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Ординатура / Офтальмология / Английские материалы / Ophthalmic Drugs Diagnostic and Therapeutic Uses 5th edition_Hopkins, Pearson_2007

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318 OPHTHALMIC DRUGS

the unavailable moxisylyte. The inclusion of sodium cromoglicate as a P produce might be considered strange (it is now supplied in a slightly smaller bottle but this still contains a month’s supply).

WHOLESALE DEALING

All products to which optometrists have access can be obtained by way of wholesale dealing.

SIGNED ORDER

To be valid, a signed order must contain the following information:

optometrist’s name

optometrist’s address

date

name and address of the patient (if applicable)

the purpose for which the POM is required

name of product

quantity

pharmaceutical form (unless obvious)

strength

labelling directions (where applicable)

signature of the optometrist (original fax and photocopies are not allowed).

The signed order must be written in indelible ink (this includes typewritten and computer-generated orders).

SALE AND SUPPLY OF CONTACT LENS SOLUTIONS

Contact lens solutions are included in the Medicines Act 1968 by virtue of an order made in 1976. As well as requiring the manufacture and marketing of solutions to be subject to licenses, this legislation can also impose further restrictions as to the sale and supply of solutions.

Contact lens solutions do not fall easily into the normal classification of GSL, P or POM. Clearly it would be ludicrous for solutions to be subject to the requirements of the Prescription-only medicines list, but there is a need to restrict sales to outlets at which patients can receive advice should they request it. Making the product a Pharmacy medicine would allow optometrists to supply solutions only ‘in an emergency’. As can be seen, contact lens solutions do not fit into any of the established categories. They are restricted to sales by registered pharmacists and opticians by mutual agreement between the manufacturers and the regulatory authorities. This restriction only applies to contact lens solutions. Contact lens cases are outside this rule.

APPENDIX 319

ACTS OF PARLIAMENT AND STATUTORY INSTRUMENTS

Medicines Act 1968: chapter 67.

The Medicines (General Sale List) Order 1984/769

1980/1924.The Medicines (Pharmacy and General Sale – Exemptions) Amendment Order

1983/1212.The Medicines (Products Other than Veterinary Drugs) (Prescription-only Order)

The Medicines (Sale or Supply) (Miscellaneous Provisions) Amendment Regulations 1978/989.

1997/1830 Prescription-only Medicine (Human Use Order) 2005/1507

321

Index

 

 

 

 

 

 

 

 

 

 

 

 

 

N.B. Page numbers in italic denote

adrenaline 25

 

 

 

polymixin B 191

 

figures or tables.

 

 

 

neurohumoral transmission 19

preservatives

69

 

 

 

 

 

 

synthesis 24

 

 

 

proxymetacaine

142

 

 

 

 

 

therapy 226–7

 

 

 

sympathomimetics 229

A

 

 

 

 

adverse effects

227

tetracyclines

181

 

 

 

 

 

 

combination 227, 238

tropicamide (bistropamide)

absorption 5–7, 285

 

 

adrenergic receptors

28–30

103, 114

 

 

penetration through cornea

6

blockers 30, 40

 

 

vancomycin

191–2

acanthamoeba keratitis 51, 169, 207,

adverse drug effects

258

 

see also drug interactions

272

 

 

 

 

in children 290

 

 

adverse ocular reactions to systemics

pseudodendrite in 272

 

drug/dosage/duration factors

288–313

 

 

 

Acanthamoeba spp. 51, 58

 

288–9

 

 

 

adverse effects

 

 

 

in contact lens solutions 161–2,

frequency 289–91

 

 

BNF classifications

292

163, 165

 

 

hypersensitivity 258

 

drug factors

288–9

in Purilens system 172

 

information sources 292–3

frequency 291

 

 

A. castellanii

161–2, 165, 166

ocular effects see adverse ocular

information sources on 292–3

A. cuthbertsonii 162

 

reactions to systemics

ocular 291–2

 

 

 

A. polyphaga

161, 172

 

patient factors

289–91

patient variability

289–91

accommodation

38–9

 

toxicity 258

 

 

 

therapeutic index

289

in cycloplegia

97–8

 

specific drugs/groups

alimentary tract drugs

residual 97, 97

 

 

adrenaline

227

 

antacids 294

 

 

 

‘negative’ 36

 

 

 

aminoglycosides 185, 187,

antispasmodics

293–4

aceclidine 225

 

 

 

188

 

 

 

analgesics 303

 

 

 

acetazolamide

67, 222, 295

 

antihistamines

214

anti-inflammatories

310

acetylcholine

13, 22–3, 129–30

 

antimuscarinics 137

anticonvulsants

301–2

neurohumoral transmission

17, 18,

atropine 102

 

 

antidepressants

302–3

19

 

 

 

 

benzalkonium chloride 248–9

antifibrinolytics

311

 

receptors 17

 

 

 

beta-blockers 230

 

antimicrobial agents 304–7

acetylcholinesterase 19, 23

 

Brolene 189

 

 

antibacterials

304–5

acetylcysteine

267, 271, 317

 

carbonic anhydrase inhibitors

antituberculars 305–6

acetylsalicylic acid 204, 206

 

222, 235

 

 

urinary antiseptics

305

aciclovir 195, 262, 270, 271

 

chloramphenicol 182

antinausea agents 303

acne rosacea 273

 

 

 

corticosteroids

206, 207–8

antiparkinsonian drugs

Acts of Parliament 319

 

cyclopentolate

103–4

299–300

 

 

 

Acular 205

 

 

 

 

cycloplegics 91

 

antipsychotics 300–1

 

acycloguanosine

195

 

 

ecothiopate iodide

133–4

anxiolytics 301

 

 

 

additive drug effects

286–7

 

fluconazole

199

 

cardiovascular drugs

294–7

adenine arabinoside

193

 

homatropine 103

 

antiarrhythmics

296

adenovirus 49, 57, 64, 194

 

local anaesthetics

145–6

antihypertensives

296–7

and contact lenses

168–9

 

miotics 136–7

 

