scholarly journals Systemic side effects of eye drops: a pharmacokinetic perspective

2016 ◽  
Vol Volume 10 ◽  
pp. 2433-2441 ◽  
Author(s):  
Andre Farkouh ◽  
Peter Frigo ◽  
Martin Czejka
Keyword(s):  
Side Effects ◽  
Eye Drops ◽  
Systemic Side Effects

scholarly journals Ocular and systemic side effects of brimonidine 0.2% eye drops (Alphagan®) in children

Eye ◽  
2004 ◽  
Vol 18 (1) ◽  
pp. 24-26 ◽  
Author(s):  
R J C Bowman ◽  
J Cope ◽  
K K Nischal
Keyword(s):  
Side Effects ◽  
Eye Drops ◽  
Systemic Side Effects

scholarly journals From Eye Drops to ICU, a Case Report of Three Side Effects of Ophthalmic Timolol Maleate in the Same Patient

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Muhammad Asim Rana ◽  
Ahmed Fouad Mady ◽  
Basheer Abdel Rehman ◽  
Abdulrahman Alharthy ◽  
Basim Huwait ◽  
...  
Keyword(s):  
Elderly Patient ◽  
Side Effects ◽  
Beta Blockers ◽  
Systemic Absorption ◽  
Eye Drops ◽  
Timolol Maleate ◽  
Raising Awareness ◽  
Adrenergic Blocker ◽  
Life Threatening ◽  
Systemic Side Effects

Timolol Maleate (also called Timolol) is a nonselective beta-adrenergic blocker and a class II antiarrhythmic drug, which is used to treat intraocular hypertension. It has been reported to cause systemic side effects especially in elderly patients with other comorbidities. These side effects are due to systemic absorption of the drug and it is known that Timolol is measurable in the serum following ophthalmic use. Chances of life threatening side effects increase if these are coprescribed with other cardiodepressant drugs like calcium channel or systemic beta blockers. We report a case where an elderly patient was admitted with three side effects of Timolol and his condition required ICU admission with mechanical ventilation and temporary transvenous pacing. The case emphasizes the need of raising awareness among physicians of such medications about the potential side effects and drug interactions. A close liaison among patient’s physicians is suggested.

New technique to reduce systemic side effects of timolol eye drops: The tissue press method—Cross‐over clinical trial

2019 ◽  
Vol 48 (1) ◽  
pp. 24-30 ◽  
Author(s):  
Luzia Müller ◽  
Berit P. Jensen ◽  
Lucas M. Bachmann ◽  
Dickson Wong ◽  
Anthony P. Wells
Keyword(s):  
Clinical Trial ◽  
Side Effects ◽  
New Technique ◽  
Eye Drops ◽  
Systemic Side Effects ◽  
Press Method

scholarly journals Side effects of 1% cyclopentolate hydrochloride in children and adolescents attended at Centro Universitário FMABC

2020 ◽  
Vol 45 (Suppl.3) ◽  
pp. e020106
Author(s):  
Ianna Luiza Avelino Valentino ◽  
Celso Lopez Fernandez ◽  
Fernando Luiz Affonso Fonseca ◽  
Glaucia Luciano da Veiga ◽  
Vagner Loduca Lima
Keyword(s):  
Side Effects ◽  
Signs And Symptoms ◽  
Point Of View ◽  
Eye Drops ◽  
Ophthalmological Examination ◽  
Vision Disorders ◽  
Ocular Side ◽  
Spontaneous Reversal ◽  
Systemic Side Effects ◽  
Systemic Symptoms

Introduction: It is known that vision disorders are within the context of public health problems. In childhood, during the neuropsychomotor development phase, visual changes are crucial, since there is a strong correlation between poor school performance and changes in acuity. For these reasons, ophthalmological examination in children, including refraction, is extremely important, aiming at the early diagnosis of diseases and possible refractive errors that may compromise the child's life and development. 1% cyclopentolate hydrochloride eye drops are the most used during ophthalmic clinical evaluation as a cycloplegic and mydriatic agent to assist in refractive examination. Objective: The ocular and systemic side effects of 1% cyclopentolate hydrochloride eye drops were studied in patients who underwent static refractive examination in the strabismus sector of the Ophthalmology Discipline of the Centro Universitário FMABC. Methods: A drop of 1% cyclopentolate is instilled in both eyes of each patient and the possible ocular and systemic signs and symptoms presented were observed after 40 minutes and 24 hours after instillation. Results: we expect to find ocular side effects more evident than systemic symptoms in the two evaluation times (40 minutes and 24 hours after instillation). All symptoms (ocular and systemic) are reversed spontaneously. Conclusion: The present study aims to show that the side effects observed by the topical (ocular) use of cyclopentolate eye drops 1% are few and present spontaneous reversal both from an eye point of view, as well as from a systemic point of view.

scholarly journals Safety and efficacy of reconstituted atropine 0.01% eye drops for Indian children with myopic progression

2020 ◽  
Vol 17 (2) ◽  
pp. 209-215
Author(s):  
Vidhya C. ◽  
Kaushik Murali ◽  
Sowmya R.
Keyword(s):  
Side Effects ◽  
Axial Length ◽  
Pupil Size ◽  
Eye Drops ◽  
Spherical Equivalent ◽  
Average Increase ◽  
Indian Children ◽  
Safety And Efficacy ◽  
Systemic Side Effects ◽  
Myopic Progression

