SOME FACTS ON ALCOHOL

ALCOHOL-SOME FACTS

Let us see how our body handles alcohol soon after its consumption.

Immediately after consumption alcohol passes through the liver as the first pass to be metabolized.

The liver can metabolize one ounce of alcohol per hour

After consumption alcohol can remain in the blood for several hours and in the urine for several days 

After consumption, approximately 20% of alcohol is absorbed by the stomach and the remaining 80% absorbed by the small intestine

Any remainder portion left is excreted out by saliva, sweat, and urine.

After absorption into the bloodstream alcohol goes to the liver. The liver produces enzymes to process alcohol.

But if someone is drinking alcohol rapidly the liver cannot process all alcohol and hence some alcohol may remain in the body without metabolized.

The total amount of unprocessed alcohol remained in the blood is known as Blood Alcohol Concentration (BAC)

The higher the BAC the more pronounced effects as follows.

Pronounced Alcoholic Effects

1.Reduced Inhibitions

2.Damaged Memory

3.Slurred Speach

4.Confusion

5.Difficult concentration

6.Respiratory depression

7.Vomiting

8. Impaired Balance and Coordination

9.Irritability

Age

Age influences the alcoholic usage by retaining alcohol longer time in the liver in old aged people.
The reasons are probably due to the slow blood flow in the old aged people and may be due to the intake of more medicines in old age which may interfere with the alcoholic metabolism in the liver.
As the liver process the alcohol at a smaller rate which increases the amount of unprocessed alcohol absorbed in the body.

Sex

Though it is not common to all, alcohol remains a long time in women's body than men's because the body of women have more fat and lesser water than the body of men.

Race

Some East Asian Race people lack the enzyme necessary to break down the alcohol molecule which leads to facial flushing, nausea, dizziness, tachycardia, and headache.

Family History 

Even though gene alone may not influence alcohol individual consumption but researches have shown that gene along with the environment may affect the alcohol handling of the body.

Body Mass Index

Similar to other drugs alcoholic metabolism may be influenced by body size

A person with a lean body or smaller BMW will have a sooner effect than the person with a larger BMW.

Medicines That Influence Liver Processing Of Alcohol

Medicines that can influence alcohol metabolism are as follows:-

1.Anxiolytics like benzodiazepines, barbiturates, meprobamate

2.Antidepressants such as amitriptyline

3.Antibiotics

4.Antihistamines

5.Antidiabetic drugs

How long does the alcohol stay in the system 

1.Blood

Measurement of BAC is one of the techniques to determine how long alcohol stays in the body.

In general alcohol is eliminated 0.015 per hour. For example if a person has a BAC of 0.08 which may be illegal to drive, it will take around 5.5 hours to flush out the alcohol from his body.

It is important to note that since alcohol is absorbed by the stomach also a person who drinks alcohol in a larger amount in an empty stomach may take even more than 24 hours to flush out the alcohol from his body.

2.Urine

The latest and more sensitive urine tests have proved that alcohol can be present in the urine up to 80 hours or up to 3 to 4 days after the last drink.

3.Breath

The most sensitive tests have proved that alcohol can be present in the breath up to 24 hours after the last drink.

4.Hair

Hair tests have proved that alcohol can be detected in the hair up to 90 days after last drink

5.Saliva

Tests have proved that traces of alcohol can be detected in the saliva up to 24 hours after the last drink.

6.Breast Milk

It is proved that alcohol is present in the breast milk as long as its presence in the blood. When it leaves from the blood automatically it would leave from the milk, hence it is not necessary to pump the milk from the breast to clear alcohol.

Long term effects of Drinking

Heavy drunkards may have the following risks

1.Cancer of the mouth, throat, and breast

2.Stroke

3.Heart problems

4.Liver damage

5.Nervous and brain damages

Conclusion 

Alcohol becomes a social drink in parties and in recreation clubs.

Frequent social drinking habit is risky. If anyone feels he drinks alcohol frequently to become a stage of heavy drink without control should speak with their doctor.

 

APLASTIC ANEMIA

This article is dedicated to giving full study regarding aplastic anemia.

Aplastic anemia is a rare syndrome but is a serious one

Usually anemias are of many types in which there is a reduced volume of blood with its total contents or reduced count of the RBCs or Red Blood Cells.

