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Biomedical subjects

S M Meyer

Publications and source records attributed to S M Meyer.

35 records · Page 2Linked to original sources
PubMed1987

Psychiatric side effects from topical ocular timolol, a beta-adrenergic blocker.

Neuropsychiatric side effects have been reported with various systemic betablockers. Data submitted to the National Registry of Drug-Induced Ocular Side Effects appear to indicate similar adverse reactions secondary to topical ophthalmic timolol. One hundred sixty-three of 369 central nervous system cases (44%) reported depression, psychosis, confusion, and hallucinations following topical ophthalmic timolol administration. The psychiatric community should be aware that sudden changes in mental status or onset of common psychiatric conditions, such as depression, may be due to topical ocular timolol. Withdrawal of the drug usually results in disappearance of these effects in 1 to 7 days.

Aged↗
PubMed1985

Adverse ocular reactions possibly associated with isotretinoin.

A total of 261 adverse ocular reactions occurred in 237 patients who received isotretinoin, a commonly used drug in the treatment of severe cystic acne. Blepharoconjunctivitis, subjective complaints of dry eyes, blurred vision, contact lens intolerance, and photodermatitis are reversible side effects. More serious ocular adverse reactions include papilledema, pseudotumor cerebri, and white or gray subepithelial corneal opacities; all of these are reversible if the drug is discontinued. Reported cases of decreased dark adaptation are under investigation. Isotretinoin is contraindicated in pregnancy because of the many reported congenital abnormalities after maternal use (including microphthalmos, orbital hypertelorism, and optic nerve hypoplasia).

Acne Vulgaris↗
PubMed1985

Hematologic reactions to carbonic anhydrase inhibitors.

The National Registry of Drug-Induced Ocular Side Effects has received 79 case reports of suspected hematopoietic toxicity caused by carbonic anhydrase inhibitors. Twenty-six of these suspected cases (32%) resulted in death secondary to aplastic anemia, thrombocytopenia, or agranulocytosis. In 54 of these 79, adverse reactions (68%) occurred during the first six months of therapy.

Acetazolamide↗
PubMed1984

Ocular toxicology update.

The National Registry of Drug-induced Ocular Side Effects has accumulated 13 cases of possible major haemopoietic responses from topical ocular chloramphenicol. Over 75 cases of major haemopoietic events from carbonic anhydrase inhibitors are also reviewed. While numerous reports of local ocular effects secondary to timolol have been received by the Registry, the more significant adverse effects are the same systemic side effects seen with any beta-receptor blocking agent. Data in the Registry have shown that allopurinol may be possibly associated with cataract formation. Severe cardiovascular effects with elevated blood pressure and stroke are uncommon systemic adverse reactions following topical ophthalmic 10% phenylephrine, but these systemic effects have also been seen secondary to concentrations of 2.5%. Other drugs, such as adrenaline (epinephrine), ecothiopate (echothiophate), practolol, thiabendazole, and penicillamine are suspected of causing ocular pseudopemphigoid.

Adult↗
PubMed1984

The national registry of drug-induced ocular side effects.

The National Registry of Drug-induced Ocular Side Effects is an international information centre for ocular toxicology. The Registry collects case reports of drug-induced ocular side effects from physicians and other national registries, and surveys the world literature for drug-related ocular events. Possible adverse drug associations can be identified in this system, and cause-and-effect relationships may on occasion be proven. Functions of this Registry include increasing ophthalmic awareness of human ocular toxicology, and promoting continuation of contributions to decrease the delay between recognition of a possible adverse drug reaction and the actual reporting of it in the literature.

Drug-Related Side Effects and Adverse Reactions↗
PubMed1983

Ocular toxicity of antineoplastic agents.

The increased use of chemotherapeutic agents has resulted in longer patient survival; consequently, the ophthalmologist is seeing more patients with adverse ocular side effects secondary to these antineoplastic agents. Many of these drugs cause aggravating ocular irritation (fluorouracil, methotrexate), canalicular fibrosis with epiphora (fluorouracil), retinopathy (mitotane, tamoxifen), corneal opacities (tamoxifen), cataracts (busulfan, methotrexate), and optic or ocular motor abnormalities (carmustine, vinblastine, vincristine). Based on the data in the National Registry of Drug-Induced Ocular Side Effects and the literature, adverse ocular reactions of the more commonly used chemotherapeutic agents are reviewed.

Adult↗
PubMed1980

3. Phenylephrine hydrochloride.

Phenylephrine hydrochloride is a potent, effective, relatively safe drug with few ocular side effects. Side effects from topical instillation are uncommon but include severe systemic cardiovascular effects with elevated blood pressure and stroke. Ten percent phenylephrine should be used with caution in patients with known cardiac disease, hypertension, aneurysms, long-standing insulin-dependent diabetes, or advanced arteriosclerosis. A 2.5% concentration is generally indicated for ophthalmic examination as well as for use in infants and in the elderly. Phenylephrine should not be used in patients with narrow-angle glaucoma, and it is also contraindicated in patients taking monoamine oxidase inhibitors or tricyclic antidepressants.

Administration, Topical↗
PubMed1977

Effects of dimethyl sulfoxide on ocular inflammation.

