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European Journal of Pharmaceutical... Mar 1999The present study investigated the influence of the rheological behaviour, the viscoelasticity and surface tension of various viscolysers on the weight of drops...
The present study investigated the influence of the rheological behaviour, the viscoelasticity and surface tension of various viscolysers on the weight of drops dispensed from a commercially available flexible dropper bottle. Furthermore, the effect of the concentration and molecular weight of some viscolysers and the angle at which the dropper bottle is held, were studied. Up to a value of 25 mPa x s, the viscosity and the rheological behaviour of the solution had no significant influence on the drop weight under conditions simulating patient manipulation. The lower the dynamic surface tension of the solution, however, the lower the weight of drops delivered. The dispensing angle (90 or 45 degrees) of the dropper bottle, on the other hand, had an impact on the weight of drops dispensed.
Topics: Chemical Phenomena; Chemistry, Physical; Excipients; Ophthalmic Solutions; Rheology; Surface Tension; Viscosity
PubMed: 9971918
DOI: 10.1016/s0928-0987(98)00036-0 -
European Journal of Pharmaceutics and... Mar 1998The influence of the physicochemical properties of various penetration enhancers on the weight of drops dispensed from flexible plastic dropper bottles was examined. Two... (Comparative Study)
Comparative Study
The influence of the physicochemical properties of various penetration enhancers on the weight of drops dispensed from flexible plastic dropper bottles was examined. Two dropper tips with a different design were compared and the dropper bottle was held in the upright position (90 degrees angle) or at a 45 degrees angle. These two angles were chosen to simulate the manipulation of an eye dropper bottle by the patient. The surface tension of the penetration enhancer solutions was determined using the dynamic drop volume method. The dynamic surface tension values ranged from 65 to 30 mN/m. The lower the surface tension of the solution, the lower the weight of the drop delivered. Both the design of the dropper tip and the manipulation technique of the dropper bottle had a moderate to important influence on the drop weight. The relationship between the surface tension of the penetration enhancer solution instilled and the comfort of the patient was evaluated by an acceptability test based on answering a questionnaire. Penetration enhancers can be used to reduce the drop size of conventional ophthalmic solutions on condition that they do not elicit local irritation.
Topics: Chemistry, Pharmaceutical; Ophthalmic Solutions; Pharmaceutic Aids; Surface-Active Agents
PubMed: 9704916
DOI: 10.1016/s0939-6411(97)00114-8 -
Pharmacotherapy 1998Edetate disodium (EDTA) and benzalkonium chloride (BAC) are often present as preservative or stabilizing agents in nebulizer solutions used to treat asthma and chronic... (Review)
Review
Edetate disodium (EDTA) and benzalkonium chloride (BAC) are often present as preservative or stabilizing agents in nebulizer solutions used to treat asthma and chronic obstructive pulmonary disease. Benzalkonium chloride is a potent bronchoconstrictor when inhaled in concentrations similar to those in which it is present in these solutions. Inclusion of BAC (together with EDTA) in the ipratropium bromide (Atrovent) nebulizer solution resulted in paradoxic bronchoconstriction in some asthmatic patients and an overall reduction in bronchodilator efficacy. The presence of BAC in albuterol nebulizer solutions does not affect the short-term bronchodilator response to a single dose, although case reports suggest that its repeated use in patients with severe asthma may result in paradoxic bronchoconstriction. When inhaled by asthmatic subjects, EDTA also causes dose-dependent bronchoconstriction, although it is less potent than BAC. The use of preservative-free bronchodilator nebulizer solutions does not result in clinically significant bacterial contamination if they are dispensed in sterile unit-dose vials, in volumes and concentrations that do not require modification by the user. Despite this evidence, in the United States a number of solutions, including some preparations of albuterol, contain either BAC or EDTA. Current regulations do not require that the concentration of preservatives be documented on the product; however, considerably different doses of BAC are delivered with different products. For example, a standard 2.5-mg dose of albuterol nebulizer solution contains 50 microg of BAC when administered from the multidose dropper bottle and 300 microg from the unit-dose screw-cap product. Furthermore, it is legal for pharmacists to substitute or compound solutions containing high concentrations of BAC when the physician has prescribed a preservative-free product. We recommend that the United States follow the practice of most Western countries and withdraw bronchodilator nebulizer solutions that contain preservatives such as BAC. We further recommend that the solutions should be prepared under sterile conditions, formulated preservative free, and made available in unit-dose vials.