 

beta-blockers

296–7

Adie’s pupil 136, 307

 

moxisylyte

136

 

cardiotonics

295

 

Adie’s syndrome

30

 

 

mydriatics

120–2

 

diuretics 295

 

 

 

administration of drugs 3–5

 

NSAIDs 203

 

 

central nervous system

adrenal gland, autonomic responses

parasympathomimetics 223

drugs 298–9

 

 

of 15

 

 

 

 

pilocarpine

223

 

chelating agents

311

 

322 INDEX

 

adverse ocular reactions to systemics

anti-inflammatories 202–19

preservatives 61–2

 

 

 

 

(cont’d)

 

 

antihistamines

211, 213–17

benzalkonium chloride

61

 

endocrine system drugs 307–10

corticosteroids

206–11

chlorhexidine gluconate

62

 

corticosteroids

308–9

mast cell stabilizers

211–13

mercury compounds 61

 

 

for diabetes 308

non-steroidal (NSAIDS) 203–6

oxidizing agents 62

 

 

oral contraceptives 309–10

precautions

258

 

resistance 63, 180, 182, 192

 

 

erectile dysfunction drugs 311–12

ocular effects of 310

plus steroids

217

 

 

migraine drugs 303

see also specific drugs

systemic, ocular effects of 304–7

 

respiratory drugs

297–8

antiarrhythmics 296

 

in tears 52

 

 

 

 

antihistamines

297–8

antibacterials

62, 179–92

see also antibacterials; antifungals;

 

bronchodilators 298

commercial/non-commercial

 

antivirals

 

agonists 9–10

 

 

180

 

 

 

 

antimuscarinics

38, 39, 40

 

AIDS 63, 161

 

 

ocular effects of 304–5

adverse effects

137

 

Alani rods

78

 

 

precautions

258

 

antihistamines

214

 

Alcian blue 149, 155, 156

resistance

63, 180, 182, 192

as cycloplegics

90–2, 102

 

alexidine 164, 165

 

see also specific drugs

drug interactions 287

 

alimentary tract

 

 

antibiotics see antimicrobial agents

as miotics 126

 

 

 

drug administration via 3–4

anticholinesterases 23, 26–7, 38

as mydriatics 111–15, 117, 118

 

drugs acting on 293–4

drug interactions 286–7

antinausea agents

303

 

alkaloid penetration through cornea 6

for glaucoma 225–6

antioxidants 71

 

 

 

allergy/antigens

 

 

in insecticides

261

 

antiparkinsonian drugs 299–300

 

allergic rhinoconjunctivitis 265–6,

irreversible

133–4

 

antipsychotics 300–1

 

266

 

 

as miotics

126, 131–4

antispasmodics

293–4

 

 

antihistamines 211, 213–17

reversible

131–3

 

Antistine

214

 

 

 

 

contact lenses/solutions 162, 170

anticonvulsants

301–2

 

antituberculars

305–6

 

 

histamine release

202

antidepressants

302–3

 

antivirals 193–6, 258, 262

 

 

mast cell stabilizers 212

antifibrinolytics 311

 

anxiolytics 301

 

 

 

 

perennial allergic conjunctivitis

antifungals 62, 196–9

 

applanation tonometry 152–3,

 

 

265–6

 

 

commercial/non-commercial

173

 

 

 

 

treatment principles 260

197

 

 

 

 

apraclonidine 228–9

 

Alomide 213

 

 

ocular effects of 306

aqueous secretion/drainage 39

alpha-agonists

 

 

precautions

258

 

arecoline

26

 

 

 

 

for glaucoma

239

 

antihelminthics

307

 

Artelac SDU 250

 

 

 

as mydriatics

115–17

antihistamines

211, 213–17

artificial tears

 

 

 

alpha-blockers 30, 38, 127, 134–5

adverse effects

214

 

alternatives 254–5

 

alpha-receptors

28–9

 

ocular effects 297–8

formulation

247–9

 

Alphagan

228

 

 

topical application

214

osmolarity/pH 248

 

amblyopia

94–5

 

 

antihypertensives

296–7

preservatives 248–9

 

 

quinine

307

 

 

antimalarials

306–7

 

viscolizers

249

 

amethocaine (tetracaine) 139, 141,

antimicrobial agents 58–9, 62, 67

indications 250

 

 

144–5

 

 

anti-infectives

179

 

requirements 247

 

 

administration by optometrists

chemotherapeutics

62–3

tear substitutes 249–54

 

317

 

 

antimetabolites

63

eyedrops

249–52

 

aminoglycosides

63, 185–8, 304

cell membrane inhibitors 63

gels 252–3

 

 

 

adverse effects 185, 187, 188

cell wall inhibitors 62

mucolytics

253–4

 

 

resistance 192

 

protein/nucleic acid inhibitors

mucomimetics 253

 

amoebae 51, 58

 

 

63

 

 

 

ointments 253

 

amphetamine 29

 

commercial/non-commercial 180,

Aspergillus spp. 57–8, 198

 

amphotericin 197, 306

197

 

 

 

 

A. niger 58

 

 

 

analgesics

303

 

 

minimum inhibitory concentration

A. panophthalmitis 57–8

 

anisocycloplegia

97

 

(MIC)

63, 179

aspirin 204, 206

 

 

 

antacids 294

 

 

physical 59–60

 

atenolol

30, 296

 

 

 

antagonistic drug effects 287

filtration

60

 

atropine

27, 38

 

 

 

antagonists 9, 10

 

freezing

60

 

 

adverse effects

102

 

antazoline

214

 

 

heat 59–60

 

 

in children 92, 93

 

anterior blepharitis 262–3, 269

hygiene as

64

 

as cycloplegic

90, 91, 92, 101–2

anterior chamber grading 109–12,

irradiation

60

 

time scale

93–4

 

110, 111

 

 

ultrasonics

60

 

tonus allowance 94

 

 

 

 

 

 

 

323

 

 

 

 

 

INDEX

 

 

 

 

 

 

 

 

atropine (cont’d)

