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Detailed explanation about Miotics, Mydriatics, and Cycloplegics for all optoms, ophthalmic assistants and DNB doctors.
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Here's a short overview about psychostimulant drugs, which will act on various areas of CNS(brain) and produce several effects and *it has the greater potential to get misused by the abusers especially youngsters* even it has been used for therapeutic purposes also as described in the PPT
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Miotics are drugs that cause constriction of pupil. The commonly used miotics belong to two groups a) parasympathomimetics (contraction of circular fibres of iris) b) sympatholytics (relaxing dilator pupillae muscle) Mydriatics are drugs that dilate the pupil while cycloplegics are agents that cause paralysis of ciliary muscle (paralysis of accommodation) The commonly used mydriatics belong to two groups a) sympathomimetics b) parasympatholytics MIOTICS Agents which cause constriction of pupil These are used in the management of glaucoma and the treatment of esotropias and accommodation insufficiency. Pilocarpine Direct acting parasympathomimetic drug Duplicates the muscarinic effects of acetylcholine (M3 receptor), but has no nicotinic effects. It is effective in the treatment of glaucoma by decreasing intraocular tension improves the aqueous humor outflow Decreases aqueous secretion. Onset of miosis occurs within 10-30 mins and lasts for 4-8 hours following topical application. Indications and Usage The control of intra-ocular pressure in angle closure glaucoma. To reverse mydriasis caused by a cycloplegic agent. In the treatment of accommodative strabismus. Controversial role in the treatment of hyphaema. After cataract extraction in cases of intra capsular cataract extraction Adverse effects Visual blurring poor dark adaptation caused by the failure of the pupil to dilate in reduced illumination Brow pain Nausea Diarrhoea Sweating Bronchospasm Dosage and Administration Pilocarpine nitrate, a sterile ophthalmic solution is available as 1%, 2% or 4% drops To aid in emergency miosis, 1 to 2 drops of one of the higher concentrations should be used. Carbachol Carbachol is a direct acting parasympathomimetic that is used when allergy or resistance to pilocarpine develops It has both nicotinic and muscarinic actions and also partially inhibits cholinesterase Available as 0.75 % - 3 % drops. Used for lowering intra-ocular pressure and pupillary constriction in the treatment of glaucoma. When instilled into the eye, it mimics the effects of Ach, causing miosis and spasm of accommodation in which the ciliary muscle of the eye remains in a constant state of contraction. Onset of action = 10-20min Intraocular pressure is reduced for 4-8hrs. Adverse effects Little or no side effects occur due to lack of systemic penetration Dosage and Administration It is administered three to four times per day. Physostigmine Sulphate An indirectly acting parasympathomimetic agent which is reversible anticholine-esterase. Given as 0.25% eye drops with 2% pilocarpine nitrate. The mechanism of action involves inhibition of choline-esterase with consequent accumulation of acetylcholine at the neuromuscular junctions. Topical application produces miosis which lasts for 6-24hrs. Dosage and Administration 0.1-1% eye drops It is administered every 4 to 6 hours Adverse Reaction Twitching Irritation allergic reaction Depigmentation of the eye lid skin
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Miotics mydriatics cycloplegics
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Here's a short overview about psychostimulant drugs, which will act on various areas of CNS(brain) and produce several effects and *it has the greater potential to get misused by the abusers especially youngsters* even it has been used for therapeutic purposes also as described in the PPT
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Poisoning is under the subject of Bio-assay and Toxicology, useful for the pharmacy and medical or students.
