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I am an ophthalmologist and part of my teaching responsibilities is
teaching residents the pharmacokinetics, pharmacodynamics etc of
antimicrobial agents (anti-bacterial, viral, fungal, etc.) as related to
the eye (e.g. corneal, scleral penetration, etc.) including topical
therapy, local injection, and systemic administration.
Any and all help regarding a syllabus and other teaching aids would be
greatly appreciated. Thank you.
Martin Mayers, MD
Director, Department of Ophthalmology
Bronx Lebanon Hospital Center
Albert Einstein College of Medicine
M_Mayers.-a-.Juno.com
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Any bibliography should include papers by Mike Barza, MD. You should also
check the textbook, Antibiotics in Laboratory Medicine, by Victor Lorian, ed.
SCE
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Although they do not address antimicrobials specifically, here some
excellent extensive general reviews of ocular pharmacokinetics:
In: Ophthalmic Drug Delivery Systems edited by Ashim K. Mitra
Ch. 4. Ocular Pharmacokinetics/Pharmacodynamics (by Schoenwald)
Ch. 8 Mathematical Models of Ocular Drug Transport and Disposition
(by Himmelstein)
In: Pharmacology of the Eye edited by M.L. Sears (Handbook of Experimental
Pharmacology Series vol. 69)
Ch. 2 Ocular Pharmacokinetics (by Maurice and Mishima)
Hope these are helpful.
Paul Damian
**********************************************************************
Paul Damian PhD, MPH phone (916) 752-7507
Program Coordinator, Western Region fax (916) 752-0903
Food Animal Residue Avoidance Databank farad.at.ucdavis.edu (FARAD)
Dept. of Environmental Toxicology pdamian.-at-.ucdavis.edu (personal)
University of California
Davis, CA 95616
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Suggestions for course syallabus:
A. Drug tear film kinetics
1. initial tear concentrations
2. drainage/spillage
3. tear turnover
4. systemic absorption
B. Formulation effects
1. viscosity
2. suspensions
3. ointments/gels
4. ocuserts
5. drug concentration
6. osmolarity
` 7. contact lenses
C. Corneal Penetration
1. 3 layers
D. Drug characteristics and ocular penetration
1. molecular size
2. water solubility
3. protein binding
4. susceptibility to active transport processes
E. Periocular admin
1. Subconjunctival inj
2. Subtenons inj
3. Retrobulbar inj
F. Intravitreal inj
Here are excellent articles you may find helpful:
Antimicrobial Drug Delivery to the Eye by Timothy S. Lesar and Richard G.
Fiscella
Drug Intelligence and Cliniccal Pharmacy 1985 sept Vol 19 p 642
Ocular Drug Delivery by Ronald D. Schoenwald Clin. Pharmacokinet 18
(4):255-269 1990
I just finished a course section on ocular pharmacokinetics and have many more
references. The most important factors I feel should be taught to future
prescribers
are:
1. the cornea saturates so while 1 gtt is good, 2 gtts is a waste of time
and money
for some drugs eg. timolol
2. tear film kinetics: the eye can only hold 30 ul transiently and the
tear film
takes up 10ul----a gtt contains 50ul----do the math!!! pretty expensive to
have drug
on the cheek.
3. practical dosing concerns: Write on the RX to space gtts by 5-15 mins. and
use NLO.
I find this topic extremely interesting and if you would like further
imput, please
let me know. I have many graphs, charts, etc you may find helpful.
Sincerely,
Carol Noreen Carson, R.Ph.
--
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Thanks for the recommendations on ocular antimicrobial pharmacokinetics.
Any information on antibiotic pharmacokinetics into biofilms ( and
applications to ocular infections, if such data exists) would also be
apppreciated. Thanks again.
Marty Mayers
M_Mayers.-at-.Juno.com
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