 

bacterial conjunctivitis 264–5

bromothymol blue 156

 

in iritis 276

 

bacterial keratitis 268–9, 270

bronchodilators, ocular effects of 298

 

as mydriatic 113, 118

benoxinate (oxybuprocaine) 139, 141,

Brücke’s muscle

33

 

 

for myopia 101–2

 

143

bupivacaine 145

 

 

 

as occluder 94–5

 

administration by optometrists

burns, first-aid for 283

 

overcoming effects 93

317

butyrocholinesterase 23

 

and pilocarpine 128

 

adverse effects 146

 

 

 

 

poisoning 102

 

dose–response curves 142

 

 

 

 

C

 

 

 

sale by optometrists

317

in tonometry 152

 

 

 

autonomic nervous system 12–31, 22

benzalkonium chloride (BKA) 61, 69,

 

 

 

 

adrenergic blockers

30

161

Candida albicans

57, 197

 

 

adrenergic receptors

14–15, 28–30

adverse effects 248–9

carbachol 26

 

 

 

axonal conduction 13, 16

in contact lens solutions 163–4, 171

for glaucoma

225

 

cholinergic antagonists 27–8

beta-blockers

30

 

 

as miotic 129, 130

cholinergic receptors 14–15, 25–8

adverse effects

230

 

carbomers 252–3

 

divisions/distribution 12–13

combination therapy 238

 

carbonic anhydrase inhibitors

effector organs

14–15, 15

 

for glaucoma 222, 230–4, 239

 

adverse effects

222, 235

junctional transmission 16–20

membrane stabilization 231

combination therapy 238

postjunctional activity 16–19

selectivity 230

 

for glaucoma

222, 234–5, 238,

transmitter degradation

19–20

sympathomimetic activity

231

239

 

 

transmitter release 16

 

ocular effects of

296–7

 

plus pilocarpine 224

neurohumoral transmission

13, 17,

plus pilocarpine 224

 

cardiotonics 295

 

22–30

 

 

 

stereo-isomers 231, 232

 

cardiovascular drugs, ocular effects

denervation supersensitivity

beta-lactams

180

 

 

of 294–7

 

 

 

30–1

 

 

 

beta-lysin 52–3

 

 

antiarrhythmics 296

evidence for

20–2

 

beta-receptors

28–9

 

antihypertensives 296–7

ocular innervation 33–41, 35

Betagan 234

 

 

 

 

beta-blockers

296–7

drug effects

37–40

 

betamethasone

209, 217, 308

 

cardiotonics

295

parasympathetic

34–5

 

betaxolol 30, 227, 233

 

diuretics 295

 

 

sympathetic

35–6

 

adverse effects

230

 

cardiovascular side effects

azelastine 215, 317

 

 

bethanechol

26, 130

 

beta-blockers

231

azidothymidine (AZT)

196

 

Betnesol 209

 

 

 

 

miotics 137, 223

Azopt 235

 

 

 

 

Betnesol-N 217

 

 

mydriatics 121–2

 

 

 

 

 

Betoptic 233

 

 

 

 

carmellose sodium 251

 

 

 

 

 

bimatoprost

236

 

 

carteolol 231, 233

 

B

 

 

 

 

 

 

 

 

 

 

 

biotransformation

7–8, 286

 

cataracts, steroid-induced 207–8

 

 

 

 

 

bistropamide see tropicamide

 

catecholamines

28

Bacillus spp.

 

 

 

(bistropamide)

 

Celluvisc 251

 

 

B. cereus

168

 

 

 

blepharitis

 

 

 

 

central nervous system drugs,

B. licheniformis

171

 

 

anterior (staphylococcal) 262–3,

ocular effects of 298–9

B. stearothermophilus

45

 

269

 

 

 

 

cephalosporins 62

bacitracin 62, 191, 317

 

 

herpes simplex

262

 

Cephalosporium acremonium 58

bacteria 42–7

 

 

 

posterior

273

 

 

chelating agents

 

 

capsules 44

 

 

 

blood supply

 

 

 

 

EDTA 162, 163, 169

classification 46–7

 

 

drugs acting on

40

 

ocular effects of 311

environmental/metabolic

 

responses to autonomic impulses

children

 

 

requirements

45–6

 

14

 

 

 

 

adverse drug effects 290

Gram-negative

47

 

 

BNF see British National Formulary

cycloplegia 92, 93, 95

cocci

54

 

 

 

Bordetella pertussis

56

 

mydriasis 119

 

rods

55–6

 

 

 

botulinum toxin 54–5

 

Chlamydia spp. 42, 50, 54

Gram-positive

47

 

 

bretylium 30

 

 

 

 

antibiotic sensitivity 184

cocci

53–4

 

 

 

brimonidine

228

 

 

conjunctivitis 265

rods

54–5

 

 

 

brinzolamide

235

 

 

C. psittaci 50

 

growth

45–6, 46

 

 

British National Formulary (BNF)

292,

C. trachomatis

58

resistance 63, 192

 

 

293

 

 

 

 

chloramphenicol

63, 181–3

sporulation 46

 

 

 

Brolene 189, 190

 

 

adverse effects

182

structure 42–4

 

 

 

dibromopropamidine isethionate

conjunctivitis 264

see also specific bacteria

 

189–90

 

 

 

 

drug interactions 286

324 INDEX

 

chloramphenicol (cont’d)

giant (contact lens induced)

hydrogel 78, 158–60, 171–2

 

 

external hordeolum 263

papillary 267–8, 268

rigid 158, 159

 

marginal keratitis 270

perennial allergic 265–6

silicone hydrogel 159

over-the counter 190

contact lens induced papillary

contraceptive pills

309–10

postoperative 277

conjunctivitis 267–8, 268

corneal conditions

268–74

resistance 192

contact lens solutions 158–77

corneal drug penetration 6

sale by optometrists 316

comfort drops 159, 171–2

‘corneal melt’

208

 

chlorbutanol 249

disinfecting solutions 162–3

corticosteroids

206–11

chlorhexidine

62, 164, 165

adverse effects

163–4

adverse effects

206

chlorine disinfection 168, 169–70,

multi-purpose

164–6

for dry eye 254

173

 

‘no-rub’

