Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0595921 (intraocular pressure)
 11,750 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The intraocular pressure responses of topically applied dipivalyl epinephrine (DPE: 0.025, 0.1, and 0.25%) were investigated in three series of open angle glaucoma patients in a double blind study. IOP responses were compared intra-individually with the effects of 1% epinephrine hydrochloride. 0.1% DPE gave an IOP reduction similar to that of 1% epinephrine-HCl. The change in IOP was less with 0.025% DPE and statistically significantly greater with 0.25% DPE when compared with the conventional epinephrine preparation. The clinical advantages of the 'pro drug' DPE are pointed out.
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PMID:The dose-response relationships of dipivalyl epinephrine in open-angle glaucoma. 30 28

Of 26 patients enrolled in a study designed to assess the usefulness of dipivalyl epinephrine 0.1%, administered topically at 12-hour intervals, for lowering intraocular pressure in patients with glaucoma and ocular hypertension, six patients (23.1%) developed adverse external ocular side effects severe enough to require that the drug be discontinued. Four of these six patients had a history of previous intolerance to epinephrine. The other two had successfully used epinephrine HCl 2% for more than two years before being treated with dipivalyl epinephrine and developed an adverse reaction after taking the drug 18 and 22 months, respectively. One patient with a history of epinephrine intolerance has successfully used dipivalyl epinephrine for 26 months to date. Our observations suggest that duration of exposure is an important factor in the development of sensitization to topically applied dipivalyl epinephrine.
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PMID:External ocular toxicity of dipivalyl epinephrine. 51 3

Nonglaucomatous individuals were classified by their intraocular pressure response to 6 weeks of topical dexamethasone, 0.1%, four times daily. Twenty GG responders (over 31 mm. Hg after dexamethasone) and 20 NN responders (below 20 mm. Hg after dexamethasone) of similar age, sex, race, initial intraocular pressure, and facility of outflow were selected. After 24 hr. of treatment (two doses) with 1% epinephrine HCl, the GG subjects demonstrated a mean (+/-sigma) corrected decrease in intraocular pressure of 4.2 mm. Hg (+/- 2.5) as opposed to 1.8 mm. Hg (+/- 2.1) in the NN subjects (p less than 0.005). The relationship between increased responsiveness to corticosteroids, to epinephrine, and to theophylline suggested cyclic nucleotides as a possible common pathway.
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PMID:The ocular hypotensive effect of epinephrine in high and low corticosteroid responders. 86 12

We evaluated the prophylactic effect of 1% apraclonidine HCl in controlling the increase in intraocular pressure after Nd:YAG posterior capsulotomy in a large, multicenter double-masked clinical trial. One hundred sixty-four patients were enrolled into the apraclonidine-treated group, and 165 into the vehicle-treated group. The incidence of increase in intraocular pressure (greater than 5 mm Hg) in the apraclonidine-treated group (7%, 11 of 163 patients) was significantly less than that in the vehicle-treated group (39%, 64 of 164 patients). Similarly, the mean maximal change in intraocular pressure in the apraclonidine-treated group (1.3-mm Hg decrease) was significantly different from the increase in the vehicle-treated group (5.3-mm Hg increase). Few adverse reactions were observed. The risk for significant loss of visual function after Nd:YAG laser posterior capsulotomy, combined with the efficacy and relative safety of prophylactic apraclonidine, suggest its addition to the treatment armamentarium.
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PMID:Prophylactic use of apraclonidine for intraocular pressure increase after Nd:YAG capsulotomies. 135 49