Topics: Benzalkonium Compounds; Bronchodilator Agents; Chemistry, Pharmaceutical; Drug Compounding; Edetic Acid; Humans; Nebulizers and Vaporizers; Preservatives, Pharmaceutical; Risk
PubMed: 9469687
DOI: No ID Found -
Klinische Monatsblatter Fur... Oct 1997Poor compliance can be dangerous to successful medical treatment of glaucoma. Among other things one reason for non-compliance represents the inability of the patients...
BACKGROUND
Poor compliance can be dangerous to successful medical treatment of glaucoma. Among other things one reason for non-compliance represents the inability of the patients to place drops in the eye appropriately. Therefore information regarding the patients ability to administer an eyedrop safely are a prerequisite to determining a therapy scheme which ensures the compliance of glaucoma patients.
PATIENTS AND METHODS
100 glaucoma patients on medical therapy who first presented in the outpatient glaucoma clinic of the University Eye Hospital of Würzburg were examined by standardised questionnaire and ability tests. We evaluated: 1. Can the eyedrop administration of glaucoma patients be improved by a standardised instruction? 2. Can the eyedrop administration be improved by the use of a drop aid (Autodrop)? 3. Can the accuracy of aiming and the manual ability be evaluated with a target-test on a sheet of paper with a series of concentric circles? 4. How do patients on combined therapy distinguish between their different bottles and where is the dosage regimen noted? 5. What kind of distinguishing marks of eyedrop-bottles do the patients prefer?
RESULTS
1. Before verbal instruction 76% of the patients applied the eyedrops appropriately, after instruction 94% (p < 0.001) were capable. Touching the eye with the tip of the dropper was reduced significantly. Touching the eye before instruction was found in 63% of the patients, after instruction it was found in 41% (p < 0.001). 2. When patients used the drop aid 81% were able to place a drop in the eye appropriately. Only by 46% of the patients the Autodrop was welcomed. 3. 16% of the patients were not able to place a drop within 1.5 cm of the center of the target (according to the size of an eye). 4. 47% of the patients who use more than one eyedrop bottle admitted problems in distinguishing the bottles, only 38% of the patients read the labels. 5. 76% of the patients would prefer markable stickers of different colours for the bottom of the bottles to improve distinguishing the bottles in combined therapy.
CONCLUSION
Instruction improves eyedrop administration in 18% of our patients. In combined therapy with several drugs new distinguishing marks are requested by the patients. To improve compliance combination preparations should be administered if available.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Drug Delivery Systems; Drug Therapy, Combination; Equipment Design; Female; Glaucoma; Humans; Male; Middle Aged; Miotics; Ophthalmic Solutions; Parasympathomimetics; Patient Acceptance of Health Care; Patient Compliance; Self Administration
PubMed: 9445914
DOI: 10.1055/s-2008-1035132 -
Optometry and Vision Science : Official... Oct 1997Spray application of cycloplegics and mydriatics is efficacious and frequently easier to use than a standard dropper bottle in the pediatric population. However, no...
BACKGROUND
Spray application of cycloplegics and mydriatics is efficacious and frequently easier to use than a standard dropper bottle in the pediatric population. However, no documentation regarding the sterility of drugs dispensed from spray bottles is available. This study was conducted to determine whether contamination of ophthalmic drugs occurs with spray bottle use.
METHODS
Fifteen milliliters of 1% cyclopentolate hydrochloride or 0.5% tetracaine hydrochloride were transferred to each of 15 disinfected spray bottles, stored at room temperature or refrigerated, and sprayed three times weekly for 12 weeks. Cultures were obtained from the spray bottles and drugs before transfer of the drug and from spray bottle contents at 0, 2, 4, and 6 to 12 weeks of storage.
RESULTS
No cultures showed significant bacterial growth. The bactericidal action of the preservative and sterility of the drugs were maintained.
