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Class notes

Sale, supply and administration of ocular drugs - 3rd year

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These comprehensive notes are perfect for any orthoptic students studying their last year with an upcoming medical exemptions exam/module or any practicing orthoptists studying for this additional qualification.

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Uploaded on
August 16, 2023
Number of pages
12
Written in
2022/2023
Type
Class notes
Professor(s)
Helen davis
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Intro and legal classification
 All general list sales, all pharmacy
medicines and the following
prescription meds:
 Atropine, cyclopentolate, tropicamide,
lidocaine with fluorescein,
oxybuprocaine, proxymetacaine,
tetracaine, chloramphenicol, fusidic
acid
 GSL i.e. artificial; tears for dry eye,
pharmacy medicines i.e. phenylephrine
2.5 and 10% for pupil dilation
 PM also include sodium cromoglycate
2%, antazoline 0.5% and
xylometazoline hydrochloride 0.05%
which are used as treatments for
seasonal allergic conjunctivitis and
perennial allergic conjunctivitis




 The module will cover:
 Atropine
 Cyclopentolate
 Tropicamide
 Phenylephrine
 Lidocaine with fluorescein
 Oxybuprocaine
 Proxymetacaine
 Tetracaine
 Chloramphenicol
 Fusidic acid

, Cycloplegia and mydriasis 1
Cycloplegia Drug Notes Cautions Interactions Side effects
 Parasympathetic nervous system innervates ciliary body Minims or Pigmented Other drugs Photophobia
 By administering Atropine 1% multi-use irides with anti- Stinging
cycloplegics/antimuscarinics/parasympatholytic, innervation is muscarinic Confusion, vision disorders
temporarily stopped as the drug competes with acetylcholine on POM Narrow effects Constipation
the post-synaptic membrane of the ciliary muscle angle Dizziness, drowsiness
3mths - (closed Levodopa Dry mouth
 Drug will occupy receptor sites but depolarisation does not
17yrs angle (Parkinson’s) Dyspepsia
occur
glaucoma) Flushing, skin reactions
 This causes the impulse started at the Erdinger-Westphal
Phenylephrine Headache, nausea,
nucleus to be ineffective temporarily so does not travel via 3rd
Neonates – risk of vomiting
CN to activate ciliary muscle
severe Palpitations, tachycardia
 This results in temporary paralysis in accommodation
hypertension Urinary disorders
Use of cycloplegics
Minims or Pigmented Other drugs Abdominal distension
 Paediatric refraction – allows for true refractive state of eye to
Cyclopentolat muti-use irides with anti- Behaviour abnormal
be investigated especially for ET – GS previously atropine 1%
e 0.5% 1% muscarinic Cardio-respiratory distress,
but now is cyclopentolate 1% as it is fast-acting, wears off faster
POM Narrow effects palpitations
but allows for adequate refraction, less likely to cause
angle Constipation, GI disorders,
local/systemic side effects
Risk of (closed Levodopa vomiting
 Amblyopia therapy – atropine 1% in better seeing eye was
amblyopia angle (Parkinspn’s Dry mouth
found to be as effective as patching for 6hrs when instilled 2
in under glaucoma) as absorption Conjunctivitis (prolonged
days a week according to a PEDIG study involving 419 children
3mth olds reduced) administration)
– atropine is longer lasting than cyclopentolate and close
Neonates Flushing
monitoring is vital and is checked by dynamic retinoscopy
3mths – 12 Hyperaemia (prolonged
 Uveitis – particularly anterior uveitis – inflammation of uveal years 1% administration)
tract/iris and ciliary body causing painful uniocular red eye Over 12s Mydriasis
affecting vision – photophobia present and history of 0.5% Urinary disorders
inflammatory disease i.e. rheumatism Psychotic disorder
o Slit lamp shows: Minims or Pigmented Other drugs Eye erythema
 Circum-limbal injection Tropicamide multi-use irides with anti- Eye irritation (prolonged)
 Cells in anterior chamber 0.5% 1% muscarinic Eye pain
 Keratic precipitate POM Narrow effects Hypotension
 Hypopyon angle Nausea
 Misshapen pupil due to posterior synechiae 1% for (closed Levodopa Syncope
 Cyclopentolate 1% given to break refn. in angle Vision blurred
synechiae teens/older glaucoma) Clozapine –
 Steroids to reduce inflammation kids + 1 drp risk of
 Alleviation of accommodative spasm – i.e. in cases of after 5 Neonates intestinal
corneal abrasion, ciliary muscle goes into spasm and mins obstruction
cyclopentolate 1% can be administered to alleviate pain
$15.17
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