OCULAR PHARMACOLOGY

ANTIBIOTICS MECHANISM OF ACTION: By inhibiting DNA gyrase a type 2 topo isomerase and topoisomerase 4, enzymes necessary to separate bacterial DNA there by inhibiting cell replication. 0.5% solution as eye drops INDICATION: Hordeolum Internum & externum Bacterial conjunctivitis Bacterial corneal ulcer/keratitis It is a broad spectrum antibiotic

ANTIFUNGAL EYE DROPS 5% NATAMYCIN VORICONAZOLE Fortified AMPHOTERICIN INDICATIONS Fungal corneal ulcer/KERATITIS

ANTIVIRAL MOA :- Blocking DNA synthesis of virus AS EYE OINTMENT 3% Acyclovir mg 5 times/day a week ORAL TABLETS FOR SYSTEMIC INFECTIONS INDICATIONS HERPES ZOSTER/ HERPES SIMPLEX keratitis, Viral uveitis

ANTIALLERGIC MOA – Stabilizes mast cells and prevent release of histamine Olapatadine. 0.1% eye drops INDICATIONS Allergic conjunctivitis like Vernal keratoconjunctivitis Giant papillary conjunctivitis

ANTIINFLAMMATORY Mechanism: inactivation of cyclo- oxygenase INDICATIONS ALL INFLAMMATORY CONDITIONS LIKE EPISCLERITIS SCLERITIS UVEITIS CYSTOID MACULAR EDEMA

STEROIDS TOPICAL CORTICOSTEROIDS As eye drops 1% Prednisolone 0.3% Dexamethasone 0.5% Loteprednol ANTI INFLAMMATORY ACTION INDICATIONS Allergic Conditions like Allergic conjunctivitis Post cataract surgery Cystoid macular edema Episcleritis Scleritis Uveitis

MYDRIATICS Available as 0.8% eye drops. Anticholinergic drug Short acting mydriatic and cycloplegic. Duration of effect (4–8 hours) Used for Dilated Fundus examination

CYCLOPLEGICS As eye drops 1% cyclopentolate INDICATIONS Therapeutic corneal ulcer/KERATITIS uveitis Diagnostic cycloplegic refraction

Parasympatholytic 2%Homatropine eye drops INDICATIONS corneal ulcer uveitis cycloplegic refraction Sympathomimetics Phenylephrine 5 % INDICATIONS mydriatic in Preoperative cataract surgery fundus examination

LUBRICANTS Indication Dry eyes Hydroxy propyl methyl cellulose – % Polyvinyl alcohol % Carboxy methyl cellulose %

ANTI GLAUCOMA

13 Carbonic anhydrase inhibitors Systemic topical acetazoamide Dorzolamide brinzolamide Mechanism of action---- reduce aqueous humour formation

ADRENERGICS Brimonidine – alpha 2 AGONIST selective

MIOTICS : Pilocarpine –Parasympathomimetic drug MOA : increases tone of ciliary muscles-pull trabecular meshwork - increases the outflow of aqueous

HYPERTONIC AGENTS MOA - Raises the osmotic pressure to reduce intraocular pressure Glycerol [10 % infusion / 1 gm /kg oral ] Mannitol [ 20 % infusion ]

ANAESTHETIC DROPS Topical E.g. propacaine Uses: applanation tonometry, goniscopy, removal of corneal foreign bodies, removal of sutures examination of patients who cannot open eyes because of pain Orbital infiltration peribulbar or retrobulbar anesthesia and akinesia for intraocular surgery e.g. lidocaine, bupivacaine MOA :- Reduce nerve impulse conduction by reducing membrane to sodium ions.

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