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Xalatan drops overmedication?

Reply from: Don W
Date: 15 Apr 2008, 06:27
Xalatan 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.






Reply from: Mike Tyner
Date: 15 Apr 2008, 08:03
Re: Xalatan drops overmedication?

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 * w w w .rxlist . com /cgi/generic/latanoprost_ids.htm


"Don W" <dwilgus@prodigy . net > wrote in message
news:O8WMj.1859$7Z2.872@newssvr12.news.prodigy . net ...
> 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.
>
>
>
>
>



Reply from: Don W
Date: 15 Apr 2008, 18:35
Re: Xalatan drops overmedication?

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.






"Mike Tyner" <mtyner@mindspring . com > wrote in message
news:MuidnQjPzYu12JnVnZ2dnUVZ_hisnZ2d@giganews . com ...
> 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 * w w w .rxlist . com /cgi/generic/latanoprost_ids.htm
>
>
> "Don W" <dwilgus@prodigy . net > wrote in message
> news:O8WMj.1859$7Z2.872@newssvr12.news.prodigy . net ...
>> 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.
>>
>>
>>
>>
>>
>
>



Reply from: Zetsu
Date: 15 Apr 2008, 18:38
Re: Xalatan drops overmedication?

On 15 Apr, 17:35, "Don W" <dwil...@prodigy . net > wrote:
> 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!

Reply from: Neil Brooks
Date: 15 Apr 2008, 18:44
Re: Xalatan drops overmedication?

On Apr 15, 9:38 am, Zetsu <absolutelyinvinci...@hotmail . com > wrote:
> On 15 Apr, 17:35, "Don W" <dwil...@prodigy . net > wrote:
>
> > 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.

Reply from: Zetsu
Date: 15 Apr 2008, 18:55
Re: Xalatan drops overmedication?

On 15 Apr, 17:44, Neil Brooks <neil0...@yahoo . com > wrote:
> On Apr 15, 9:38 am, Zetsu <absolutelyinvinci...@hotmail . com > wrote:
>
> > On 15 Apr, 17:35, "Don W" <dwil...@prodigy . net > wrote:
>
> > > 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.

Are you calling God an idiot?

Aren't you Christian, Neil?

Reply from: Mike Tyner
Date: 15 Apr 2008, 19:01
Re: Xalatan drops overmedication?


"Don W" <dwilgus@prodigy . net > wrote

> 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



Reply from: Don W
Date: 15 Apr 2008, 20:09
Re: Xalatan drops overmedication?

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).








"Mike Tyner" <mtyner@mindspring . com > wrote in message
news:RpudnTIzY9LlQpnVnZ2dnUVZ_hisnZ2d@giganews . com ...
>
> "Don W" <dwilgus@prodigy . net > wrote
>
>> 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
>
>






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