But in aplastic anemia even if there is the correct volume of blood is present but there are reduced count of red cells,white cells and platelets

Platelets are fragments of blood cells that help the blood to clot at the site of cuts or wounds and stop to bleed further.

If there is insufficient count of platelets then internal bleeding occur which may be superficial under the skin to form red patches and blisters under the skin. This may cause scratching and itching sense which may be wrongly diagnosed as microbial or fungal infections

Aplastic anemia occurs mainly due to damaged or inactive bone marrow

Bone marrow is a spongy soft tissue that develops to form stem cells. The stem cells further mature into various blood cells and release them into the bloodstream.

Normally our blood count of platelets is from 150,000 to 450,000 per microliter of the blood. The lifespan of the platelets is around ten days.

If the bone marrow does not produce sufficient platelets within this lifetime then aplastic anemia occur.

Causes

Bone Marrow can be damaged or improperly work due to many reasons as follows:

1.Radio and Chemotherapies

2.AIDS

3.Viral diseases

4.Pregnancy

5. Fanconi anemia is common inherited anemia may cause aplastic anemia by damaging bonemarrow

6. Iron deficiency anemia may oo cause itchy skin which can be wrongly diagnosed as aplastic anemia

Symptoms

1.Itchy skin

2.Bleeding nose and Gums

3.Blood in the stool

4. Retinal bleeding leads to vision problems.

5.Over menstrual bleedings

6.fatigue

7.Nausea

6.Shortness of breath

7.Irregular heartbeats

8.Pale skin

9.Unexplained or easy bruising

10.Dizziness

11.Headache

The following symptoms may be due to lack of RBCs in the blood:-

1.Weakness

2.Tiredness

3.Shortness of breath

4.Lightheadedness

5.Palpitations

6.Cold hands and feet

7.Chest pain

Aplastic anemia can cause serious and frequent infections due to the lack of WBCs

Diagnoses

Medical Histories 

1.Exposure to toxins, radiations or other harmful environments

2. Cancer treatments with radio and chemotherapies

3.History of certain infectious diseases or autoimmune disorders

3.Infected or inherited conditions

A doctor's diagnosis may involve internal bleedings under the skin and may examine the stomach for the enlargement of the spleen

4. Blood total count and RBC count should be a part of diagnosis as they may show the entire picture of the blood cells.

Fewer than 150000 per microliter of the platelet counts may be considered as serious.

Treatments

Aplastic anemia can be classified as nonsevere, severe, and more severe determined by the blood cell count. The very low count indicates the severity of the condition.

The treatment may include,

1.Blood transfusion

2.Blood and bone marrow stem cell transplant

3.Medical therapy

Medicines may be used to attain the following stages

1.Bone marrow stimulation

2.Autoimmunity suppression

3.Prevent and treat infections

Outlook

Aplastic anemia causing rashes are rare but serious

If left untreated the condition gets worsen overtime

Medications

The following medications are useful in the treatment of Aplastic anemia but subjected to the diagnostic conditions from mild to moderate and under doctor's supervisions

1.Filgrastim Injections (Brand: Neupogen)

2.Sargramostim Injections Intradermal (Brand: Liukin)

3.Antithymocyte Globulin Intravenous shots (Brand: Agam)

AGRANULOCYTOSIS

AGRANULOCYTOSIS

When the body is unable to produce granulocytes a type of WBCs the condition is known as agranulocytosis.

The condition is very serious as WBCs are a crucial part of our body's immune system and the insufficiency in their production leads to an impairment of the body's resistance to serious infections.

Granulocytes also are known as neutrophils are the major portion of the total count of WBCs such as 80%. This forms the main part of the WBCs immune power as it contains enzymes that kill the invading bacterias.

Hence without sufficient neutrophils our body cannot fight against various infecting bacterias and remove unwanted foreign bodies that cause infections.

Symptoms

Symptoms are generally as follows

1.Fever

2.Chills

3.Drop-in B.P.

4.soreness in throat and mouth

5.Tiredness and weakness due to low B.P.

6.Headaches

7. sweating 

8. Swollen glands

If the symptoms are left untreated they may spread throughout the body and blood leads to a condition known as sepsis

The symptoms of sepsis include rapid heartbeat, fast breathing, and a change in mental status.

Causes and Risk Factors

Agranulocytosis is usually acquired by some causatives but rarely it is provided from birth.

