Therapeutics News

Viroptic (trifluridine 1%, Glaxo) is an antiviral that is currently the drug of choice for treating primary keratoconjunctivitis and recurrent epithelial keratitis caused by herpes simplex virus (HSV) type 1 (oral) or type 2 (genital). It is also indicated for treating HSV keratitis that has not responded to idoxuridine or vidarabine (Vira-A, Parke-Davis). It is not indicated for other common forms of viral conjunctivitis.

Voltaren (diclofenac sodium 0.1%, Ciba Vision Ophthalmics) was initially approved for treatment of postoperative inflammation following cataract surgery. Some surgeons switched to Voltaren as their drug of choice after cataract surgery, but most continued to use the time-proven anti-inflammatory prednisolone acetate 1%. Reports and studies began to conclude that Voltaren did help relieve pain after injury or anterior segment surgery, especially radial keratotomy (RK).

I was asked the following question at a pharmaceutical advisory meeting a few years ago: "What new drug would you like to see available for your patients?" My answer was: "A combination antihistamine/mast-cell inhibitor to improve convenience and compliance for my patients now having to use two ophthalmic allergy drops, with each being used four times per day."

ST. ANN, Mo. - In solo private practice here, Donald E. Walter Jr., OD, believes good patient care is more than just educating the patient.

TobraDex (tobramycin dexamethasone, Alcon) is a widely used suspension drop or ointment for postoperative prophylaxis for infection and postsurgical inflammation. Because tobramycin is effective against a wide range of bacteria, this combination drug is also an effective tool against bacterial conjunctivitis with moderate to severe inflammation of the ocular tissue. The dexamethasone is a strong steroid that suppresses the body's autoimmune responses, inhibiting inflammation of the ocular tissue.

Interesting reports have surfaced recently in the ophthalmic literature regarding surprising ocular side effects purportedly attributed to various topical ophthalmic and oral systemic medications. The effects of these drugs vary considerably in that some are detrimental while others are relatively innocuous or, in some instances, potentially beneficial. Further research and publication in peer-reviewed form is necessary to substantiate these observations.

BETHESDA, Md. — The results of a new study conducted to determine the optimum dosing plan for a leading anti-allergy drug suggest "as-needed" dosing may be effective in relieving ocular discomfort for patients suffering symptoms of allergic conjunctivitis. The Food and Drug Administration (FDA) approved Livostin in 1994 based on studies of four times daily use for a maximum of 2 weeks.

Polysporin ointment (polymyxin B sulfate/bacitracin zinc, Glaxo Wellcome) is a broad-spectrum antibiotic that has been used for many years, causing few reactions while providing excellent therapeutic results. The antibiotic ointment has been my choice for treating the most common infection we encounter in optometric practice: blepharitis. Eyelid disease associated with Staphylococcus infection is a commonplace occurrence that requires maintenance treatment as the disease waxes and wanes throughout the patient’s lifetime.

Practitioner use of anti-infectives has undergone considerable change in the past few years, as they have waged an ongoing battle with infectious organisms. The continuing emergence of resistant bacteria has continued to confound prescribers. However, in other areas the struggle has tilted in favor of the eye care professional: powerful, new broad-spectrum agents and formulations have been developed and extensive research has helped all prescribers — from the primary care giver to the surgeon — hone and refine their treatment regimens.

The combination drug neomycin and polymyxin B sulfates and dexamethasone (Maxitrol, Alcon and Dexacidin, Ciba Vision) has been approved since October 1964. It is available in suspension or ointment form and is an inexpensive, broad-spectrum drug that can be used to treat many eye inflammations.