[Models in nursing education].
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Biomedical subjects
Publications and source records attributed to C M Chapman.
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The ocular side-effects of prolonged practolol administration concern the cornea and conjunctiva and are related to deficient tear secretion and the formation of an autoantibody which has an affinity for the intercellular zones of squanmous epithelium. Histopathological study of six cases, including a review of the necropsy findings in two, showed destruction of lacrimal gland tissue, epidermalization of the conjunctival epithelium, with epitheliolysis and stromal ulceration of the cornea leading to perforation in two patients. Immunoperoxidase studies showed fixation of specific antibody in the corneal and conjunctival epithelium but, in the one case in which the tissue could be adequately studied, complement fixation could not be demonstrated. Possibly, therefore, the immune response in patients with practolol-induced ocular damage is secondary to the epithelial disturbance rather than its cause.
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Sixty-three patients with mild to moderate hypertension completed a double-blind, randomised crossover trial of atenolol 100 mg daily, enalapril 20 mg daily and the fixed combination atenolol 50 mg and nifedipine retard 20 mg (Tenif) once daily. In the three areas of efficacy that the study compared-24-hour post dose blood pressure, control of blood pressure over the dosing period with particular reference to the waking day and attenuation of systolic blood pressure on exercise-atenolol and the fixed combination demonstrated greater efficacy than enalapril.