1.Chemotherapy

2.Bonemarrow transplant

3.Autoimmune disorder

4.Bone marrow disease and leukemia

5.HIV infections

6.Taking certain medicines such as Clozapine

7.Antithyroid drugs

Diagnosis

The doctor can diagnose the disease by a simple WBC differential count and an Absolute Neutrophil Count (ANC) tests

If the test results yield a poor count of neutrophils then it may be agranulocytosis.

The normal count of Neutrophils (ANC) is 1500 per microliters of the blood

If it is less than 1500 and more than 100 then the conditions are known as granulocytopenia or neutropenia which also causes immunity impairment of the body.

The doctors also diagnose with by simple physical exam and a bone marrow test and a genetic test to find out the exact causes for this condition.

Treatments

1.By stopping the causative medications such as antithyroid drugs such as propylthiouracil and may be advised to take alternate drugs by doctor's advice.

2. Antibiotics, Antiviral or antifungals may be prescribed to neutralize the respective infections infections

3. ByInjecting Granulocyte Colony Stimulating factor G-CSF to stimulate bone marrow to produce more WBCs.
This therapy is more useful in patients who receive anti-cancer drugs
There are three types of G-CSFs such as Filgrastim,Pegfilgrastim,and Lenograstim.
4. Immune suppressing medicines such as some steroids can be used to preserve the production of WBCs
5.Granulocyte infusion

Prevention

1. Avoid crowds

2. Avoid cut flowers

3. Avoid eating fruits that cannot be peeled or cleaned
4. Avoid close contacts with pet animals
5. Do not eat undercooked or raw foods
6.Maintain personal hygiene

வெள்ளை அணு குறைபாடு நோய்

 

நமது உடலிலுள்ள இரத்தத்தில் வெள்ளை அணுக்கள் தான் நமது நோய் எதிர்ப்பு சக்தியை நிர்ணயிக்கின்றன 

வெள்ளை அணுக்களில் பிரதானமானது நியூட்ரோபில் அல்லது granulocytes என்ற அணுக்கள் தான்.இவை பொதுவாக 80% இருக்கும் பொதுவாக வெள்ளை அணுக்கள் என்றாலே இவற்றைத்தான் குறிக்கும் இந்த அணுக்கள் குறைவாக இருந்தால் அப்பத்தான் தோற்று நோய்க்களுக்கு நம் உடல் ஆளாக நேரிடும்.இந்த நிலைக்கு sepsis என்று பெயர்.

அறிகுறிகள் 

1.காய்ச்சல் 

2.குளிர் 

3.குறை ரத்த அழுத்தம் 

4. களைப்பு 

5.தொண்டை புகைச்சல் 

6.தலை வலி 

7.வியர்த்தல் 

8.சுரப்பிகள் வீக்கம் 

காரணிகள் 

1.மருந்துகள் 

2.எலும்பு மஜ்ஜை மாற்று சிகிச்சை
3.எயிட்ஸ்
4.க்ளோசப்பின் மற்றும் தைராயிட் எதிர்ப்பு மருந்துகள்

பரிசோதனைகள் 

1.இரத்த வெள்ளை அணுக்கள் Differantial  Count (DC )

2.தனி நியூட்ரோபில் அணு டெஸ்ட் (சாதாரணமாக 1500/mcL )

3.எலும்பு மஜ்ஜை டெஸ்ட் 

மருத்துவம் 

1.காரணி மருந்துகளை நிறுத்துதல் 

2.ஆண்டிபையாட்டிக்குகள் 

3.Granulocyte Coloney Stimulating Factor GCS -F ஊசி மூலம் எடுத்துக்கொள்ளுதல் 

PHEOCHROMOCYTOMA

PHEOCHROMOCYTOMA

Pheochromocytoma is a pathological condition in which there are benign tumor developments in or outside adrenal glands either one or both. Even though the condition is rare and asymptomatic at the beginning if left untreated it may produce serious effects including death.

Pathophysiologically the tumors are formed from the chromaffin cells of the adrenal medulla either by mechanical over-stimulation such as frequent stress, anxiety, and tension or due to some pathological conditions.

Pathologically the tumors may stimulate overproduction of catecholamines such as adrenaline and noradrenaline which in turn produce high blood pressure, tachyarrhythmia, stress and other serious cardio and pulmonary vascular effects.

