Prostaglandins latanoprost

The rather simpler ophthalmic prostaglandin latanoprost (10), carries a simple benzene ring directly at the end of the side chain. The amide of this drug is said to be better tolerated because of the absence of an acidic carboxyl group. Reaction of 10 with l,8-diazobicyclo[5.4.0]undec-7-ene... 

In a meta-analysis of all clinical trials with a direct comparison of prostaglandins (latanoprost, bimatoprost, and travoprost) in which adverse events were reported, there was a higher incidence of conjunctival hyperemia in patients who used bimatoprost 0.03%. [34 ]. 

Prostaglandin Analogs Latanoprost Prostaglandin Xalatan Solution 0.005 1 drop every night Increases aqueous... 

Prostaglandin analogs Latanoprost Prostaglandin F2a analog Xalatan Solution... 

Xalatan drops is a proprietary preparation of latanoprost (prostaglandin analogue), indicated in glaucoma. 

Xalatan (latanoprost) is a prostaglandin analogue, which increases the uvoscleral outflow, thereby decreasing the intraocular pressure. The drops, which are applied once daily, preferably in the evening, may cause eye discoloration especially in patients with mixed colour irides. 

K. Bergh, P. Wentzel, J. Stjernschantz, Production of prostaglandin E2 by iridial melanocytes exposed to latanoprost acid, a prostaglandin p2a analogue, J. Ocular Pharmacol. Then 18 (2002) 391. 

T. Ota, FI. Murata, E. Sugimoto, M. Aihara, M. Araie, Prostaglandin analogues and mouse intraocular pressure Effects of tafluprost, latanoprost, travoprost, and uno-prostone, considering 24-hour variation. Invest. Ophthalmol. Vis. Sci. 46 (2005) 2006. 

Seven patients using different topical prostaglandin F2a analogues developed bilateral poliosis, which appeared at 1.5-6 months after the start of therapy (17). Four used latanoprost, two used bimatoprost, and one used travaprost... 

Unoprostone is a synthetic prostaglandin analogue of PGF2a used in the treatment of glaucoma. Its mechanism of action is believed to be by enhancing uveoscleral outflow, like latanoprost. 

Latanoprost (Figure 3.19) is a recently introduced prostaglandin analogue which increases the outflow of aqueous humour from the eye. It is thus used to reduce intraocular pressure in the treatment of the eye disease glaucoma. 

The Pfizer process to latanoprost starts with the Corey aldehyde benzoate (13, CAB), available as a relatively stable crystalline solid via the historic Upjohn prostaglandin synthesis (Scheme 3).17 The reaction of the phosphonate with CAB (13) is done using... 

Basu S, Sjoquist B (1996) Development of a radioimmunoassay for latanoprost and its application in a long-term study in monkeys. Prostaglandins-Leukot-Essent-Fatty-Acids 55(6) 427-432... 

Topical beta-blockers can precipitate asthma and therefore must not be used to treat this patient s glaucoma. Topical prostaglandin analogues (e.g. latanoprost drops) are used as first-line treatment of glaucoma together with a sympathomimetic agent, brimonidine, as an alternative to beta-blockers in asthmatic and COPD patients. 

Latanoprost and other prostaglandin analogues have supplanted the p-blockers as the drugs of first choice... 

Numerous cases have been reported in which latanoprost therapy has been associated with the development of cystoid macular edema (CME). Considering the role that prostaglandins play in the pathogenesis of CME, it may be reasonable to assume that topically applied latanoprost can increase the risk of CME. However, latanoprost itself is not known to be vasoactive or to affect vascular permeability. Furthermore, pharmacokinetic studies have feiled to demonstrate significant levels of latanoprost in the posterior segment of the eye after topical application. Indeed, controlled clinical studies... 

Similar to CME, a number of cases have been reported alleging an association between latanoprost therapy and the development of anterior uveitis. Although prostaglandins play an important role in the development of vascular permeability associated with uveitis, disruption of the blood-aqueous barrier associated with latanoprost can be small, transient, and sometimes reversible despite continued latanoprost therapy. 

Several cases have been reported in which herpes simplex virus keratitis developed after initiation of latanoprost therapy. Although these cases are anecdotal, it is known that prostaglandins may play a crucial role in mediating inflammatory events that could incite herpetic infection. 

It is recognized that many patients treated for glaucoma require a second concomitant medication to lower lOP. The appeal of a combination product stems from the belief that adherence to complex multiple medical regimens is improved with simplified dosing schedules. The two most common ocular hypotensive medications are in the prostaglandin and P-blocker classes. Several combination products are presently available worldwide that combine various prostaglandin analogues with a non-selective P-blocker.These products include a combination of latanoprost or travoprost with timolol. Studies have demonstrated comparable efficacy and in the case of the travoprost-timolol combination, a favorable lOP reduction between the combination product and the separate compounds administered concomitantly. At the present time, neither combination product is available in the United States. 

Brimonidine s efficacy has been compared with that of prostaglandin analogues, topical CAIs, and P-blockers. Results in patients with glaucoma and ocular hypertension indicate that the peak ocnlar hypotensive effect of 0.2% brimonidine is comparable with that of 0.5% timolol (Figure 10-11). When dosed twice daily, 0.2% brimonidine is less effective than latanoprost 0.005% administered once daily. Brimonidine 0.15% with Purite is similar to dorzolamide 2% when used twice daily fc>r treatment of primary open-angle glaucoma or ocular hypertension. 

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