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it contains almost all the drugs which causing ocular toxicity.hope will useful for u guyz
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Miotics are drugs that cause constriction of pupil. The commonly used miotics belong to two groups a) parasympathomimetics (contraction of circular fibres of iris) b) sympatholytics (relaxing dilator pupillae muscle) Mydriatics are drugs that dilate the pupil while cycloplegics are agents that cause paralysis of ciliary muscle (paralysis of accommodation) The commonly used mydriatics belong to two groups a) sympathomimetics b) parasympatholytics MIOTICS Agents which cause constriction of pupil These are used in the management of glaucoma and the treatment of esotropias and accommodation insufficiency. Pilocarpine Direct acting parasympathomimetic drug Duplicates the muscarinic effects of acetylcholine (M3 receptor), but has no nicotinic effects. It is effective in the treatment of glaucoma by decreasing intraocular tension improves the aqueous humor outflow Decreases aqueous secretion. Onset of miosis occurs within 10-30 mins and lasts for 4-8 hours following topical application. Indications and Usage The control of intra-ocular pressure in angle closure glaucoma. To reverse mydriasis caused by a cycloplegic agent. In the treatment of accommodative strabismus. Controversial role in the treatment of hyphaema. After cataract extraction in cases of intra capsular cataract extraction Adverse effects Visual blurring poor dark adaptation caused by the failure of the pupil to dilate in reduced illumination Brow pain Nausea Diarrhoea Sweating Bronchospasm Dosage and Administration Pilocarpine nitrate, a sterile ophthalmic solution is available as 1%, 2% or 4% drops To aid in emergency miosis, 1 to 2 drops of one of the higher concentrations should be used. Carbachol Carbachol is a direct acting parasympathomimetic that is used when allergy or resistance to pilocarpine develops It has both nicotinic and muscarinic actions and also partially inhibits cholinesterase Available as 0.75 % - 3 % drops. Used for lowering intra-ocular pressure and pupillary constriction in the treatment of glaucoma. When instilled into the eye, it mimics the effects of Ach, causing miosis and spasm of accommodation in which the ciliary muscle of the eye remains in a constant state of contraction. Onset of action = 10-20min Intraocular pressure is reduced for 4-8hrs. Adverse effects Little or no side effects occur due to lack of systemic penetration Dosage and Administration It is administered three to four times per day. Physostigmine Sulphate An indirectly acting parasympathomimetic agent which is reversible anticholine-esterase. Given as 0.25% eye drops with 2% pilocarpine nitrate. The mechanism of action involves inhibition of choline-esterase with consequent accumulation of acetylcholine at the neuromuscular junctions. Topical application produces miosis which lasts for 6-24hrs. Dosage and Administration 0.1-1% eye drops It is administered every 4 to 6 hours Adverse Reaction Twitching Irritation allergic reaction Depigmentation of the eye lid skin
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Optometers are subjective if the patient judges the clarity of the retinal image or objective when the machine or examiner does it. Subjective optometers control the focus of the retinal image and are used to determine when a target is conjugate to the retina. Objective optometers measure the defocus or disconjugacy of the retinal image and the stimulus target. There are also measures of accommodation that measure characteristics of the crystalline lens such as front surface curvature via the third Purkinje image. SIMPLE OPTOMETER: The simple optometer is a plus lens placed in the anterior focal plane or spectacle plane of the eye. The virtual image of objects placed before the lens can be imaged from infinity to close to the spectacle plane, simply by moving the target from the anterior focal plane of the lens to the lens plane respectively. The virtual image distance is calculated from the Gaussian equation 1/u + F = 1/v where: u= object distance, v=image distance, F = focal power One problem with the simple optometer in the measurement of accommodation is that the image increases in size with proximity so that you have both size and blur cues to accommodation. BADAL OPTOMETER: Invented by Jules Badal in 1876, who is French scientist The Badal optometer utilizes a plus lens placed so that its posterior focal plane is coincident with the anterior focal plane of the eye. This instrument keeps image size constant while varying target distance and stimulus to accommodation. The optical system is telecentric in both the object and image space, that is, the rays are parallel. NAGEL OPTOMETER: The Nagel optometer is based on a similar concept. Here ,a plus lens whose posterior focal plane is coincident with the nodal point of the eye. It also keeps image size constant with changing object distance. SUBJECTIVE OPTOMETERS For Δz = 0, the light emerging from the lens is collimated (i.e. object at infinity) For Δz > 0, the light emerging from the lens is diverging. The object appears in front of eye, so will be in focus for myopes. For Δz < 0, the light emerging from the lens is converging. The virtual image is behind the eye, so will be in focus for hyperopes. STIGMATOSCOPY: Combine of Simple and Badal lens optometers with various visual stimuli to enhance the sensitivity of subjective measures by improving sensitivity to blur detection. The stigmascope enhances blur perception with a small point source as the target viewed through the optometer lens. When the image of the point source is seen clearly and sharply, it is optically conjugate to the fovea. At the same time, this image may be introduced so that the eye can be fixating some other target which acts as the stimulus to accommodation such as Snellen chart. Bracketing the measures of positive and negative blur of the stigma allows you to estimate the accommodative response. SCHEINER’S PUPIL: Scheiner developed a double pupil that causes images viewed through it to app
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Optometers are subjective if the patient judges the clarity of the retinal image or objective when the machine or examiner does it. Subjective optometers control the focus of the retinal image and are used to determine when a target is conjugate to the retina. Objective optometers measure the defocus or disconjugacy of the retinal image and the stimulus target. There are also measures of accommodation that measure characteristics of the crystalline lens such as front surface curvature via the third Purkinje image. SIMPLE OPTOMETER: The simple optometer is a plus lens placed in the anterior focal plane or spectacle plane of the eye. The virtual image of objects placed before the lens can be imaged from infinity to close to the spectacle plane, simply by moving the target from the anterior focal plane of the lens to the lens plane respectively. The virtual image distance is calculated from the Gaussian equation 1/u + F = 1/v where: u= object distance, v=image distance, F = focal power One problem with the simple optometer in the measurement of accommodation is that the image increases in size with proximity so that you have both size and blur cues to accommodation. BADAL OPTOMETER: Invented by Jules Badal in 1876, who is French scientist The Badal optometer utilizes a plus lens placed so that its posterior focal plane is coincident with the anterior focal plane of the eye. This instrument keeps image size constant while varying target distance and stimulus to accommodation. The optical system is telecentric in both the object and image space, that is, the rays are parallel. NAGEL OPTOMETER: The Nagel optometer is based on a similar concept. Here ,a plus lens whose posterior focal plane is coincident with the nodal point of the eye. It also keeps image size constant with changing object distance. SUBJECTIVE OPTOMETERS For Δz = 0, the light emerging from the lens is collimated (i.e. object at infinity) For Δz > 0, the light emerging from the lens is diverging. The object appears in front of eye, so will be in focus for myopes. For Δz < 0, the light emerging from the lens is converging. The virtual image is behind the eye, so will be in focus for hyperopes. STIGMATOSCOPY: Combine of Simple and Badal lens optometers with various visual stimuli to enhance the sensitivity of subjective measures by improving sensitivity to blur detection. The stigmascope enhances blur perception with a small point source as the target viewed through the optometer lens. When the image of the point source is seen clearly and sharply, it is optically conjugate to the fovea. At the same time, this image may be introduced so that the eye can be fixating some other target which acts as the stimulus to accommodation such as Snellen chart. Bracketing the measures of positive and negative blur of the stigma allows you to estimate the accommodative response. SCHEINER’S PUPIL: Scheiner developed a double pupil that causes images viewed through it to app
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Physiology of reproduction
Minor complaints during pregnancy
Minor complaints during pregnancy
Diagnosis of pregnancy
Diagnosis of pregnancy
Antenatal care
Antenatal care
Postpartum mood disorders
Postpartum mood disorders
Normal and abnormal puerperium
Normal and abnormal puerperium
Version
Version
Vacuum extraction (ventouse)
Vacuum extraction (ventouse)
Symphysiotomy
Symphysiotomy
Forceps delivery
Forceps delivery
Episiotomy
Episiotomy
Caesarean section
Caesarean section
Normal labour
Normal labour
Anatomy of the foetal skull
Anatomy of the foetal skull
Anatomy of the female pelvis
Anatomy of the female pelvis
Active management of normal labour
Active management of normal labour
Thyrotoxicosis in pregnancy
Thyrotoxicosis in pregnancy
Cns stimulants
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CNS Stimulants
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