As the produced catecholamines by the tumor are usually metabolised within the chromaffin itself a test for the metabolites may give us a positive result rather than testing for the parent compounds.

Adrenalin is metabolized to metanephrine and noradrenaline to normetanephrine.
Adrenal glands are a pair of small pea-shaped endocrines or ductless glands each one situated at the top of the two kidneys on either sides. They produce important hormones like adrenaline, noradrenaline, and steroid-like hydrocortisone and cortisol.
Adrenal hormones help balance body functions such as
1.Heart Rate
2.Blood Pressure
3.Metabolism
4.Blood Glucose
5.Stress
6.Immunity

Symptoms

1)Skin reactions

2)Elevated heart rate

3.Elevated B.P.

4)Panic and anxiety

5)High sweating

6)Head pain

7) Pallor 

8)Weight Loss

9)Elevated Glucose Level due to lipolysis

The main cause of the disease is genetic.
10.Elevated sweating
11)Tremor
12)Sudden Headaches

Diagnoses

1)By direct measurements of catecholamines in blood plasma or in a 24-hour collection of urine

2)CT or MRI scans of the head, neck, chest, and abdomen. This can help to localize the tumor

Treatments

1. The best treatment is to remove the tumors

this requires a non invasive laparoscopic surgeries with small short recovery incisions.

2. In case if the tumor cannot be removed the doctor may remove the entire affected gland as one gland is sufficient for body control.

3. In rare cases if both the glands are completely affected then complications begin as both the glands are to be removed and the patient should be subjected to have entire hormone replacement therapy.

ERECTILE DYSFUNTIONS(ED)-CAUSES-SYMPTOMS AND TREATMENTS

ERECTILE DYSFUCTION-THERAPIES

Erectile Dysfunction (ED) is a form of sexual impotency that occurs when a man cannot attain a perfect erection sufficiently enough time to perform intercourse to satisfy his partner.

It often ends with depression and an unsatisfied relationship between the couple.

ED cannot be considered to be a disease unless it is not associated with a pathological or physiological defect.

Stress and mental depression can play important roles in affecting a person's sexual performances.

Age is another factor that plays an important role in sexual performance. Men over 75 years are reported more as having erectile disorder according to American Acadamy Of Family Physicians(AAFP). However, men can also have ED at younger ages too.

Nitric oxide produced in the body as a by-product of protein metabolism plays an important role in performing penile erection.

Nitric oxide production from the amino acid L-arginine is a complex process by the group of enzyme nitric oxide synthase.

Nitric oxide has many neuronal functions one of them is vasodilation. Through this effect it dilates the blood vessels of the muscular system of the penis known as corpus cavernosum,to get more blood supply. The corpus cavernosum relaxes leads penile erection.

If the above Nitric Oxide passage disturbed by any means then the penile erection will be disturbed.

There are many prescribed medicines available with some naturally available herbal medicines in the market. Among the natural herbal medicines Red Ginseng occupies an important place.

Red ginseng technically known as Panax ginseng is a Korean herbal remedy for ED.

But this is a traditional older form of remedy practiced in Korea and China. The plant takes at least six years to attain maturity for harvesting.

Red ginseng is available in medical practice in powder, capsule,and syrup formulations.

The main active ingredient in this herb is a glycoside known as Ginsenoside which is responsible for various biological benefits of Ginseng.

Researches still cannot come to a clear understanding of the mechanism of action of these herbal remedies.

In 2008 various study results have been published in the British Journal of Clinical Pharmacology which revealed that six of the studies proved that ginseng consumption improves sexual activities and penile erection by an unknown mechanism on the comparison. But all the studies could never come to a clear conclusion regarding the definite mechanism of action of ginseng to cure ED.

Other generic medication for ED.

There are a number of medications in generic forms have been invented for ED therapy.

They are sildenafil(Viagra by Pfizer), tadalafil(Cialis by Eli Lilly), vardenafil (Levitra by Bayer), and so on. All these drugs work by the route of nitric oxide pathway to improve penile erections

SIDE EFFECTS OF GINSENG

1.Insomnia

2.Headaches

3.Stomach upset

4.Constipation

Other Herbal Remedies For ED

1.Dehydroepiandrosterone (DHEA):-

A supplement of this hormone is available with the dosage forms of 75 mg but should be consulted with the doctor.

