Hypersensitivity reactions to ophthalmic products
ABSTRACT Adverse reactions after administration of ophthalmic products have frequently been observed. These reactions can be provoked by both active principles and excipients. Different pathogenic mechanisms have been suggested for such reactions, including immunologic ones. Basophils and mast cells participate in IgE-mediated reactions through the release of mediators like histamine and tryptase, whereas a T-cell-mediated pathogenic mechanism is involved in most delayed reactions, particularly conjunctival ones and eyelid dermatitis. Prick tests and immediate-reading intradermal tests are carried out to diagnose immediate hypersensitivity reactions, while patch tests are usually performed to evaluate delayed reactions. Other diagnostic tests, such as serum-specific IgE assays in immediate reactions, as well as delayed-reading intradermal tests and/or lymphocyte transformation tests in delayed ones, are rarely performed. In this review, particular attention is addressed to the clinical and practical aspects of both cell-mediated and IgE-mediated hypersensitivity reactions to ophthalmic products.
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ABSTRACT: Identifying contact allergens in ophthalmic medications can be a challenging and daunting experience. We summarize data on topical ophthalmic medications with the potential to cause periorbital contact dermatitis and allergic conjunctivitis, highlighting current dilemmas and controversies in this area. The following groups of allergens are reviewed: preservatives, antiglaucoma medications (prostaglandin analogues, β-blockers, carbonic anhydrase inhibitors, parasympathomimetics, sympathomimetics), antiinflammatory medications (nonsteroidal antiinflammatory drugs, corticosteroids), antibiotics, antivirals, antiallergic medications (antihistamines, cromones), anaesthetics, mydriatics, and cycloplegics.Clinics in dermatology 05/2011; 29(3):295-9. DOI:10.1016/j.clindermatol.2010.11.008 · 1.93 Impact Factor
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ABSTRACT: A surprisingly large proportion of new chemical entities (NCE) are emerging from the drug discovery pipeline, and many active components extracted from herbal medicines are water insoluble, which represents a great challenge for their development. Nanosuspensions, which are submicron colloidal dispersions of pure drug particles that are stabilised by a small percentage of the excipients, could dramatically enhance the saturated solubility, dissolution rate and adhesion of drug particles to cell membranes. Nanosuspensions are the most suitable for drugs that require high dosing or have limited administrative volume. After 20 years of development, several oral products and one injectable product are commercially available. The aim of this review is to fill the gap between rational formulation designs and the in vivo performance of poorly water-soluble drug nanosuspensions. Specifically, this review will correlate characteristics of nanosuspension formulations, including drug property, particle size, crystallinity, stabiliser and surface property, with their transport, pharmacokinetics, bioactivity and toxicity after delivery by different administration routes. The elucidation of the mechanisms of targeted drug delivery, cellular transport and internalisation of nanosuspensions are also reviewed to interpret the in vivo performance of these nanosuspensions. Moreover, the recent application of nanosuspensions for poorly water-soluble herbal medicines is highlighted.Current pharmaceutical design 05/2013; DOI:10.2174/13816128113199990403 · 3.29 Impact Factor