Chirality in ocular agents.
OBJECTIVE
To review the role of chirality in current ocular pharmacology. The importance of stereo-isomeric purity has frequently been emphasized in recent years. Development of chirally pure medications can lead to improved efficacy and side-effect profiles. Practitioners prescribing ocular agents may benefit from understanding the effects of chirality in their evaluation of old and new medications.


RESULTS
Chirality can affect multiple classes of ocular agents. Although the ways in which stereo-isomers influence the properties of a drug differ, this review illustrates the benefit of knowledge of individual isomers' effects in clinical decision making. The variety of possible effects stereo-isomers produce further underlines the importance of purification and in-depth analysis of chiral compounds.


CONCLUSIONS
Many important agents exist as a mixture of two different stereoisomers. Both isomers may produce a pharmacological effect; however, these effects may be different from one another and one isomer may even give a result opposite from the desired pharmacological effect. Here we examine published findings on ocular medications relating to their chiral nature and summarize the possible ways chirality affects the activity of a few ocular agents. Many more ocular medications have not been investigated to ascertain their chiral properties. This review adds to the recent emphasis on investigating stereo-isomers for individual selectivity of beneficial and adverse profiles.
Leonov
Andrey
A
UMDNJ - New Jersey Medical School, Newark, NJ 07103, USA.
Bielory
Leonard
L
D000777:Anesthetics / Q000737:chemistry / Q000627:therapeutic use; D000818:Animals; D018926:Anti-Allergic Agents / Q000737:chemistry / Q000627:therapeutic use; D018680:Cholinergic Antagonists / Q000737:chemistry / Q000627:therapeutic use; D064420:Drug-Related Side Effects and Adverse Reactions; D005128:Eye Diseases / Q000188:drug therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000737:chemistry / Q000627:therapeutic use; D004364:Pharmaceutical Preparations / Q000737:chemistry*; D013237:Stereoisomerism; D014662:Vasoconstrictor Agents / Q000737:chemistry / Q000627:therapeutic use
D000777:Anesthetics; D018926:Anti-Allergic Agents; D018680:Cholinergic Antagonists; D007166:Immunosuppressive Agents; D004364:Pharmaceutical Preparations; D014662:Vasoconstrictor Agents