160, 164, 165

and infection 210

chloromycetin 183

one-step

167–8

 

ocular effects of 308–9

chloroquine 306, 307

single purpose

163–4

postoperative

277

cholinergic antagonists 27–8

stable 163–6

 

 

precautions

258

cholinergic receptors 25–8

transient/oxidative 166–8

see also steroids

blockers 37–8

trial lenses 173

 

cortisone 207, 308

stimulants

37, 39

two-step

167

 

Corynebacterium spp. 182

cholinomimetics 26

enzymatic cleaners 160, 170–1

C. diphtheriae

54

chronic conditions

and lens type 159, 159

Cosopt 239

 

 

postoperative 276–7

properties, ideal

160

COX II inhibitors

203

see also dry eye (keratoconjunc-

reasons for use

159

cromolyn sodium

212

tivitis sicca); glaucoma

sale by optometrists 318

Cyclogyl 97

 

 

ciclosporin 255

saline 158, 169–70

 

cyclooxygenase II inhibitors 203

ciliary muscle

33–4, 39

lens testing 170

cyclopentolate

 

 

innervation 34, 36

preserved 169–70

adverse effects

103–4

paralysis 85

pressurised containers 170

in children 95

 

tonus allowance 94

single-use containers 170

as cycloplegic

90, 91, 92, 95–8

Ciloxan 184

 

saliva, use of 160

 

age/dose

95–6

ciprofloxacin

183, 184, 269, 270

soaking solutions

158, 162

depth of

96–8

cleaners, contact lens

surfactant cleaner

161–2

with phenylephrine 92

enzymatic

158, 160, 170–1

multi-purpose

164–6

time course

96

surfactant

161–2, 164–6

tonicity 165–6

 

 

in iritis 276

 

 

clindamycin 63, 304

wetting solutions

158, 160–1

as mydriatic

113, 114, 117, 118

clobetasone

208, 209

 

contact lenses

 

 

in iris pigmentation 118

Clostridium spp.

54

 

adverse drug effects

291

sale by optometrists 317

antibiotic sensitivity

189

adverse ocular reactions to

therapeutic uses

98

C. botulinum

51, 54–5

systemics 291

 

cycloplegia 39

 

C. tetani

55

 

 

 

antigen formation 162

cycloplegics

79, 82, 85–106

clotrimazole

198

 

 

care

 

 

adverse effects 91, 102–4

‘cobblestone’ papillae 267

daily care routine

160

ocular

90

 

cocaine

 

 

 

 

daily cleaning

161–2

choice of

90–3, 91

abuse 145

 

 

 

development 158

atropine 93–5

 

as anaesthetic

25, 141

disinfection 168–72

cyclopentolate 95–8

mode of action

30

 

products 159, 159

tropicamide (bistropamide)

as mydriatic

25, 116, 117

rinsing 164, 167, 169

 

98–9

 

collagen shields

78, 188

as drug carriers 225

 

contraindications

86

comfort drops 171–2

 

fluorescein patterns

151

examination under 88–90

Committee on the Safety of

infections

 

 

indications 85–6

 

Medicines 292–3

 

Acanthamoeba

51

 

in myopia 101–2

 

concentration–response relationships

Aspergillus 58

 

 

ophthalmoscopy

90

10–12

 

 

 

 

bacterial keratitis

269

precautions 104, 258

conjunctival hyperemia

273

local anaesthetic

140

precycloplegic examination 87

conjunctival infections

264–8

patient education

173–4

prescribing following 100–1

conjunctivitis

 

 

 

rose bengal staining

154

properties, ideal

86

allergic rhinoconjunctivitis 265–6,

storage case infection 168

refraction under

85

266

 

 

 

tolerance 171

 

 

advantages 86

bacterial

264–5

 

trial lenses 172–3

 

 

disadvantages 87

chlamydial 265

 

types 159

 

 

subjective 90

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

325

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INDEX

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

cycloplegics (cont’d)

 

 

 

biotransformation 7–8

 

exophthalmos

154

 

 

 

retinoscopy 86, 88–9

 

 

concentration–response 10–12

 

exposure keratitis

145, 146, 283

 

 

therapeutic use

 

 

 

development 2–3

 

external hordeolum 263

 

in bacterial keratitis 269

 

 

distribution 7

 

eyes

 

 

 

 

 

 

 

in iritis 276

 

 

 

dosage/duration 260, 288–9

 

anterior portion, section of 33

 

cytomegalovirus 56

 

 

 

efficacy

11, 12

 

innervation

 

 

 

 

 

 

 

 

 

 

excretion

8

 

autonomic 33–41, 35

 

 

 

 

 

 

 

modifications 5–8

 

sensory

35, 37

 

 

D

 

 

 

 

 

naturally occurring 2

 

microbiology

52–3

 

 

 

 

 

 

 

nomenclature 3

 

musculature

33–4, 36, 38, 39

 

dapiprazole

135

 

 

 

 

potency

11–12

 

vasculature 40

 

 

 

decongestants 79

 

 

 

 

receptors

9

 

eye lotions

76

 

 

 

 

 

demecarium 225

 

 

 

 

responses 9–12

 

eye ointments 74–6

 

dendritic keratitis

154

 

 

semi-synthetic 2

 

instillation

75, 75–6

 

dendritic ulcers 56, 193, 270

 

 

sources of

1–2

 

eyedrops 70, 257

 

 

 

denervation supersensitivity 30–1,

 

synthetic

2

 

antioxidants

71

 

 

119, 229

 

 

 

 

see also ophthalmic drugs

 

aqueous 68–71

 

 

 

development of drugs 2–3

 

dry eye (keratoconjunctivitis sicca)

 

containers

72–3

 

dexamethasone 209, 217, 308

 

 

154, 244–7

 

drug absorption 68–9

 

with diclofenac 205

 

 

corticosteroids 254

 

dwell time

70

 

 

 

postoperative

277

 

 

evaporation rate 244

 

instillation

73, 73–4

 

diabetes 119, 308

 

 

 

 

immunomodulators 255

 

pH adjusters 70

 

diagnostic drugs

79, 82–4

 