Treatment with topical anesthetics was reported to increase corneal permeability and improve ocular drug bioavailability. These changes were attributed to the loss of reflex blinking, reduction of tear secretion and appearance of superficial corneal epithelial lesions. A recent report showed that pretreatment with Ophthetic (0.5% proparacaine HCl) (OPH) in pentobarbital-anesthetized rabbits significantly increased the permeability of the lipophobic carbonic anhydrase inhibitor (CAI) benzolamide (B) and transformed it to a highly active ocular hypotensive drug. This did not affect the permeability and activity of other, more lipophilic, CAI like methazolamide and ethoxzolamide (E). Similar experiments in awake rabbits using other CAI failed to reproduce the finding reported for B. We compared the ocular drug levels and the intraocular pressure lowering (delta IOP) with and without application of Ophthetic prior to 1 drop of 2% suspensions, in groups of anesthetized and conscious albino rabbits. In unanesthetized rabbits pretreatment with Ophthetic, lidocaine or benzalkonium had minimal and insignificant effects on ocular drug levels and delta IOP of B as well as E. On the other hand, Ophthetic or lidocaine pretreatment in anesthetized rabbits led to a highly significant increase in both ocular drug levels and hypotensive activity of B. We conclude that the error introduced by pretreatment with OPH occurs only in the presence of pentobarbital anesthesia and has little relevance to the normal, unanesthetized condition.
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PMID:The effects of topical and general anesthesia on ocular drug levels and intraocular pressure lowering activity of topically applied carbonic anhydrase inhibitors. 317 30

The aim of the present study was to show the effect of different topical beta-blocking agents on aqueous humor formation with a clinically practicable method. In a clinical, randomized, prospective double-blind study, 60 healthy volunteers were examined by means of oculopression tonometry according to Ulrich. The placebo was applied to 29 subjects; a nonselective beta-blocker (timolol maleate 0.5%) was given to 14 volunteers and 17 subjects received a cardioselective, beta-1-blocking agent (betaxolol-HCl 0.5%). On the 1st day, intraocular pressure (IOP) was lowered by the suction cup method and then we measured the time required for IOP to return to the initial value. The examination procedure of the 1st day was repeated on the 2nd day 3 h after application of the ophthalmic solution. After evaluation of the different groups, we could show that the recovery times in the placebo groups were comparable. Furthermore, we showed that both beta-blockers slow down the increase of IOP to the initial value. There was a statistically significant difference in recovery time between timolol and placebo. This difference was statistically not significant between betaxolol and placebo.
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PMID:[Effect of nonspecific and cardioselective beta receptor blockers on the formation of aqueous humor. An oculopressure tonometry study]. 328 32

A clinical study of 70 ambulant and stationary patients showed that of 104 eyes with pseudoexfoliation (PE) syndrome there were 62 eyes (60%) with confirmed chronic glaucoma and 8 (8%) with suspected chronic glaucoma. This is a considerably higher percentage than would normally be expected in a comparable group with an average age of 75 years (between 50 and 95 years). The biomicroscopic picture reveals symptoms of dispersion glaucoma with pigment participation. Provoked through diagnostic mydriasis by means of 0.5% tropicamide HCl and 10% phenylephrine HCl, 44 (52%) of the 84 eyes tested showed a significant increase in intraocular pressure by greater than or equal to 4 mm Hg and 20 (24%) by greater than or equal to 10 mm Hg. A possible cause of the pressure increase, in each case with open chamber angle, is the observed dispersion of the PE material and the adhering pigment fragments. From this observation and from a comparison with existing literature, it is inferred that the PE layers are the result of a sedimentation which also takes place in the chamber angle and in the trabecular meshwork, causing, in a first stage, chronic secondary open-angle glaucoma. In a second stage, the sediments may become detached from their base and cause pressure peaks through acute obliteration of the trabecular meshwork. The lack of proof of an inflammatory, immunological, or hereditary origin of this disease where it frequently occurs in certain areas, leads to the hypothesis of an alimentary or toxic disorder.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Pseudoexfoliation syndrome as a cause of chronic glaucoma]. 380 21