CONCLUSIONS
Despite the transfer to and use of a spray bottle there appears to be minimal risk of instilling contaminated diagnostic drugs using the spray method when a single drug is stored in a spray bottle.
Topics: Anesthetics, Local; Bacteria; Cyclopentolate; Disinfection; Drug Contamination; Drug Packaging; Mydriatics; Nebulizers and Vaporizers; Ophthalmic Solutions; Tetracaine
PubMed: 9383801
DOI: 10.1097/00006324-199710000-00026 -
American Journal of Health-system... Mar 1997The stability of acetylcysteine in an extemporaneously compounded ophthalmic solution was studied. Acetylcysteine 10% ophthalmic solution containing 0.025% disodium...
The stability of acetylcysteine in an extemporaneously compounded ophthalmic solution was studied. Acetylcysteine 10% ophthalmic solution containing 0.025% disodium edetate and 0.5% chlorobutanol in an artificial tears base was prepared and stored at 2-8 degrees C in clear, 15-mL, low-density polyethylene dropper bottles. At 0, 7, 14, 21, 28, 35, and 60 days, a 1-mL sample was removed from each bottle and analyzed for acetylcysteine concentration by high-performance liquid chromatography. Another set of 10% acetylcysteine solutions containing 0.025%, 0.050%, 0.075%, or 0.10% disodium edetate were prepared, stored at room temperature (23-25 degrees C), and analyzed at 0, 7, 15, 30, 40, and 50 days. In the solutions containing 0.025% disodium edetate, acetylcysteine was stable for 60 days at 2-8 degrees C but for less than 7 days at 23-25 degrees C. In the solutions containing 0.75% and 0.10% disodium edetate, acetylcysteine was stable for 40 and 50 days, respectively, at 23-25 degrees C. Acetylcysteine in a 10% acetylcysteine ophthalmic solution containing 0.025% disodium edetate and 0.5% chlorobutanol in an artificial tears base was stable for 60 days at 2-8 degrees C.
Topics: Acetylcysteine; Chromatography, High Pressure Liquid; Drug Stability; Humans; Hydrogen-Ion Concentration; Mucus; Ophthalmic Solutions; Temperature
PubMed: 9066864
DOI: 10.1093/ajhp/54.5.549 -
Journal of Clinical Pharmacy and... Dec 1995The compatibility of the 7 ml size of Steri-Dropper, a commercially available low-density polyethylene sterile eye-drop container, was studied for use with solutions... (Comparative Study)
Comparative Study
The compatibility of the 7 ml size of Steri-Dropper, a commercially available low-density polyethylene sterile eye-drop container, was studied for use with solutions containing the antimicrobial preservatives benzalkonium chloride and phenylmercuric acetate. For benzalkonium chloride, there was no difference between the Steri-Dropper and the glass eye-drop bottles throughout the study period of 84 days. However, there was less phenylmercuric acetate present in the Steri-Dropper compared to the glass containers by the end of the study. The suitability of the Steri-Dropper bottle was also studied for use with potassium ascorbate eye drops; these degraded more in Steri-Dropper compared to glass containers and a yellow discoloration of the product was also seen in these containers. The Steri-Dropper bottle is therefore potentially compatible with dispensed formulations containing benzalkonium chloride and, for short periods only, with phenylmercuric acetate. The container would only be suitable for use with oxygen-sensitive drugs for short periods. Further validation of the suitability of the Steri-Dropper bottle would be required for use with any specific formulation.
Topics: Ascorbic Acid; Benzalkonium Compounds; Drug Packaging; Drug Stability; Ophthalmic Solutions; Phenylmercuric Acetate; Polyethylenes; Preservatives, Pharmaceutical
PubMed: 8847373
DOI: 10.1111/j.1365-2710.1995.tb00708.x -
Acta Ophthalmologica Scandinavica Aug 1995In 1993, a case of adenovirus type 8 keratoconjunctivitis acquired in Central Europe was the starting point of an outbreak in Malmö, Sweden. Of the 33 diagnoses cases,...