 

incidence

244

 

tonicity agents

71

 

 

advantages/disadvantages 83

 

NSAIDs

254

 

viscosity agents

70–1

 

drug/concentration selection

84

 

questionnaire 247

 

eyelash pigmentation 236, 237

 

patient selection

84

 

 

testing/staining 151, 245–6

 

eyelid conditions 261–4, 273

 

properties, ideal

83–4

 

 

Dyflos

 

 

 

 

lice/nits

261

 

 

 

 

dibromopropamidine isethionate

 

 

for glaucoma 225

 

 

 

 

 

 

 

 

 

189–90

 

 

 

 

 

as miotic

132, 133, 134

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

F

 

 

 

 

 

 

 

dichlorphenamide 222

 

 

DYMED 164

 

 

 

 

 

 

 

 

 

diclofenac 204–5, 254, 308, 317

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

dilator pupillae muscle 34, 38

 

 

 

 

 

 

Falck–Hillarp technique 25

 

 

 

E

 

 

 

 

innervation 35–6

 

 

 

 

 

 

famciclovir

271

 

 

 

 

dimorphic fungi 50

 

 

 

 

 

 

 

fibroblasts

203

 

 

 

 

dipivefrin 227, 238

 

 

 

ecothiopate iodide 133–4, 225

filamentary keratitis 253–4

 

disinfecting lens solutions 162–3

 

 

EDTA 162, 163, 169

filtration

60

 

 

 

 

 

adverse effects

163–4

 

 

efficacy 11, 12

 

first aid

278–84

 

 

 

 

multi-purpose

164–6

 

 

emedastine (Emadine) 215, 266, 317

 

blow with blunt instrument 282–3

 

one-step 167–8

 

 

 

emergencies, common 280–4

 

burns, chemical/thermal 283

 

single purpose

163–4

 

 

endocrine system drugs, ocular effects

 

common emergencies 280–4

 

stable 163–6

 

 

 

 

of 307–10

 

equipment

279–80

 

transient/oxidative 166–8

 

 

Entamoeba spp. 51

 

exposure keratitis 283

 

two-step

167

 

 

 

 

enzymatic lens cleaners 158, 160,

 

eyepads

279

 

 

 

 

diuretics, ocular effects of 295

 

 

170–1

 

 

 

foreign bodies 280–2

 

doconasoids

237–8

 

 

 

ephedrine

98, 116–17, 298

 

glaucoma, closed-angle 283

 

dorzolamide

235, 238, 239

 

 

epinastine

216–17

 

pharmaceuticals 280

 

dosage 289

 

 

 

 

 

episcleritis

274–5

 

principles

278–9

 

dosage forms see ophthalmic dosage

 

simple diffuse 274–5

 

record-keeping

278–9, 280, 281–2

 

forms

 

 

 

 

 

erectile dysfunction drugs, ocular

 

referral

279

 

 

 

 

dose–response curves 11

 

 

effects of 311–12

flashlight (penlight) test 109–10, 110,

 

drug interactions

259, 285–7

 

 

erythromycin

181, 286

111

 

 

 

 

 

 

ocular reactions to systemics

291

 

Escherichia coli

163

fluconazole

199

 

 

 

 

pharmacodynamics 285, 286–7

 

antibiotic sensitivity 182, 186, 189

flucytosine

198

 

 

 

 

pharmacokinetic

285–6

 

 

eucatropine

115

fluorescein

149, 150–4

 

drugs

 

 

 

 

 

eukaryotic cells 196

 

contamination 154

 

absorption 5–7

 

 

 

excretion 286

 

 

indications

151–3

 

administration

3–5

 

 

excretion of drugs 8

 

applanation tonometry 152–3

 

agonists/antagonists 9–10

 

 

Exocin 184

 

 

 

 

contact lens fitting 151–2

326 INDEX

 

fluorescein (cont’d)

 

glaucoma

 

 

 

 

 

 

homatropine

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

corneal defects 151–3

 

angle-closure

 

 

 

 

 

adverse effects

103

 

 

lacrimal patency

153

 

first aid 283–4

 

 

 

as cycloplegic

90, 91, 97, 99, 100

 

tear break-up time 153

 

with mydriasis

120–1

 

 

as mydriatic 113, 114–15, 117, 118

 

tear flow assessment 153–4

 

symptoms 121

 

 

 

sale by optometrists 317

 

optimum conditions of use

 

differential diagnosis 135, 226

 

Horner’s syndrome

 

 

 

 

150–1

 

 

narrow-angle

214

 

 

 

denervation supersensitivity 30,

 

paper strips 152–3, 154

 

open-angle 125, 226

 

119, 229

 

 

 

 

with rose bengal 155

 

steroid-induced

208

 

 

diagnostic drugs

119–20

 

fluorometholone 208, 210

glaucoma treatment 220–42

 

 

hydrocortisone 207, 210, 217

 

blepharitis

262

 

 

anticholinesterases

225–6

 

 

hydrogel contact lenses

78, 158–60

 

dry eye

255

 

 

beta-blockers

222, 230–4

 

 

care product summary 159

 

phlyctenulosis 274

 

 

membrane stabilization

231

 

hydrogen peroxide

62, 166, 171

 

vernal conjunctivitis

267

 

selectivity

230

 

 

 

hydroxyamphetamine 98, 116, 118

 

fluoroquinolones 183–5, 269

 

sympathomimetic activity

 

and pilocarpine

128

 

 

resistance

192

 

231

 

 

 

 

 

hydroxyethylcellulose 251

 

flurbiprofen

206, 255

 

 

carbonic anhydrase inhibitors

 

hydroxypropylguarpolysaccharide

 

FML 210

 

 

 

 

 

222, 224, 234–5

 

253

 

 

 

 

 

 

foreign bodies

 

 

 

combinations

238–9

 

 

hygiene in practice

64

 

 

intraocular

278, 282

 

 

doconasoids

237–8

 

 

 

hyoscine 90, 100, 118

 

 

superficial

280–2

 

 

guidelines 239

 

 

 

