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Medical Forum / General / Vision / April 2008Xalatan drops overmedication?
In talking to my glaucoma doctor, he is mentioning that one should be pretty accurate in applying that first drop. If one misses, say by a half drop, and redrops a singular drop, this could be overmedicating and could have a negative overall effect. i.e., the drug not being as effective as it should. I've looked over the prescription sheet for Xalantan and have seen no such warning or admonition. And in conversations with another users, one wonders if one is getting the "standard drop". Comments appreciated. Don W. One drop always exceeds the available space in the tear reservoir between the lid and eye, so don't worry about getting an accidental "half" drop. A second or third or fifth drop all at the same time mostly just runs off. Your doctor is saying don't add a second dose ten minutes later, or the next morning, because prostaglandins only work at low doses. Adding another dose or a second prostaglandin like Lumigan can _increase_ IOP paradoxically. The main reason to be stingy is the stuff costs like liquid gold. See http://www.rxlist.com/cgi/generic/latanoprost_ids.htm > In talking to my glaucoma doctor, he is mentioning that one should be > pretty accurate in applying that first drop. If one misses, say by a half [quoted text clipped - 11 lines] > > Don W. Mike, thanks. Pulling both lids apart with thumb and forefinger, head way back, and staring directly up at the end of dropper is OK? Some directions indicate just making a pocket with the lower lid and dropping medication directly into that. Both methods OK? Another question. Following that initial question. One drops a drop and it feels slight, like 1/2 to 1/3 of a drop. One should reissue the 2nd drop right away? Even some will be a waste? Don W. > One drop always exceeds the available space in the tear reservoir between > the lid and eye, so don't worry about getting an accidental "half" drop. A [quoted text clipped - 24 lines] >> >> Don W. > Mike, thanks. > > Pulling both lids apart with thumb and forefinger, head way back, and > staring directly up at the end of dropper is OK? Don't stare, you'll injure the eyes! > > Mike, thanks. > > > Pulling both lids apart with thumb and forefinger, head way back, and > > staring directly up at the end of dropper is OK? > > Don't stare, you'll injure the eyes! God, you're an idiot. > > > Mike, thanks. > [quoted text clipped - 4 lines] > > God, you're an idiot. Are you calling God an idiot? Aren't you Christian, Neil? > Pulling both lids apart with thumb and forefinger, head way back, and > staring directly up at the end of dropper is OK? Um, yes, if you can stand it. I always had problems watching stuff fall into my eye so I pull the lower lid out to make a pocket and put the drop in the pocket, looking at myself in the mirror. > Another question. Following that initial question. One drops a drop and > it feels slight, like 1/2 to 1/3 of a drop. One should reissue the 2nd > drop right away? Even some will be a waste? I think that, if you can feel it, you got it in. Period. I don't find much difference in (dilating) drops whether it's a little or a lot, half a drop or six. There's more variation between individuals than there is between doses. My take is that once the drop touches wet conj anywhere, it mixes out into the tear bath with the first blink and then fades out (dilutes out) over about a minute. After that, another drop is like another dose. -MT Mike thanks. What is interesting is a passage from US patent 2007/0262906 A1 which has this comment: "...Yet, despite instructions on proper eye drop dispensation and placement, more than one-half of glaucoma patients incorrectly administer drop medication" From a "new" set of concepts (patentable??) on drop dispensers from a Gaynes at Rush University Medical Center. What started this is a colleague that was getting a couple month's supply of Xalantan. Number of bottles changed by a factor of 2+. New nozzle design was a comment he obtained. Like a more efficient definition of a drop size??? In our discussions (with colleague) I am saying it really is ug's that are important, not uL's. But that is of course fixed by solution strength. Oh, I also said I keep mine in the frig, so I know when it hits the eye. And I speculated, that the drop size (amount) doing this would be bigger due to lower temperature (greater surface tension). Don W. PS. This is more complicated than what meets the eye (hmmmm). >> Pulling both lids apart with thumb and forefinger, head way back, and >> staring directly up at the end of dropper is OK? [quoted text clipped - 17 lines] > > -MT |
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