It is assumed that DHEA works through the stress hormone Adrenaline which helps the body to produce various hormones to improve the body, sexual abilities.

2.Horney Goat Weed (Epimedium)

Chinese herbal medicine which the doctors believe that can cure various sexual dysfunctions including ED.

3.Ginko

Ginkgo Biloba is herbal medicine is believed to be correcting the ED by dilating the blood vessels of corpus cavernosum.

EYE CARE-CONTACT LENSES

SOME IMPORTANT ASPECTS OF CONTACT LENSES

 

Wearing the contact lenses verily depends on sufficient tear production by the eyes. Dry eye condition makes difficulty and insufficiency in contact lenses wearing.

Indications

1.Protrusion of or extension of the central part of the cornea beyond the limit. (Cornea-the pupil cap).This condition is known as Keratoconus

2.Absence of eye lens. The condition is known as Aphakia

3.Visual blurring

4. Nearsightedness is known as Myopia

5.Distant sightedness known as Hyperopia

6.Improper focus of light rays known as Astigmatism

7.Improper accommodation and no flexibility of lens known as Presbyopia

8. One eye is having near vision while the other is having a far vision. The condition is known as Monovision.

Contra-Indications

1. Work requires high exposure to dust.

2. Exposure to high winds

3.Exposure to high smoke.

4.Chronic conjunctivitis

5.Chronic blepharitis

6.Recurring infections

Precautions

Caution should be exercised by patients who suffers and possibilities of changes in eye conditions as follows:-

1.Epilepsy

2.High B.P. which may damage retina

3.Cardiac diseases.

4.Diabetes Mellitus which causes outgrowth of  vessels in the iris and  the eye's anterior chamber.

5. Taking oral contraceptives as regular consumption may alter the optical physiology. These changes are corneal sensitivity elevation, color changes, decreased visual acuity.

Types of Contact Lenses

1. There are some contact lenses made of polymethylmethacrylate(PMMA). These are rigid and water-resistant. These are Hard Glasses commercially known as Lucite or Plexiglas.

These hard lenses are having major advantages are their cost effects when compared with soft lenses and they can be easily marked to identify for the left or right eye.

The disadvantages also like minimum wettability,and limited oxygen permeability. Because of the hardness which does not permit sufficient oxygen and moisture it is difficult for the individual to adapt with it for a longer time.

2. Soft Lenses are made out of glasses that are flexible, and oxygen and water permeable.

These are easy to use,more comfortable to wear, and more difficult to dislocate from the position.

There are disadvantages like they are prone to absorb harmful chemicals,high costs,very easily deteriorate from storage,and altered visual acuity due to hydration of the lens.

Patients wearing soft lenses can use a few drops of rewetting agents. At the same time they should avoid other ophthalmic agents.

3. There are other types of lenses such as Gas Permeable Lenses. These are soft lenses contains PMMA. Hence they permit only oxygen but resist water.

They have the advantages over the hard lenses by their comfortability,and increased visual acuity.

Also they have the advantage over the soft lenses by their impermeability to resist chemicals.

The disadvantage of the gas permeable lenses is the accumulation of proteins and lipid deposits as they are moisture resistant.

Toxic Effects

Corneal edema due to improper oxygenation of the eye.

Medication can affect the eyes and potentiate the problems.

e.g.Oral contraceptives.

      Decongestants

      Antihistamines

      Tricyclic Antidepressants such as amitriptyline,imipramine etc

      Diuretics

Lens Care

Hard lenses are cleaned to remove oil,dust, and debris,followed by soaking in a storage solution,wetting to retain its hydrophilic surface,and rewetting.

Soft lenses are cleaned by surface-active or enzymatic cleaners,followed by disinfectants thermally or chemically. Finally rewet them.

Gas permeable lenses are cared for by cleaning,wetting, and soaking. Some are containing more silicone agents, requiring conditioning solutions that are made especially for rewetting purposes.

Solutions Recipe

Cleaning Products generally contain non ionic or amphoteric surfactants,which remove mucus,lipids,and proteins from the lens. Contact lenses should be rinsed following the cleaning steps to prevent eye irritations

Wetting Solutions are applied directly into the lens before inserting the lens into the eyes. Wetting solutions are intended to lubricate,decrease lens surface tension,and change the lens surface from hydrophobic to hydrophilic.