Aim: To evaluate safety and efficacy of reconstituted atropine 0.01% eye drops for Indian children with myopic progression. Methods: Fifty children with progressive myopia with their spherical equivalent increasing at least 0.75 D in 6 months (0.75 to 1.50 D) were put on reconstituted atropine 0.01%. Ocular examination, including near vision, near point of accommodation (NPA), pupil size and axial length, was done. Subjective symptoms of glare and photophobia were noted. Systemic side effects were documented. Analysis was done using Microsoft Excel 2010. Results: The average age of patients was 9.5 years (range 5 to 14 years) and they were followed up for 1 year. Average mesopic and photopic pupil size was 5 and 4 mm, respectively. Average NPA was 9 cm. Mean increase in spherical equivalence was 0.18 D over 6 months. Average increase in axial length was 0.12 ± 0.11 mm over 6 months and 0.2 ± 0.29 mm over 1 year. Average increase in spherical equivalent over 6 months was 0.07 ± 0.19 D and over 1 year was 0.32 ± 0.29 D. No systemic side effects were recorded. Conclusion: Reconstituted atropine 0.01% eye drops is safe and efficacious in slowingthe progression of myopia in Indian children.

scholarly journals Systemic side effects with eye drops.

BMJ ◽  
1981 ◽  
Vol 282 (6273) ◽  
pp. 1359-1359 ◽  
Author(s):  
W D Alexander
Keyword(s):  
Side Effects ◽  
Eye Drops ◽  
Systemic Side Effects

scholarly journals Ritka szisztémás gyógyszer-interakció: timololtartalmú szemcsepp és lerkanidipintabletta együttes alkalmazása során ismétlődően jelentkező syncope

2019 ◽  
Vol 160 (8) ◽  
pp. 309-313 ◽  
Author(s):  
Edit Kun ◽  
Lóránt Dienes ◽  
Gábor Simonyi ◽  
Ervin Finta
Keyword(s):  
Side Effects ◽  
Beta Blockers ◽  
Channel Blockers ◽  
Eye Drops ◽  
Negative Results ◽  
Blood Pressure Fall ◽  
Systemic Side Effects ◽  
Systemic Drug ◽  
Pressure Fall

Abstract: The control and planning of the treatment of hypertensive patients need specific attention. As regards concomitant diseases and treatments, glaucoma and the use of eye drops should be taken into consideration. The ingredients of the administered eye drops get through the nasolacrimal canal and can be absorbed by the nasal mucosa. Because of the lack of enterohepatic ‘first pass’ effect, they can act systemically – like after intravenous administration. This way they can cause systemic side effects. The authors present a case of a patient, too, who was examined and medically checked regularly for years with negative results because of repeated syncope. It became clear only at the Hypertension Centre that the timolol-containing combined eye drops caused the symptoms. The authors draw attention to the fact that in the case of systemic side effects which can be connected to beta-blocking agents (blood pressure fall, bradycardia, breathing disturbance, depression), the role of the eye drops should be taken into consideration. At the same time, the possibility of the systemic drug interactions should not be forgotten either. The interaction with dihydropyridine-type calcium-channel blockers can be of great importance. In these cases, after consultation with an ophthalmologist, the glaucoma treatment with eye drops containing beta-blockers should be modified. Orv Hetil. 2019; 160(8): 309–313.

scholarly journals Recent advances in understanding NRF2 as a druggable target: development of pro-electrophilic and non-covalent NRF2 activators to overcome systemic side effects of electrophilic drugs like dimethyl fumarate

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 2138 ◽  
Author(s):  
Takumi Satoh ◽  
Stuart Lipton
Keyword(s):  
Side Effects ◽  
Specific Interaction ◽  
Dimethyl Fumarate ◽  
Carnosic Acid ◽  
European Medicines Agency ◽  
Related Factor ◽  
Inflammatory Phase ◽  
First Case ◽  
Systemic Side Effects ◽  
Transcriptional Pathway

Dimethyl fumarate (DMF) is an electrophilic compound previously called BG-12 and marketed under the name Tecfidera®. It was approved in 2013 by the US Food and Drug Administration and the European Medicines Agency for the treatment of relapsing multiple sclerosis. One mechanism of action of DMF is stimulation of the nuclear factor erythroid 2-related factor 2 (NRF2) transcriptional pathway that induces anti-oxidant and anti-inflammatory phase II enzymes to prevent chronic neurodegeneration. However, electrophiles such as DMF also produce severe systemic side effects, in part due to non-specific S-alkylation of cysteine thiols and resulting depletion of glutathione. This mini-review presents the present status and future strategy for NRF2 activators designed to avoid these side effects. Two modes of chemical reaction leading to NRF2 activation are considered here. The first mode is S-alkylation (covalent reaction) of thiols in Kelch-like ECH-associated protein 1 (KEAP1), which interacts with NRF2. The second mechanism involves non-covalent pharmacological inhibition of protein-protein interactions, in particular domain-specific interaction between NRF2 and KEAP1 or other repressor proteins involved in this transcriptional pathway. There have been significant advances in drug development using both of these mechanisms that can potentially avoid the systemic side effects of electrophilic compounds. In the first case concerning covalent reaction with KEAP1, monomethyl fumarate and monoethyl fumarate appear to represent safer derivatives of DMF. In a second approach, pro-electrophilic drugs, such as carnosic acid from the herb Rosmarinus officinalis, can be used as a safe pro-drug of an electrophilic compound. Concerning non-covalent activation of NRF2, drugs are being developed that interfere with the direct interaction of KEAP1-NRF2 or inhibit BTB domain and CNC homolog 1 (BACH1), which is a transcriptional repressor of the promoter where NRF2 binds.

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