types: Types:

Sulpha (Sulpha (Albuvit, Albucid, CetapredAlbuvit, Albucid, Cetapred))

Tetrasiklin (Tetrasiklin (Terramycin, OxytetracyclineTerramycin, Oxytetracycline))

Trimetoprim Trimetoprim

chloramphenicol 0.25%, 0.5%, 1% (Fenicol, Mycetine)chloramphenicol 0.25%, 0.5%, 1% (Fenicol, Mycetine)

AntifungalAntifungal

Natamycin (Natamycin (NatacenNatacen))

Fluconazole (Fluconazole (DiflucanDiflucan))

Ketoconazole (Ketoconazole (SolnazolSolnazol))

Anti-inflammatory drugsAnti-inflammatory drugs

CorticosteroidsCorticosteroids

Types: Types:

Prednisolone acetate (in Prednisolone acetate (in Cendo PNPCendo PNP))

Dexamethasone (in Dexamethasone (in Xitrol, PolydexXitrol, Polydex, dll), dll)

Fluorometholone (in Fluorometholone (in FMLFML))

Hidrocortisone acetate (in Hidrocortisone acetate (in PolynelPolynel))

Non-steroids/NSAIDSNon-steroids/NSAIDS

Na-diclofenac (Na-diclofenac (Voltaren ophtha, Flamar, NoncortVoltaren ophtha, Flamar, Noncort))

Indomethacin (Indomethacin (Indocollyere, DometIndocollyere, Domet))

Ketorolac tromethamine (Ketorolac tromethamine (AcularAcular))

Antiviral:Antiviral:

Acyclovir (Acyclovir (Hervis, Zovirax, PoviralHervis, Zovirax, Poviral))

Idoxuridin (Idoxuridin (Cendrid, Isotic IxodineCendrid, Isotic Ixodine))

GancyclovirGancyclovir

Artifical eyedropsArtifical eyedrops

Cellulose esters: Cellulose esters: Refresh, Cenfresh, EyefreshRefresh, Cenfresh, Eyefresh

Lubricen, Tears Naturale IILubricen, Tears Naturale II

Polyvinyl alcoholPolyvinyl alcohol

Sodium hyaluronateSodium hyaluronate

Glaucoma DrugsGlaucoma DrugsAdrenergic agonists (alfa dan beta) : decrease aqueous productionAdrenergic agonists (alfa dan beta) : decrease aqueous production

- Epinephrine (- Epinephrine (GlauconGlaucon))

- Dipifevrin - Dipifevrin

- Aprakconidin HCl - Aprakconidin HCl

- Brimonidin tartrate (- Brimonidin tartrate (AlphaganAlphagan))

- Timolol maleate 0.25%, 0.5% (- Timolol maleate 0.25%, 0.5% (Timol, Timoptic): Timol, Timoptic): non-non-

selective, do not use in asthma, heart failureselective, do not use in asthma, heart failure

- Betaxolol HCl (- Betaxolol HCl (Betoptima, TonorBetoptima, Tonor): selective): selective

Carbonic anhidrase inhibitors: decrease aqueous productionCarbonic anhidrase inhibitors: decrease aqueous production

- Asetazolamid (- Asetazolamid (DiamoxDiamox) tablet 125 mg, 250 mg) tablet 125 mg, 250 mg

- Dorzolamid HCl (- Dorzolamid HCl (Trusopt, CosoptTrusopt, Cosopt))

- Brinzolamid (- Brinzolamid (AzoptAzopt))

Glaucoma drugsGlaucoma drugsCholinergic Agonists : increase trabeculo-canalicular outflowCholinergic Agonists : increase trabeculo-canalicular outflow- Pilokarpin HCl- Pilokarpin HCl

Prostaglandine-analogs: increase uveoscleral outflowProstaglandine-analogs: increase uveoscleral outflow- Latanaprost (- Latanaprost (XalatanXalatan))- Travoprost - Travoprost (Travatan)(Travatan)

Note: several products are in combination, eg Latanaprost + Note: several products are in combination, eg Latanaprost + Timolol = XalacomTimolol = Xalacom

Hyperosmotic agents: making plasma hypertonic to aqueous Hyperosmotic agents: making plasma hypertonic to aqueous humorhumor

- Glycerin 50% oralGlycerin 50% oral- Mannitol 5-25% solution for injectionMannitol 5-25% solution for injection

Mydriatics dan cycloplegicsMydriatics dan cycloplegics

Tropicamide 0.5%, 1%: Tropicamide 0.5%, 1%: MidriatylMidriatyl

Atropine sulphate 0.5%, 1% Atropine sulphate 0.5%, 1% TropineTropine

Homatropine HBr 2% Homatropine HBr 2% HomatroHomatro

Phenilephrine 2.5%, 10% Phenilephrine 2.5%, 10% EfriselEfrisel