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lacrisert
Indication
and
usage:
including
LACRISERT
is
*
*
*
also
keratoconjunctivitissicca.
indicated
for
Exposure
treatment
of
Decreased
patients
with:
keratitissicca.
dry
corneal
eye
syndromes
sensitivity
Contraindications:
B) Soluble
ocular
drug
insert
(SODI):
blur
vision
while
the
polymer
is
dissolving.
SODI
C)
It consists of contoured disc with convex front and concave back surface in contact with eyeball.
Diameter-4-5mm.
The symmetric circular design of the minidisc in contrast with the elliptical or rod shape elimination the need to align a
particular geometric axis of device with eyelid margin.
Can be hydrophilic or hydrophobic to permit extended release of both water soluble and insoluble drugs.
Ex. Sulfisoxazole (poorly water soluble) incur-orrate in hydrophilic matrix and drug was release for 170 hrs.
Gamma irradiation and heat exposure,slow down drug release because cross linking of polymer matrix.
Advantages:
Disadvantages:
Patient discomfort.
Ocular Inserts
Insertsaresolidorsemisoliddosageformswithoutdisadvantagesoftraditionalophthalmicdrugforms[5,21].Theyare
lesssusceptibletodefencemechanismslikeoutflowthroughnasolacrimalduct,showtheabilitytostayinconjunctivalsac
foralongerperiod,andaremorestablethanconventionaldosageforms.Theirundoubtableadvantagesoverconventional
formsarealsoaccuratedosing,thepossibilityofslowsubstancereleasewithconstantspeed,andlimitingitssystemic
absorption.Moreover,usingthemenablesreductionofthedrugapplicationfrequency,aswellasadverseeffectsand
blurring of vision occurrence [8,21]. Polymeric materials most often employed in developing inserts include, for
example, methylcellulose [22] and its derivatives, that is, hydroxypropyl methylcellulose (HPMC) [8,2123],
ethylcellulose[22,24,25],polyvinylpyrrolidone(PVPK90)[8,21,25],polyvinylalcohol[8,23],chitosan[21]and
itsderivatives,likecarboxymethylchitosan[22],gelatin[24,26],andvariousmixturesoftheaforementionedpolymers.
Employed polymers indicate the division of inserts into soluble, insoluble, and biodegradable. A wellknown insert
Ocusert (Alza Corporation), built from copolymer of ethylene and vinyl acetate, is an example of insoluble insert,
containingpilocarpineasanactiveingredient[5,8,27].Themainfactorslimitingtheemploymentofinsertsinthe
therapyarestillpatientsunwillingnesstoabandontraditionaldosageforms,thefeelingofforeignbodyintheeye,and
sporadicfailuresinusingandintroducinginserts,suchasunnoticedexcretionfromtheeye[4,5,21,27].
2.3.3. SODI (Soluble Ophthalmic Drug Inserts)
SODIaresolubleeyeinsertsintheformofsmallovalwafers,producedfromacrylamide,vinylpyrrolidone,andethyl
acrylate.Aftertheirapplicationtoconjunctivalsac,theyaremoistenedbytearfluid,andthentheysoftenandadhereto
eyeballsurface.Thisdosageformwasoriginallydevelopedforastronautstoapplyitinthestateofweightlessness.Drugis
releasedfromSODIinapulsational,uncontrolledmanner,andthedosageformensuresitsprolongedeffect.Active
ingredients employed in the course of research on SODI include neomycin, kanamycin, atropine, pilocarpine,
dexamethasone,sulfapyridine,andtetracaine[4,28,29].
2.3.4. Minidiscs/OTS (Ocular Therapeutic System)
Minidiscisaprofiled,convexoutside,concavefromthesideofcontactwitheyesurface,dosageformsimilartoacontact
lens with 45mm diameter. Main copolymers from which minidiscs are developed are bis(4methacryloxy)butyl
poly(dimethylsiloxane)andpoly(hydroxyethylmethacrylate).Thisdosageformmaybeeitherhydrophilicorhydrophobic,
which enables extended time period of release of watersoluble and poorly watersoluble drugs. Active ingredients
employedinresearchonminidiscswere,amongothers,sulfisoxazoleandgentamicinsulfate[2,4,28,30].