The effects of 3-[2-[4-(2-methylphenyl)-1- piperazinyl]ethyl]-5,6,7,8-tetrahydro-1,2,4-triazolo[4,3-a]pyridine HCl (dapiprazole), a new drug with alpha-adrenergic blocking properties, on pupillary diameter and intraocular pressure have been studied in rabbits. Following i.v. administration, a reduction of intraocular pressure is observed at doses devoid of activity on pupillary diameter. Following topical application, a miotic and ocular hypertensive action was observed at the same doses; the hypotensive action is produced in both normal rabbits and in rabbits with water load- or corticosteroid-induced ocular hypertension. Contact lenses increase the duration of effects of dapiprazole. These results suggest a potential interest of dapiprazole in glaucoma, with particular reference to the topical treatment of angle-closure glaucoma.
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PMID:Effects of dapiprazole on pupillary size and intraocular pressure in rabbits. 612 99

Ampholyte carbonic anhydrase inhibitors (including MK-927) have previously been shown to elicit greater intraocular pressure reduction when applied in ionized form at moderately acidic or alkaline pH compared to application of un-ionized drug at neutral pH. Since ionized solutions should be far more membrane-impermeant than un-ionized solutions, we attempted to solve this apparent paradox. We studied the distribution at 0.5-18 hr of MK-927 in eye tissues and fluid after topical instillation of one drop of a 0.5% solution at pH 4.9, 7.0 and 9.1. Measured drug concentrations at 30 min in corneal epithelium and stroma are approximately 4.5-fold greater after acidic or alkaline application than after neutral application, with the highest levels being found in corneal epithelium. The same pattern is seen in ciliary process, the site of aqueous humor production. Here drug concentration is approximately 60% of that in cornea at 30 min. Free drug concentrations in ciliary process were used to compute the time course of maximal carbonic anhydrase inhibition for the three modes of application. Drug concentration in sclera, uvea and aqueous humor at all times are all low by comparison, suggesting drug movement is from cornea to ciliary process via the corneo-scleral junction. The k(in) for proton movement across the corneal epithelium was measured (k(in) = 12.4 hr-1) from which a permeability coefficient (P = 2.7 x 10(-2) cm sec-1) was computed. Separate analysis was made of the pH status of the cornea 30 min and 1 hr following instillation of 1 drop 2% acidic (pH 4.9) and alkaline (pH 9.1) MK-927, with sodium sulfadiazine and pilocarpine.HCl as pH controls. Stromal bicarbonate at 30 min was approximately halved after acidic drops and doubled after alkaline drops consistent with pH decrease or increase of nearly 0.3 U. The results are in accord with classical schemes for amine permeation of the cornea at acidic pH when consideration is given to movement of acid equivalents and corneal pH. Thus drug inside the eye is in relatively (> 95%) lipophilic form except that trapped in the cornea shortly after acidic or alkaline applications.
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PMID:Effect of pH on the ocular distribution of a topical carbonic anhydrase inhibitor. 755 85

The aim of this randomized, double-blind study with two parallel groups was to examine the safety, efficacy and tolerability of two combination eye drops containing 0.5% timolol and 2% pilocarpine (Fotil, Leiras, Finland, and Timpilo, MSD, USA) in patients with glaucoma or ocular hypertension. Efficacy was determined based on daytime intraocular pressure curve and safety by examining visual fields, visual acuity, optic discs, by determining blood pressure and pulse rate, and by performing Schirmer and fluorescein tests. A total of 89 patients were enrolled, and 71 completed the 10-week treatment period. This study showed that the two combinations of 0.5% timolol maleate and 2% pilocarpine HCl compared in this study were equally effective in reducing intraocular pressure. The decrease in mean daily intraocular pressure from 0 to 10 weeks was 7.48 mmHg for Fotil, and 6.31 for Timpilo. The mean decrease in mean daily intraocular pressure was 29.3% for Fotil, and 26.0% for Timpilo. No significant differences were found between the groups. Adverse event were reported by 70 out of 89 patients by the end of 2 weeks, but were severe enough only in 11 for the treatment to be discontinued. In all others, adverse events were of transient nature and considered mild. In general, adverse events were similar in both study groups. However, burning was more common in patients on Fotil, and blurring of vision and light sensitivity were more common in patients on Timpilo. In patients with no contraindication to beta-blockers, these drugs appeared to be safe.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Efficacy and safety of timolol/pilocarpine combination drops in glaucoma patients. 782 20


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