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Monographs of Topical Drugs that Have Caused Contact Allergy/Allergic Contact Dermatitis
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
Cromoglicic acid (better known as cromolyn) is a mast cell stabilizer with anti-inflammatory activity. It probably interferes with the antigen-stimulated calcium transport across the mast cell membrane, thereby inhibiting mast cell release of histamine, leukotrienes, and other substances that cause hypersensitivity reactions. Cromoglicic acid also inhibits eosinophil chemotaxis. It is used as inhalation aerosol in the prophylactic treatment of both allergic and exercise-induced asthma, but does not affect an established asthmatic attack. In eye drops, it has been used to treat allergic conjunctivitis and vernal keratoconjunctivitis and it is useful as nasal spray in patients with allergic rhinitis. In oral form, sodium cromoglycate may prevent allergic reactions to foods which cannot be avoided. In pharmaceutical products, cromoglicic acid is employed as its sodium salt cromolyn sodium (sodium cromoglycate, disodium cromoglycate) (CAS number 15826-37-6, EC number 239-926-7, molecular formula C23H14Na2O11) (1).
Adherence and the Elderly
Published in Lynn B. Myers, Kenny Midence, Adherence to Treatment in Medical Conditions, 2020
James C. McElnay, C. Rosaleen McCallion
Accurate administration of eye-drops is particularly important when treating glaucoma, a not uncommon condition in elderly patients. A number of devices such as Auto-Drop®, Easidrop® and Opticare® are available to help with aiming the drop. The Opticare® devise also aids squeezing the eye-drop bottle (Rivers, 1992). A range of other devices are available for use with inhalers, where co-ordination of firing the dose and inhaling can be particularly problematic in elderly patients.
Corneal Defects, Abrasions and Foreign Bodies
Published in Amy-lee Shirodkar, Gwyn Samuel Williams, Bushra Thajudeen, Practical Emergency Ophthalmology Handbook, 2019
Debride: If the epithelium is irregular around the defect it should be debrided to aid healing. Use of lubricating eye drops also promotes epithelial healing and helps to alleviate discomfort. In cases of corneal abrasions acquired through sharp cut trauma, it might be beneficial to continue long term lubricating drops and ointment to reduce the risk of recurrent erosion syndrome occurring at a later date.
Evaluation of corneal staining with an antihistamine-releasing contact lens
Published in Clinical and Experimental Optometry, 2023
Multi-dose eye drops are commonly prescribed by eye care professionals to treat ophthalmic diseases such as glaucoma, ocular infection, and allergic conjunctivitis. However, there are a number of potential limitations associated with delivering therapeutics via eye drops, including inefficient drug delivery and patient difficulties with application. Eye drops can suffer from low bioavailability – the proportion of drug accessible to the site of physiological activity – due to tearing and blinking after drop instillation, which can reduce the drug concentration to non-therapeutic levels.1–3 Eye drops can also suffer from poor patient compliance; for example, approximately 27% of glaucoma patients omit prescribed doses,4,5 and as many as 80% demonstrate improper administration technique (e.g., contaminating the dropper tip).6 In addition, multi-dose eye drops may require preservatives, which can cause side-effects at the ocular surface and other parts of the eye.7,8
A review of dry eye disease therapies: exploring the qualities of varenicline solution nasal spray
Published in Expert Review of Ophthalmology, 2023
Siddharth Bhargava, Ranjani Panda, Asma M Azam, John D Sheppard
Current therapies for symptomatic relief of dry eye include over-the-counter lubricant eye drops and ointment. Some common over-the-counter drops contain active ingredients such as hyaluronic acid, carboxymethylcellulose sodium 5% or polyethylene glycol 0.4% and propylene glycol 0.3% to aid in symptom relief [39]. These ingredients work by supplementing viscosity and coating by the ocular tear film and have been shown to improve the Ocular Surface Disease Index (OSDI) score in dry eye patients [40]. Lubricating ointments with ingredients such as mineral oil and white petrolatum have also become available over the counter with increased residence time serving as the main advantage over lubricating drops. Some ointments, especially those which contain mineral oil, have also been shown to increase the thickness of the lipid layer in the tear film and therefore, increase the tear breakup time [41]. Though lubricating drops and ointments aid primarily through symptomatic relief and at least a temporary decrease in osmolarity, they cannot replace the eye’s natural tear film, nor do they offer sustained surfaced action.
Sustained release glaucoma therapies: Novel modalities for overcoming key treatment barriers associated with topical medications
Published in Annals of Medicine, 2022
Aditya Belamkar, Alon Harris, Ryan Zukerman, Brent Siesky, Francesco Oddone, Alice Verticchio Vercellin, Thomas A. Ciulla
There is a depth of emerging research that is aimed at developing alternative SR therapies for glaucoma, including contact lens delivery systems. As opposed to topical eye drops, which generally have a bioavailability less than 5%, contact lenses present a favourable alternative as they are able to be placed directly on the cornea separated only by the post-lens tear film [81]. Contact lenses purport to present several advantages to topical eye drops. Contact lenses may retain drugs in the tear film for upward of 30 min, versus two minutes for topical eye drops, a time difference which may increase drug bioavailability by upwards of 50% [86–88]. Additionally, contact lenses present advantages related to ease of wear, direct contact with the ocular surface, and hydrogel composition. Traditional hydrogel contact lenses allow for molecular movement of water and nutrients to the corneal surface, so approaches using this delivery system have focused on soaking hydrogel lenses in concentrated solutions of active pharmaceuticals [81].