Toxicity of Dipivalyl Epinephrine

Wandel, Thaddeus; Spinak, Maria

doi:10.1016/s0161-6420(81)35042-8

Cited by 26 publications

(4 citation statements)

References 5 publications

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“…Epinephrine was introduced for lowering of IOP in the 1930s 11 and was later replaced by dipivefrin; they are non-selective alpha-adrenergic agonists and also lower outflow resistance, although the mechanism is not well understood. Both are associated with the frequent development of local adverse events, including blepharoconjunctivitis 12, 13 . These various adverse effects limit the utility of these drug classes for long-term therapy.…”

Section: Introductionmentioning

confidence: 99%

Rho Kinase Inhibitors as a Novel Treatment for Glaucoma and Ocular Hypertension

2018

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In an elegant example of bench-to-bedside research, a hypothesis that cells in the outflow pathway actively regulate conventional outflow resistance was proposed in the 1990s and systematically pursued, exposing novel cellular and molecular mechanisms of intraocular pressure (IOP) regulation. The critical discovery that pharmacologic manipulation of the cytoskeleton of outflow pathway cells decreased outflow resistance placed a spotlight on the Rho kinase pathway that was known to regulate the cytoskeleton. Ultimately, a search for Rho kinase inhibitors led to the discovery of several molecules of therapeutic interest, leaving us today with 2 new ocular hypotensive agents approved for clinical use: ripasudil in Japan and netarsudil in the United States. These represent members of the first new class of clinically useful ocular hypotensive agents since the US Food and Drug Administration approval of latanoprost in 1996. The development of Rho kinase inhibitors as a class of medications to lower IOP in patients with glaucoma and ocular hypertension represents a triumph in translational research. Rho kinase inhibitors are effective alone or when combined with other known ocular hypotensive medications. They also offer the possibility of neuroprotective activity, a favorable impact on ocular blood flow, and even an antifibrotic effect that may prove useful in conventional glaucoma surgery. Local adverse effects, however, including conjunctival hyperemia, subconjunctival hemorrhages, and cornea verticillata, are common. Development of Rho kinase inhibitors targeted to the cells of the outflow pathway and the retina may allow these agents to have even greater clinical impact. The objectives of this review are to describe the basic science underlying the development of Rho kinase inhibitors as a therapy to lower IOP and to summarize the results of the clinical studies reported to date. The neuroprotective and vasoactive properties of Rho kinase inhibitors, as well as the antifibrotic properties, of these agents are reviewed in the context of their possible role in the medical and surgical treatment of glaucoma.

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Section: Introductionmentioning

confidence: 99%

Rho Kinase Inhibitors as a Novel Treatment for Glaucoma and Ocular Hypertension

2018

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“…However, external dipivefrin toxicity with hypersensitivity reactions and giant follicular con-502 junctivitis has been described (Wandel & Spinak 1981;Liesegang 1985;Coleiro et al 1988). …”

Section: Side Effectsmentioning

confidence: 99%

“…The prodrug dipivefrin which is converted to epinephrine inside the eye can be expected to produce less external and systemic adverse reactions but causes just as many macular edema as epinephrine. However, external dipivefrin toxicity with hypersensitivity reactions and giant follicular con-502 junctivitis has been described (Wandel & Spinak 1981;Liesegang 1985;Coleiro et al 1988).…”

Section: Side Effectsmentioning

confidence: 99%

Pharmacological and clinical aspects of glaucoma therapy

Berggren

1990

Acta Ophthalmologica

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“…Porém, os demais efeitos tópicos induzidos pela epinefrina, como conjuntivite folicular e alergia, estão presentes na mesma intensidade, uma vez que a dipivefrina é uma pró-droga da epinefrina (Wandel et al, 1981;Liesegang et al, 1985 …”

Section: Dipivefrinaunclassified

Alterações conjuntivais induzidas por análogos das prostaglandinas e maleato de timolol: estudo histomorfométrico

Giacometti

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Toxicity of Dipivalyl Epinephrine

Cited by 26 publications

References 5 publications

Rho Kinase Inhibitors as a Novel Treatment for Glaucoma and Ocular Hypertension

Rho Kinase Inhibitors as a Novel Treatment for Glaucoma and Ocular Hypertension

Pharmacological and clinical aspects of glaucoma therapy

Alterações conjuntivais induzidas por análogos das prostaglandinas e maleato de timolol: estudo histomorfométrico

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