Wetting and Soaking solutions are meant for creating an aseptic environment and to hydrate the lens.

Preservatives

1.Benzalkonium chloride,

2. Thimerosal,this may produce more irritating episodes.

3.Phenylmercuric nitrate,

4.Sorbic acid,

5.Sodium edetate.

 

 

CONCEPT OF EYE PREPARATION USES

EYE CARE

There are varieties of eye drops for various uses of eye diseases and defects. It is very essential to know how to use them for different purposes.

A BRIEF ANATOMY OF EYE 

                              

Eyelids are protecting the eyes. They are folds of tissues. They distribute tears.
The eyes can be divided into two parts.
The external eye is formed by the tear gland and the conjunctival cul de sac
The internal eye is composed of the followings:
1.The outer coating of the eyeball known as the sclera
2.The colored membrane of the pupil that regulates the light entering through the pupil known as the iris.
3.The fluid-like substance derived from the blood by a process of ultrafiltration and secretion, known as the aqueous humor
4. The transparent tissue hanging at the center balanced by ciliary tissues on either side is known as the lens. The lenses are light refracting, focuses light rays to form an image at the retina.
5. The tissue linings of the eyelids are known as the conjunctiva

6. In between the lens and retina space is filled with a thick viscous gel- fluid known as the vitreous body or humor. The vitreous is very important which keeps the eyeball in shape, keeps retina sufficiently apart from the lens so that the lens can produce a clear image on the retina. Any detachment or shrinkage in vitreous may cause blurred images and sight problems.

Unlike the aqueous humor which is more watery the vitreous is stagnant and more vicious. Any detached cells can float inside the vitreous and can be reflected in the retina as flying bubbles in front of us. A heavy blow in the head, or during faint the vitreous may get disturbed to form many virtual flys in front of us.

At the corner of the conjunctiva there is fine meshwork followed by a downward draining canal known respectively as trabecular meshwork and canal of Schlemm through which the aqueous humor can be drained out.

1.Anti-infective eye preparations 

The concept of anti-infective eye preparations such as 

1.sulpha preparations and antibiotics such as chloramphenicol, gentamicin, tobramycin, and polymixin trimethoprim combinations are used if an infection is found in the eyes.

A stye is a condition in which there are symptoms such as pain, tenderness, redness, and eye swelling may present. The style is a kind of eye infection involving one or more sebaceous(sweat) glands of the eyelid. More often without medication a frequent hot compress is enough to get relief from stye but some times it needs an antibiotic prescribed by a doctor.

Other eyelids inflammatory infectious conditions such as blepharitis whose symptoms are inflammation, redness, and itching of the eyelid certainly need antibiotic eye preparation.

The black eye is a condition there is a black stain surrounding the eye resulted in a blow that can often be treated with cold compresses for 24 hours followed by warm compresses. If eyelids are damaged a physician should be inferred.

Conjunctivitis, an infection of the conjunctiva(the white part of the eye).Symptoms are redness, burning, and pain needs antibiotic treatments.

Dacryoadenitis

It is the swelling of the tear glands due to infection. Symptoms include red burning eyes, and the sensation of a foreign body in the eye.
The following antibiotics alone or with some combinations are available as additional pieces of information:
1. Ofloxacin (Antibiotic) eye drops-This preparation can be used if an infection is present.
2. Gatifloxacin (Antibiotic) with Dexamethasone (Corticosteroid) Combination can be used if there are reddening and inflammation along with infection.
3.Hypromellose (Tears Naturale): Can be used in dry eyes.

2.Astringents

Astringents are substances that are chemical compounds that make body tissues tend to shrink and thereby relieve irritations and pain.

The only FDA approved astringent in the USA is 0.25% zinc sulfate in eye drops to be used to relieve eye irritations.Of course zinc sulfate is a mild astringent it is safe and widely used in medicine.

3..Demulcents

Demulcents are used to protect and lubricate the dry eyes give relief from light irritations. They are relatively free from side effects and can act as artificial tears.

The best examples are sodium carboxymethylcellulose,dextran-70,gelatin,glycerin,hydroxyethylcellulose,hydroxypropyl methylcellulose,methylcellulose,polyethylene glycol-300,polyethylene glycol-400,polysorbate-80,polyvinyl alcohol,povidone and propylene glycol.Whenever you tend to use demulcents check any of the above ingredients on the label.

