Effects of local and systemic medications on eye health: Adverse reactions

Abstract

Introduction: Medications can cause both local and systemic adverse effects. The field of ophthalmology involves a range of medical interventions performed within a relatively small anatomical space, often involving various medications. This presents challenges in monitoring the adverse effects of drugs, as they may produce both local and systemic side effects. Given that patients often have comorbid conditions, accurately assessing the causality of adverse effects requires a team of experienced physicians. Topic: This paper explores three distinct avenues regarding the effects of medications on ocular health: I. Local effects of locally applied medications; II. Systemic effects of local ophthalmic medications; III. Effects of systemic medications on ocular structures. Conclusion: Systemic side effects of eye treatment locally applied drugs are adverse effects of a medication or substance that impact the entire body or multiple organ systems, rather than being limited to the area of contact or administration. These effects occur because the substance is absorbed and distributed throughout the body via the bloodstream. Examples include fatigue, nausea, hair loss, and fluctuations in blood sugar levels. The most common ocular adverse effect of systemic medications is dry eye, which can be caused by antidepressants, antihistamines, beta-blockers, diuretics, H2 blockers, proton pump inhibitors (PPIs), hormones (including contraceptive preparations and hormone replacement therapy), and isotretinoin (used for acne). One of the most urgent ophthalmologic condition is retinal detachment, which can be a serious adverse effect of fluoroquinolones. Ophthalmic complications of systemic drugs are typically transient and often resolve after the discontinuation of the therapy that caused them. The most serious adverse events are associated with neurotropic (neuroleptic), immunotropic, and antitumor medications (including chemotherapy). These treatments are frequently administered for severe conditions, are difficult to discontinue, and are typically long-term. Thus, when prescribing these medications, it is crucial to assess the associated risks and to monitor ophthalmic complications during treatment.Uvod: Lekovi mogu izazvati i lokalne i sistemske neželjene efekte. Oblast oftalmologije obuhvata niz medicinskih intervencija koje se izvode u relativno malom anatomskom prostoru, često uključujući više lekova. Ovo predstavlja izazove u praćenju neželjenih efekata lekova, jer oni mogu izazvati i lokalne i sistemske neželjene efekte. S obzirom na to da pacijenti često imaju komorbiditete, tačna procena uzročnosti neželjenih efekata zahteva tim iskusnih lekara.Tema: Ovaj rad istražuje tri različita puta povezana sa efektima lekova na zdravlje oka: I. Lokalni efekti lokalno primenjenih lekova; II. Sistemski efekti lokalnih oftalmoloških lekova; III. Efekti sistemskih lekova na očne strukture. U skladu sa ovom podelom, rad navodi i analizira neželjene efekte lekova u okviru oftalmologije.Zaključak: Sistemski neželjeni efekti lokalnih očnih lekova su neželjeni efekti leka ili supstance koji utiču na celo telo ili više organskih sistema, a ne da su ograničeni na područje kontakta ili primene. Ovi efekti se javljaju zato što se supstanca apsorbuje i distribuira po celom telu putem krvotoka. Primeri uključuju umor, mučninu, gubitak kose i fluktuacije nivoa šećera u krvi. Najčešći očni neželjeni efekat sistemskih lekova je suvoća očiju, koju mogu izazvati antidepresivi, antihistaminici, beta-blokatori, diuretici, H2 blokatori, inhibitori protonske pumpe, hormoni (uključujući kontraceptive i hormonsku substitucionu terapiju) i izotretinoin (koristi se za akne). Jedno od najhitnijih oftalmoloških stanja je ablacija mrežnjače, što može biti ozbiljan neželjeni efekat fluorokinolona. Oftalmološke komplikacije sistemskih lekova su obično prolazne i često se povlače nakon prekida terapije koja ih je izazvala. Najozbiljniji neželjeni efekti povezani su sa neurotropnim (neuroleptičkim), imunotropnim i antitumorskim lekovima (uključujući hemoterapiju). Ove terapije se koriste za ozbiljna medicinska stanja, rizično ih je prekinuti i obično su dugotrajni. Stoga je prilikom propisivanja ovih lekova neophodno proceniti rizik I dobit i pratiti oftalmološke komplikacije tokom lečenja.