[Various application forms of synthetics in ophthalmology. Synthetics in ophthalmological drug therapy].
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NMR studies for the identification of methadone in sustained release tablets is conducted. Up-field shifts of the N-methyl and phenyl groups of the compound were observed. These changes indicate an increased lipid solubility and therefore better absorptivity of the drug in the current form.
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A prolonged-release derivative of cytosine arabinoside (Ara-C), cytosine arabinoside-agarose bead conjugate (Ara-C-AB), was synthesized and its pharmaceutical and pharmacological characteristics were examined. Ara-C was released successively for considerably long period from Ara-C-AB in vitro. Following intraperitoneal injection of 3H-Ara-C-AB, radioactivity could be detected in plasma and urine of BDF1 mouse for four days, while 3H-Ara-C administered as a free form was excreted completely in the first 24 hr. Increase in lifespan of L1210 leukemia-bearing mice was demonstrated after intraperitoneal injection of Ara-C-AB with both the dosage schedules of three days before and one day after inoculation of L1210 cells at the dose of 30 mg equivalent Ara-C/kg.
The medical service of Deutsche Bundesbahn supervises through its eye-doctors all those employees who, affected to glaucoma caused by shift and stress, are rated approximately 170 per year. The drug carrier Ocusert (Federal Republic of Germany: Chemie Grünenthal) which is applied on most of the glaucomas is discussed-especially with regard to social-medical aspects.
Aqueous fluid was withdrawn from eyes of patients undergoing cataract extraction at various intervals after administration of two drops 2% pilocarpine-HCl in a standard manner. Determination of aqueous pilocarpine concentration was made both by spectroscopy of a ferric hydroxylamine complex and by gas-liquid chromatography. These methods were consistent in indicating that concentration does not rise beyond 5 micrograms/ml at any time following topical instillation. The mean of 71 GLC determinations of aqueous tapped between 2 and 32 minutes after drops was 1.67 micrograms/ml. With assumption of a total chamber volume of 400 microliter, the average total pilocarpine in aqueous in these circumstances is less than 1 microgram. These findings correlate well with investigations of transcorneal flux of pilocarpine for the rabbit in a partial in vitro transport chamber system, with which comparable low flux efficiency was found after simulated drop administration. This serves to validate in some measure in extrapolation of other findings in chamber experiments to the living human eye. The combined in vitro and in vivo experimental results suggest that two distinct mechanisms govern the flux of pilocarpine across the cornea. High doses, comparable to those in standard clinical use, whether administered in drops or in constant flow, are transported inefficiently with kinetics indicating a diffusional mechanism and are associated with intracorneal retention or degradation of a substantial moiety. Low doses, if continuously applied, are much more efficiently transported. Hydrogel polymer vehicles appear to mobilize this low-dose mechanism by retaining drug against mechanical dissipation and elution by tear flow, but also by retaining drug against the capability of the cornea to take up more pilocarpine than can be transported to produce an intracorneal drug "depot." Although the exact nature of the "depot" is not clear, it is not elutable as pharmacologically active drug. It is consistently associated with the relatively poor flux efficiency found with high doses, and thus may act in some manner to disable a more efficient mechanism. The flux efficiency found with hydrogel mediation is more than double the best found in constant flow determinations. Vehicular mediated flux is rate limited by the cornea, independent of dose, linear with time despite exponentially secreasing available drug, and not associated with an intracorneal drug "depot." These features are consistent with carrier mediation of some type.
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The parenteral long-acting phenothiazines are drugs frequently used in the treatment of hospitalized and ambulatory psychiatric patients. The usual side effects of these drugs are familiar to psychiatrists. However, the "Neuroleptic malignant syndrome" reported in this paper can give rise to considerable diagnostic difficulty. The clinical characteristics and differential diagnosis of this syndrome are described with a care report. The need for prompt initiation of adequate therapy is stressed.
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Within the conditions of the double-blind trial, it appears that long-acting amitriptyline (Diffucaps), given at the dosage of 25 mg at the evening meal, is more active and better tolerated than a dosage of 40 mg of ordinary amitriptyline at bedtime in depressive sleep disorders.
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