Pharmacological safety of using medicinal drugs in patients with dry eye syndrome and in patients with the risk of dry eye syndrome development
Authors: Tomashevska Yu. O. , Kryvoviaz O. V. 
Published: August 2020

The dry eye syndrome (DES) belongs to the group of tear film disorders, which are caused by either lowering of tear secretion or by the tear film instability. DES lowers the working capacity, worsens the quality of life and, if its symptoms are ignored for a long time, may lead to serious vision disorders, including blindness. The influence of environmental factors may be one of the reasons for intensification of the DES caused symptoms. In addition, there is a concept of iatrogenic DES, caused by a systemic and local use of medicinal drugs, by contact lenses, and by ophthalmological surgical and non-surgical manipulations.

The purpose of the research was to study the clinical-pharmacological characteristics of medicinal drugs in terms of peculiarities of their application in patients with DES who have adjoining disorders as well as to determine medicines that may contribute to DES occurrence and exacerbation causing secondary lowering of tear production and sensor glandular secretion, inflammation of Meibomian glands or direct irritation.

Materials of the research included the data of the medicinal drugs’ register, the search database of medicinal drugs Compendium, prescribing information and labelling of the drugs. Methods of research: biblio-semantic, content-analysis, segmenting, graphic, system analysis.

It has been determined that 194 medicinal drugs, which in accordance to the 1st level of ATC-classification system belong to 10 pharmaco-therapeutic groups, have certain treatment peculiarities in patients with dry eye syndrome. DES is mentioned in different sections of prescribing information and labelling of the drugs: «side effects» – 172 drugs, «peculiarities of use» – 21 drug, «drug-to-drug interaction» – 1 drug. Segmentation of the market by the type of medicinal form demonstrated a significant prevalence of eye drops and pills (34.02% and 33.50% respectively).

Taking into consideration the prevailing share of eye drops among other medicinal forms, which cause iatrogenic DES, further research is required to study their composition and define the correlation between the content of excipients and the risk of development of side effects in the form of dry keratoconjunctivitis of local ophthalmological medicinal drugs.

The results of the conducted complex research determine the groups of medicinal drugs that should be prescribed with special caution for pharmacotherapy of various organs and systems in patients with the risk of DES acquisition or exacerbation. The most numerous among them are such groups as S01E – Antiglaucoma drugs and myotics, L01X – Antineoplastic drugs and N02B – Analgesics and antipyretics, which account for 21.13%, 12.37% and 9.79%, respectively.

Presence of information about the risk of DES development as a result of drug-to-drug interaction in only 1 of 194 prescribing information and labelling of the drugs signifies an extremely low level of attention to the issue of medicinal drugs’ synergy in terms of their side effects.