4.Decongestants and Vasoconstrictors

These agents work by producing a temporary constriction of the blood vessels present in the conjunctiva and thereby relieve eye redness and pain.
Examples are naphazoline hydrochloride (e.g.Clear Eyes), phenylephrine hydrochloride (e.g.Isopto Frin),
tetrahydrozoline (Murine Plus) and oxymetazoline hydrochloride (OcuClear)
Combination decongestant and antihistamine products include Naphazoline Plus Solution, Naphcon-A, and Opcon-A.
Keep in your mind that continue the use of any of the above product may cause a rebound of the condition.
Decongestants and vasoconstrictors are contraindicated in angle-closure glaucoma patients.

5.Hypertonic Eye Drops

It is known that a 2 to 5% sodium chloride solution can be conveniently hypertonic to the lacrimal fluid. Hypertonic solutions are used to relieve corneal swelling.

Even though hypertonic solutions are available on the counter as nonprescription medicine it is advisable to use it under doctor's supervision because of its hypertonicity which may cause rupture of the cornea.

6.Artificial Tears

These are a combination of a hypertonic agent, buffering agent, an agent that causes viscosity, and a preservative.

In general OTC nonprescription eye products should not be used for more than three days.Any abnormal symptoms persists immediately the patient should be referred to a physician.

The followings are the usual contents of artificial tears:-

1.Carboxymethylcellulose or any methylcellulose compound as demulcents

2.Polyvinyl alcohol (A lubricating agent)

3.Hyaluronic acid (A viscosity agent)

4.Sodium chloride solution below 0.9%(as a hypertonic agent)

5.Sodium perborate (as an oxidative preservative)

It is advisable to use those eye lubricants without preservatives in mono-dose-vials to prevent harmful side effects.

Artificial tears are prescribed for dry eyes,keratoconjunctivitis sicca

PRESCRIPTION MEDICINES

1.Atropine 

First of all you must keep in your mind that in general atropine is an anti cholinergic antimuscarinic drug. It will block all acetylcholine muscarinic receptors and to pave the for adrenergic overactivity.

Hence using atropine in eyes causes dilation of the pupil and causes a decrease in eye sensitivity towards light. It is usually used during eye examinations.

The drug may relieve pain but should be dangerous if use without medical consent.

Atropine after application shall cause blurred vision for some times and do not rub the eyes. Since atropine causes high pressure due its anticholinergic effects and adrenergic overactivity in the eyes it should not be used by diabetics especially those who suffers glaucoma (both open-angle or close angle).

2.Cosopt eye drops:

This is a combination of two medicines a beta-adrenergic blocker(Timolol) and a carbonic anhydrase inhibitor (Dorzolamide).
The concept of using this eye drops is to reduce the elevated eye pressure and to relieve open-angle glaucoma. Untreated glaucoma and elevated will cause blindness.
The preparation should be used as per the medical advice.

Corticosteroid Eye Drops & ointments

Corticosteroids are immunity sparing drugs and should be used with caution.
Corticosteroids are used in eye preparation to get relief from inflammations, injuries in post-operative conditions, and in some other allergic conditions which need immunity compromises such as pain and swellings.
1.Dexamethasone (Maxidex)
2.Fluocinolone
3.Difluprednate
4.Fluorometholone (FML forte)
5.Loteprednol
6.prednisolone
7.prednisone
Whenever using eye preparations the following concepts are to be kept in the mind.
1. Thoroughly wash your hands and wipe them to dry.
2. Take the vial in your hand and open the lid.
3.Sit in a chair or sofa in a relaxed position and tilt the head up sufficiently supported by the sofa head at the back.
4. Pull the lower eyelid a little and without touching the eye get the vial nozzle sufficiently closer to the eye and direct it towards the corner of the eye just above the nose and press the vial to instill the medicine in drops and close the eye immediately.
5. To apply ointment no need of seat arrangements. Stand in front of a mirror and pull the eyelid little and apply for the medicine by slowly pressing the tube. Direct the tube nozzle towards the corner of the eye just above the nose and get it closer without touching the eye. Put the medicine started from the corner followed by the lower lid lining and blink the eyes.