The anti-inflammatory properties of topical ocular dimethyl sulfoxide (DMSO) were investigated using a standard experimental model of an acute inflammatory ocular inflammation. Ninety percent and 100% DMSO aggravated the inflammatory response, 50% to 70% DMSO had similar responses as the control eye; however, 30% DMSO had definite anti-inflammatory properties. Dexamethasone 0.1% was superior to 30% DMSO as an anti-inflammatory agent. From this study it is evident that high concentrations of DMSO are irritating to the inflammatory ocular model used while lower concentrations have anti-inflammatory properties. The two side effects of skin irritation at the site of application and breath odor may be the subjective influence that leads certain patients to report a beneficial effect of DMSO treatment in ocular inflammation.

Acute Disease↗
PubMedDate not supplied

Systemic reactions to ophthalmic drug preparations.

Adverse systemic reactions associated with the use of topical ophthalmic timolol, chloramphenicol, phenylephrine and cyclopentolate are surveyed, with special emphasis on precautions and contraindications for these ophthalmic drug preparations. Systemic reactions secondary to timolol, a beta-adrenergic antagonist indicate that it should be used with caution in patients with asthma or a history of asthma, chronic obstructive pulmonary disease or cardiovascular disease and in those patients receiving systemic administration of beta-blockers or verapamil. Because significant blood dyscrasias or aplastic anaemia have been reported following topical ophthalmic chloramphenicol, the only absolute indication in ocular conditions is an organism that is resistant to all other antibiotics. Both 2.5% and 10% phenylephrine have been associated with cardiovascular effects and should be used with caution in selected patients on monoamine oxidase inhibitors, tricyclic antidepressants or atropine or in those with hypertension, advanced arteriosclerotic changes, aneurysms, orthostatic hypotension, long-standing insulin-dependent diabetes and in children with low bodyweights. Central nervous system toxicity secondary to cyclopentolate is dose-related and can be avoided by use of minimal concentrations and avoidance of unnecessary repetition of administration. Occlusion of the nasolacrimal passage with finger pressure immediately after instillation of any eyedrop also decreases the amount of drug that is absorbed systemically.

Chloramphenicol↗
PubMedDate not supplied

Physiologic assessment of the coronary collateral circulation in transplanted human hearts.

Coronary arteries of transplanted hearts frequently develop a vasculopathy characterized by severe lumenal narrowing in the distal coronary arteries. It has been thought, on the basis of angiographic studies, that the coronary circulation of transplanted hearts with vasculopathy fails to develop collateral vessels normally. To determine the extent of the collateral circulation in transplanted hearts with a significant coronary stenosis, we measured an index of the collateral circulation, the coronary artery occlusion pressure, during single-vessel coronary angioplasty in seven patients with allograft vasculopathy and 18 patients with atherosclerotic disease who did not undergo transplantation. Aortic and coronary artery pressure distal to the stenosis in the epicardial artery were measured during balloon occlusion (> or = 45 seconds). Measurement variability for determination of coronary occlusion pressure was assessed by measuring occlusion pressure on two separate balloon inflations (n = 17). The severity of the dilated stenotic lesion was assessed with quantitative angiography (Reiber-PIE Data method). The indexes of stenosis severity were similar in coronary arteries of transplanted and native hearts. Coronary occlusion pressure measurements were highly reproducible (mean absolute difference between measurements, 1 +/- 1 mm Hg, r = 0.98). Coronary occlusion pressure in transplanted hearts (32 +/- 4 mm Hg) was nearly identical to that measured in coronary arteries of native hearts (29 +/- 2 mm Hg). When vessels with total occlusion were excluded and corrections were made for minor differences in hemodynamics (heart rate and blood pressure) were made, the coronary occlusion pressure in transplanted hearts remained nearly identical to native hearts.(ABSTRACT TRUNCATED AT 250 WORDS)

Angina Pectoris↗
PubMedDate not supplied

Coronary angioplasty in heart transplant recipients: a quantitative angiographic long-term follow-up study.

Late morbidity and death as a result of transplant-related coronary vascular disease is a major unresolved problem for heart transplant recipients. Treatment of discrete coronary lesions in transplanted coronary arteries with angioplasty may be beneficial, but the long-term outcome and factors affecting restenosis are not known. To determine the effects of angioplasty on coronary caliber and the correlates of late restenosis, we studied the results of 25 balloon angioplasty procedures for physiologically significant coronary artery stenosis (> 15 mm Hg translesional pressure gradient) in nine heart transplant recipients. All patients underwent repeat coronary angiography within 6 months of angioplasty. Angiograms were analyzed by the Reiber-CAAS method of quantitative angiography. Procedural success rate was 100%, and there were no major complications. The minimum cross-sectional area of the lesion increased from 0.8 +/- 0.5 mm2 to 3.1 +/- 1.7 mm2 immediately after dilation. Percent area stenosis decreased from 89% +/- 7% to 62% +/- 13%. Six (24%) of 25 lesions developed late physiologically significant restenosis, defined as greater than 15 mm Hg translesional pressure gradient, and 10 of 25 had angiographic restenosis, defined as 50% area stenosis by quantitative angiography. The loss in minimum cross-sectional area of the lesion at late follow-up was related significantly to the minimum cross-sectional area (r = 0.67; p < 0.001) and percent area stenosis (r = 0.62; p < 0.01) immediately after angioplasty and the gain in minimum area (r = 0.62; p < 0.01) or loss in percent area stenosis (0.51%; p = 0.02) during the procedure.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