 

hypnotics, ocular effects of 299

 

antimicrobial prophylaxis 281

 

local 221, 222–39

 

 

 

Hypotears

251

 

 

 

 

corneal sensitivity 282

 

parasympathomimetics 222–5

 

hypromellose

250

 

 

 

 

history-taking 280

 

patient compliance

221, 224

 

 

 

 

 

 

 

 

local anaesthetic

140, 144, 281

 

properties required

220–1

 

 

 

 

 

 

 

 

 

 

 

 

I

 

 

 

 

 

 

location/removal

278, 281

 

prostaglandins

235–7

 

 

 

 

 

 

 

 

record-keeping 280, 281–2

 

sympathomimetics

226–9

 

 

 

 

 

 

 

 

 

staining

281

 

 

systemic

221, 222

 

 

 

ibuprofen 204, 308

 

 

 

visual acuity 281

 

glycerol 284

 

 

 

 

 

 

idoxuridine

193

 

 

 

 

framycetin

186, 217

 

Golden Eye

189, 190

 

 

 

imidazoles

198–9

 

 

 

 

freezing 60

 

 

 

 

Goldmann tonometer 152, 152

 

 

immunomodulators 255

 

Fucithalmic

190

 

gramicidin 217

 

 

 

 

 

indometacin

204, 308

 

 

fungal infections 196

 

guanethidine 30, 227

 

 

 

infection

 

 

 

 

 

 

ocular 197

 

 

 

 

 

 

 

 

 

 

acute

 

 

 

 

 

 

fungi 50, 57–8

 

 

 

 

 

 

 

 

 

 

conjunctival 264–8

 

 

 

 

H

 

 

 

 

 

 

contact lens contamination 163

 

 

 

 

 

 

 

corneal

268–74

 

 

fusidic acid

179, 190

 

 

 

 

 

 

 

 

 

eyelid

261–4

 

 

 

conjunctivitis 264

 

Haemophilus spp. 55–6

 

 

 

scleral

274–5

 

 

 

external hordeolum

263

 

antibiotic sensitivity 182, 186

 

ocular effects of systemic drugs

 

sale by optometrists

317

 

H. aegypticus (conjunctivitidis) 56

 

304–7

 

 

 

 

 

 

 

 

 

 

 

H. ducreyi

56

 

 

 

 

 

and steroids 210

 

 

 

 

 

 

 

 

 

 

H. influenzae

55–6, 163

 

 

transmission/control

63

 

G

 

 

 

 

 

 

 

 

 

 

 

 

 

heart, autonomic responses of

14

 

treatment principles

259–60

 

 

 

 

 

 

 

 

heat 59–60

 

 

 

 

 

 

inflammation 202, 260

 

 

gall bladder, autonomic responses

 

herpes infections

 

 

 

 

injection of drugs

5, 67

 

 

of

15

 

 

 

 

 

herpes simplex blepharitis

262

 

intestines, autonomic responses

 

ganciclovir

196, 262, 270

 

herpes zoster ophthalmicus

271,

 

of 15

 

 

 

 

 

ganglionic transmission

19, 20

 

271–2

 

 

 

 

 

intraocular muscles

33–4

 

gatifloxacin

185

 

 

herpes viruses 49, 56

 

 

 

intraocular pressure

39

 

 

GelTears

252

 

 

 

 

herpes simplex

56, 64, 193, 194

 

reduction

220, 230

 

 

General Sale List (GSL)

315, 316

 

and steroids

210

 

 

iodine 62, 168

 

 

 

 

genetic engineering 2

 

 

herpes zoster

56

 

 

 

iodonitrotetrazolium 156

 

gentamicin

187

 

 

heterophoria

86

 

 

 

 

 

ionizing radiation

60

 

 

Genteel

249

 

 

 

 

histamine

 

 

 

 

 

 

iontophoresis

77–8

 

 

 

Genticin

187

 

 

 

 

inhibition see antihistamines

 

Iopidine 228, 229

 

 

 

 

giant papillae

266, 267

 

 

liberation from mast cells 202

 

irido-cyclitis

275

 

 

 

 

giant papillary conjunctivitis 267–8

 

receptors

213–14

 

 

 

iris hyperpigmentation

236, 237

 

contact lens induced

268

 

HIV 63, 161, 193

 

 

 

 

iris pigmentation

118

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

327

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INDEX

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

iritis 275

 

 

 

 

Prescription-only medicines (POM)

mast cells

202

 

 

 

 

 

 

isoprenaline

29

 

 

315–16

 

 

 

 

mast cell stabilizers

211–13

 

 

 

isopropyl unoprostone 237–8

 

sale/supply of drugs/solutions

Maxidex

209

 

 

 

 

 

 

Isopto Alkaline/Plain/Frin

250

 

316–18

 

 

 

 

Maxitrol

217

 

 

 

 

 

 

 

 

 

 

 

by additional supply

 

 

Medicines Act 1968

314–16, 318, 319

 

 

 

 

 

 

optometrists 317–18

Menicon lens solutions 173

 

 

 

J

 

 

 

 

 

 

 

 

 

 

administration by optometrists

mercury compounds 61

 

 

 

 

 

 

 

 

317

 

 

 

 

metachol 225

 

 

 

 

 

 

junctional transmission 16–20

 

by all optometrists 316–17

methacholine 26, 130

 

 

 

 

postjunctional activity 16–19

 

contact lens solutions

318

methylcellulose 249, 250

 

 

 

 

transmitter degradation

19–20

 

signed orders 318

 

 

 

methylene 156

 

 

 

 

 

 

transmitter release 16

 

 

wholesale dealing

318

 

 

methylprednisolone

254, 308

 

 

 

 

 

 

 

 

leucocytes in inflammation

203

metipranolol 234

 

 

 

 

 

 

 

 

 

 

 

leukotrienes

202, 205

 

 

 

metronidazole 63, 304

 

 

 

 

K

 

 

 

 

 

 

 

 

 

 

 

 

 

 

levobunolol

234

 

 

 

 

miconazole 198

 

 

 

 

 

 

 

 

 

 

 

levocabastine 215, 266, 317

 