In 1993, a case of adenovirus type 8 keratoconjunctivitis acquired in Central Europe was the starting point of an outbreak in Malmö, Sweden. Of the 33 diagnoses cases, 23 were infected nosocomially. In 29 the diagnosis was verified by virus culture. The outbreak was recognised 15 days after the appearance of the first secondary case. Nosocomial transmission was stopped by protective measures which didn't include separation of the infected patients from others. Epidemiologic investigation disclosed unrecognised infections as the main source of virus transmission; contaminated hands and a dropper bottle appeared to be major vectors. A new case of adenovirus type 8 infection, again introduced from Central Europe, turned up in September 1994. There was only one secondary case.
Topics: Adenoviridae; Adenoviridae Infections; Adult; Aged; Aged, 80 and over; Cross Infection; Disease Outbreaks; Female; Humans; Iatrogenic Disease; Infectious Disease Transmission, Patient-to-Professional; Infectious Disease Transmission, Professional-to-Patient; Keratoconjunctivitis; Male; Middle Aged
PubMed: 8646586
DOI: 10.1111/j.1600-0420.1995.tb00044.x -
The Journal of Pediatrics Jun 1995The purposes of this article are to introduce a formal definition of nipple confusion and to propose various hypotheses concerning its cause. The term nipple confusion...
The purposes of this article are to introduce a formal definition of nipple confusion and to propose various hypotheses concerning its cause. The term nipple confusion refers to an infant's difficulty in achieving the correct oral configuration, latching technique, and suckling pattern necessary for successful breast-feeding after bottle feeding or other exposure to an artificial nipple. Many early breast-feeding failures are attributed to nipple confusion, although scientific data are lacking to document its prevalence, the mechanisms involved, or various factors that predispose an infant to this phenomenon. Two classifications of nipple confusion are recommended to distinguish the impact of artificial nipples during the newborn period from their influence after breast-feeding is well established. Maternal and infant risk factors making an infant more susceptible to nipple confusion are discussed. Future studies are planned to help elucidate the nature of nipple confusion and identify the circumstances under which infants are most vulnerable to this phenomenon. Meanwhile, it would seem prudent for clinicians to identify newborns at risk for nipple confusion and to minimize the use of bottle feedings in such babies. Medically indicated supplements in the early days of life could be provided by alternative methods, such as cup, spoon, or dropper feeding, until breast-feeding can be established.
Topics: Bottle Feeding; Breast Feeding; Female; Humans; Infant; Infant, Newborn; Nipples; Sucking Behavior
PubMed: 7776072
DOI: 10.1016/s0022-3476(95)90252-x -
Cornea 1990The practitioner's office can be an unsafe environment for fitting contact lens (CLs), owing to numerous reservoirs of microbial contamination. These include sinks,... (Review)
Review
The practitioner's office can be an unsafe environment for fitting contact lens (CLs), owing to numerous reservoirs of microbial contamination. These include sinks, trial lenses, solutions, lens cases, multidose dropper bottles, and storage trays. Microbes may also be introduced to the eyes via the practitioner's fingers, the patient's lashes or lids, or cosmetic residues on the ocular adnexa. Because sterility is difficult to achieve in an office, CL fitters must accept the more realistic goal of disinfection. Periodic cultures are necessary to monitor the effectiveness of office hygiene and disinfection. Cultures are especially important, considering that the panel of organisms routinely used to test lens care solutions may not reflect those in office settings, which may become resistant to preservatives. It has been shown, for example, that 50% of chlorhexidine-preserved solutions used in offices can become contaminated with Serratia marcescens within 7 days of bottle opening. At present, it appears that contamination is best avoided by using solutions containing 15 ppm of polyaminopropylbiguanide (PAPB). Frequent replacement of solutions, trial lenses, and lens cases may also help to reduce the likelihood of microbial contamination in the office.
Topics: Accident Prevention; Bacterial Infections; Biguanides; Chlorhexidine; Contact Lenses; Disinfection; Drug Resistance, Microbial; Equipment Contamination; Humans; Ophthalmic Solutions; Physicians' Offices; Preservatives, Pharmaceutical; Safety
PubMed: 2189681
DOI: 10.1097/00003226-199010001-00018