Intraocular hypertension

Glaucoma Lowering intraocular pressure (lOP) in patients with chronic open-angle glaucoma and intraocular hypertension. 

The enzyme chymotrypsin has been used for enzymatic zonulolysis during operations for cataract (1). Its possible role in precipitating postoperative intraocular hypertension has been studied, but the use of enzymatic... 

Pandey K, Badola RP, Kumar S. Time course of intraocular hypertension produced by suxamethonium. Br J Anaesth 1972 44(2) 191-6. 

Pate, D.W. Jarvinen, T. Jarvinen, K. Urtti, A. Anandamide Analog Compositions and Method of Treating Intraocular Hypertension Using Same 1999 US 5,977,180... 

The combination is indicated in reduction of lOP in patients with ocular hypertension or open-angle glaucoma. Timolol (Blocadren, others) is a potent, non-subtype-selective P-receptor antagonist. It has no intrinsic sympathomimetic or membrane-stabilizing activity. It is used to treat hypertension, CHF, migraine prophylaxis, and has been widely used for treatment of open-angle glaucoma and intraocular hypertension. 

This drug exhibits strong diuretic action during both acidosis and alkalosis. It is used for arterial hypertension, in edematous syndromes of various genesis, congestive effects in cardiovascular insufficiency, nephrosis and nephritis, and toxicosis. It is especially recommended for hypertonic illnesses. It lowers intraocular pressure in a number of cases. Synonyms of this drug are clotride, diupres, diuril, and others. 

Special risk patients Administer with caution to patients with thyroid disease, diabetes mellitus, cardiovascular disease, coronary artery disease, hypertension, peripheral vascular disease, heart disease, ischemic heart disease, increased intraocular pressure, or prostatic hypertrophy. 

Special risk patients Use antihistamines with caution in patients with narrow-angle glaucoma, stenosing peptic ulcer, pyloroduodenal obstruction, symptomatic prostatic hypertrophy, bladder neck obstruction, bronchial asthma, increased intraocular pressure, hyperthyroidism, cardiovascular disease, and hypertension. 

Intraocular pressure (lOP) To lower lOP in patients with open-angle glaucoma or ocular hypertension. 

Elevated intraocular pressure f/OPJ Treatment of elevated lOP in patients with ocular hypertension or open-angle glaucoma. 

Elevated intraocular pressure (lOP) For reduction of elevated lOP in patients with open-angle glaucoma and ocular hypertension who are intolerant of other lOP-lowering medications or insufficiently responsive to another lOP-lowering medication. 

Blockers can reduce intraocular pressure in glaucoma and ocular hypertension. The mechanism is believed to be related to a decreased production of aqueous humor. 

Blockers can be used topically to reduce intraocular pressure in patients with chronic open-angle glaucoma and ocular hypertension. The mechanism by which ocular pressure is reduced appears to depend on decreased production of aqueous humor. Timolol has a somewhat greater ocular hypotensive effect than do the available cholinomimetic or adrenomimetic drugs. The 3-blockers also are beneficial in the treatment of acute angle-closure glaucoma. 

Other reported side effects include vomiting, salivation, lacrimation, shivering, skin rash, and an interaction with thyroid preparations that may lead to hypertension and tachycardia. Ketamine also may raise intracranial pressure and elevate pulmonary vascular resistance, especially in children with trauma or congenital heart disease. Increases in intraocular pressure also may occur, and vigilance is required if ketamine is used in ocular surgery. 

Glucocorticoids induce cataract formation, particularly in patients with rheumatoid arthritis. An increase in intraocular pressure related to a decreased outflow of aqueous humor is also a frequent side effect of periocular, topical, or systemic administration. Induction of ocular hypertension, which occurs in about 35% of the general population after glucocorticoid administration, depends on the specific drug, the dose, the frequency of administration, and the glucocorticoid responsiveness of the patient. 

Antagonists of glucocorticoid and mineral ocorticoid activity have found increased use clinically in the treatment of hypertension, Cushing s disease, and heightened intraocular pressure. 

The effects of topical dexamethasone on intraocular pressure have been compared with those of fluorometho-lone (SEDA-22, 446 66). The ocular hypertensive response to topical dexamethasone in children occurs more often, more severely, and more rapidly than that reported in adults. It should be avoided in children if possible and it is desirable to monitor the intraocular pressure when it is being used. Fluorometholone may be more acceptable. 

The ocular hypertensive response in this case could have been due to systemic absorption of glucocorticoid through the skin of the eyelid, especially when there was a surgical wound. Alternatively, a sufficient amount of ointment could have seeped over the eyelid margins, causing the rise in intraocular... 

Interactions The vitamin pyridoxine (B6) increases the peripheral breakdown of levodopa and diminishes its effectiveness (Figure 8.6). Concomitant administration of levodopa and monoamine oxidase (MAO) inhibitors, such as phenelzine (see p. 124), can produce a hypertensive crisis caused by enhanced catecholamine production therefore, caution is required when they are used simultaneously. In many psychotic patients, levodopa exacerbates symptoms, possibly through the buildup of central amines. In patients with glaucoma, the drug can cause an increase in intraocular pressure. Cardiac patients should be carefully monitored because of the possible development of cardiac arrhythmias. Antipsychotic drugs are contraindicated in parkinsonian patients, since these block dopamine receptors and produce a parkinsonian syndrome themselves. 

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