 

microbiology 42–66

 

 

 

 

 

keratitis

 

 

 

 

light reflex, pupillary

38

 

 

antimicrobial agents/methods

52,

 

 

acanthamoeba 51, 169, 207, 272

 

lignocaine (lidocaine)

139, 141, 143–4

58–64

 

 

 

 

 

 

bacterial

268–9

 

 

administration by optometrists

chemotherapeutics 59, 62–3,

 

dendritic

154

 

317

 

 

 

 

 

 

 

179–201

 

 

 

 

exposure

145, 146, 283

 

 

adverse effects 145

 

 

see also antibacterials;

 

 

 

marginal (staphylococcal

 

with fluorescein

152

 

 

 

antifungals; antivirals;

 

 

hypersensitivity)

269–70

 

limbal phlycten

274

 

 

 

 

specific agents

 

 

 

rosacea 273

 

 

linezolid 305

 

 

 

 

 

physical 59–60

 

 

 

 

viral 270–1

 

 

Liposic 252

 

 

 

 

 

 

preservatives

61–2

 

 

 

 

keratitis neuroparalytica 154

 

Liquifilm Tears

251

 

 

 

 

see also specific agents

 

 

 

keratoconjunctivitis

 

 

Liquivisc 253

 

 

 

 

 

antisepsis 59

 

 

 

 

 

 

sicca (dry eye) 154, 244–7

 

lissamine green

155, 246

 

 

bacteria 42–7

 

 

 

 

 

 

corticosteroids 254

 

 

liver, autonomic responses of

15

Gram-negative cocci

54

 

 

 

evaporation rate 244

 

 

Livostin 215

 

 

 

 

 

 

Gram-negative rods

55–6

 

 

 

immunomodulators

255

 

local anaesthetics 67, 79, 82, 139,

Gram-positive cocci

53–4

 

 

 

incidence 244

 

 

139–48

 

 

 

 

 

 

Gram-positive rods

54–5

 

 

 

NSAIDs 254

 

 

abuse 145–6

 

 

 

 

 

chlamydiae 50, 58

 

 

 

 

questionnaire 247

 

 

advantages/disadvantages

140–1

contact lens contamination 161–2,

 

staining 151, 245–6

 

 

adverse effects 145–6

 

 

163

 

 

 

 

 

 

vernal (spring catarrh) 266–7

 

choice of

141–5

 

 

 

 

disease transmission 51–2

 

 

 

ketorolac

204

 

 

and healing

144

 

 

 

 

disinfection 59

 

 

 

 

 

 

ketotifen

216, 266, 268, 317

 

 

indications 140

 

 

 

 

eukaryotic cells

42, 43, 44

 

 

 

Klebsiella spp. 186

 

 

mode of action 141

 

 

of eye

51–2

 

 

 

 

 

 

Koch–Weeks bacillus 56

 

 

precautions

145–6

 

 

 

fungi

50, 57–8

 

 

 

 

 

 

 

 

 

 

 

properties, ideal

139

 

 

microscopy 47

 

 

 

 

 

 

 

 

 

 

 

systemic effects

146

 

 

ocular pathogens

53–9

 

 

 

 

L

 

 

 

 

tonometry 140, 152

 

 

prokaryotic cells

42–4, 43

 

 

 

 

 

 

 

 

local drug administration 5

 

 

protozoa 51, 58

 

 

 

 

 

 

labetalol

30, 296

 

 

lodoxamide

213, 266, 268, 317

 

sterilization 59

 

 

 

 

 

 

lachesine

98–9

 

 

lomefloxacin

183

 

 

 

 

viruses 48–50, 56–7

 

 

 

 

Lacri-lube 253

 

 

Lubri-tears 253

 

 

 

 

 

microwave disinfection 172

 

 

 

lacrimal gland 34

 

 

Lumigan 236

 

 

 

 

 

migraine drugs, ocular effects of

303

 

 

autonomic responses of

15

 

lungs, autonomic responses of

14

MIMS 292

 

 

 

 

 

 

innervation 34–5, 36

 

 

lysozyme

 

 

 

 

 

 

Minims 183, 187, 208, 209, 226, 234,

 

lacrimal secretion 40

 

 

antimicrobial 52, 53

 

 

251

 

 

 

 

 

 

 

lamellae

77

 

 

 

on contact lenses 170

 

 

minocycline 180

 

 

 

 

 

 

latanoprost

236, 238, 239

 

 

 

 

 

 

 

 

 

Miochol-E 129–30

 

 

 

 

 

 

legal issues

314–19

 

 

 

 

 

 

 

 

 

miosis in glaucoma

222–3

 

 

 

 

 

 

M

 

 

 

 

 

 

 

 

 

 

Acts of Parliament/Statutory

 

 

 

 

 

 

 

miotics 37, 38, 79, 82, 125–30

 

 

 

 

Instruments 319

 

 

 

 

 

 

 

 

 

for Adie’s pupil

136

 

 

 

 

General Sale List (GSL)

315, 316

 

macrolides 63, 181, 304

 

 

adverse effects

136

 

 

 

 

Pharmacy (P) medicines

315, 316

 

marginal keratitis 269–70

 

 

anticholinesterases 131–4

 

 

328 INDEX

 

miotics (cont’d)

 

 

 

 

nasopharyngeal glands, autonomic

 

eyedrops

68–74

 

 

 

 

 

 

 

 

 

 

 

 

 

choice of 135

 

 

 

 

responses of 15

 

 

 

 

aqueous 68–71

 

 

 

indications/contraindications 126

natamycin 198

 

 

 

 

 

oily

71–2

 

 

 

 

 

mixed/combinations 135, 238

naturally occurring drugs 2

 

 

hydrogel contact lenses

78

 

 

mode of action 126–8, 132

nedocromil 212–13, 266, 267

 

 

iontophoresis

77–8

 

 

 

on dilator muscle 127

 

sale by optometrists

317

 

 

 

lamellae

77

 

 

 

 

 

on sphincter muscle

126

Neisseria spp. 54, 190

 

 

 

 

Ocuserts

77

 

 

 

 

 

after mydriasis 125

 

 

N. gonorrhoeae 181, 268

 

 

 

ophthalmic rods

78

 

 

 

parasympathomimetics

127–34

Neo-cortef 217

 

 

 

 

 

paper strips 76

 

 

 

 

preparations 132–3

 

neomycin (Neosporin)

185–6, 217,

 

routes of administration

67–8

 

 

properties, ideal

125–6

 

272

 

 

 

 

 

 

spray for closed eyelid 119

 

 

for squint

136

 

 

 

neostigmine 27, 225

 

 

 

 

ophthalmic drugs

 

 

 

 

 

MK-927 234–5

 

 

 

neosynephrine

118

 

 

 

 

classification 79, 82

 

 

 

Monthly Index of Medical Specialities

nerves see autonomic nervous system;

 

contraindications/precautions

 

 

(MIMS) 292, 293

 

 

sensory nerve supply

 

 

 

258–9

 

 

 

 

 

Morax–Axenfeld bacillus 56

neurohumoral transmission

 

 

 

dose/duration

260

 

 

 

Moraxella lacunata 56

 

 

 

motor nerves 17

 

 

 

 

indications 257–8

 

 

 

moulds 50

 

 

 

 

 

see also autonomic nervous system

 

infections/infestations 260

 

 

moxifloxacin

185

 

 

 

neuromuscular junctions 20

 

 

ophthalmic rods 78

 

 

 

moxisylyte (thymoxamine)

127,

nicotinic receptors 25

 

 

 

 

Opticrom

212

 

 

 

 

 

134–5, 136

 

 

 

 

blockers 27, 38

 

 

 

 

Optilast 215

 

 

 

 

 

MRSA 53

 

 

 

 

nomenclature of drugs 3

 

 

 

optometrists

 

 

 

 

 

Müller’s muscle 33, 40

 

non-invasive break-up time

245

 

sale/supply of drugs 316–18

 

 

multidose containers

69, 72

non-specific cholinesterase

23

 

 

contact lens solutions

318

 

 

muscarine 25, 26

 

 

 

non-steroidal anti-inflammatory

 

 

wholesale dealing 318

 

 

muscarinic receptors

25

 

 

drugs (NSAIDS)

203–6

 

 

signed orders

318

 

 

 

blockers 27, 38

 

 

 

 

adverse effects 203

 

 

 

 

Optrex Infected Eyes 183

 

 

 

muscles, intraocular

 

33–4

 

 

analgesia 205

 

 

 

 

oral administration

3–4

 

 

 

Mycobacterium tuberculosum

44, 45

 

for dry eye

254

 

 

 

 

oral contraceptives

309–10

 

 

 

Mycoplasma spp. 181

 

 

 

precautions

258

 

 

 

 

organophosphates

132, 133

 

 

 

Mydriacyl see tropicamide

 

 

therapeutic effects 203

 

 

 

oropharyngeal administration 4

 

 

(bistropamide)

 

 

noradrenaline (norepinephrine)

13,

 

Otrivine-antistin 214

 

 

 

mydriasis

 

 

 

 

 

23–5, 28–9

 

 

 

 

oxidative disinfecting solutions

 

 

and cycloplegia

85

 

 

neurohumoral transmission

17, 19

 

166–8

 

 

 

 

 

 

long-term effects

 

101

 

 

receptors 17

 

 

 

 

oxidizing agents 62

 

 

 

mydriatics 38, 79, 82, 107–24, 113

 

storage vesicles 25

 

 

 

 

oxybuprocaine see benoxinate

 

 

adverse effects 120–2

 

 

synthesis 24

 

 

 

 

(oxybuprocaine)

 

 

 

antimuscarinics

111–15, 117

noradrenaline reuptake inhibitors 30

 

oxyphenbutazone

204

 

 

 

contraindications

109–11

norfloxacin 183

 

 

 

 

 

 

 

 

 

 

 

 

dilation difficulties 118–19

Nyogel

232

 

 

 

 

 

 

 

 

 

 

 

 

 

indications 107–9

 

 

nystatin

197

 

 

 

 

 

P

 

 

 

 

 

 

 

mixed 117–18

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

mode of action 111

 

 

 

 

 

 

 

 

 

 

pachometry 145

 

 

 

 

 

 

 

O

 

 

 

 

 

 

 

 

 

 

 

precautions 120, 258

 

 

 

 

 

 

 

 

 

palpebral fissure

40

 

 

 

properties, ideal

107

 

 

 

 

 

 

 

 

 

 

palpebral smooth muscle 34

 

 

sympathomimetics 115–17

oblique illumination test 109–10, 111

 

pancreas, autonomic responses of

15

 

therapeutic uses

108

 

Ocufen

206

 

 

 

 

 

papain 170–1

 

 

 

 

 

Mydrilate see cyclopentolate

ocular first aid see first aid

 

 

 

paper strips

76

 

 

 

 

 

myoneural junctions

20

 

Oculotect

252

 

 

 

 

 

staining

152–3, 154

 

 

 

myopia 101–2

 

 

 

Ocuserts

77, 225

 

 

 

 

parasympathetic nervous system

12,

 

 

 

 

 

 

ofloxacin

183, 184, 269

 

 

 

 

13, 34–5

 

 

 

 

 

 

 

 

 

 

olopatadine (Opatanol)

216, 266, 268

 

parasympathomimetics 38, 40, 119

 

N

 

 

 

 

 

 

 

 

 

 

sale by optometrists

317

 

 

 

drug interactions 287

 

 

 

 

 

 

 

 

ophthalmic dosage forms 67–81

 

for glaucoma 222–5

 

 

 

Naegleria spp. 58

 

 

 

 

collagen shields 78

 

 

 

 

adverse effects 223

 

 

 

N. fowleri

51

 

 

 

 

drug classification 79

 

 

 

contraindications 223

 

 

nalidixic acid

183, 305

 

 

eye lotions

76

 

 

 

 

miotics

126, 127–34

 

 

 

naphazoline

214, 266

 

 

eye ointments 74–6

 

 

 

 

paredrine

116