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At least 55 records · Page 3Linked to original sources
PubMed1983

Drop attack in glaucoma. The Melbourne experience with topical miotics, adrenergic and neuronal blocking drops.

We have considered the effectiveness of miotics (pilocarpine 2% and ecothiopate iodide (Phospholine Iodide) 0.125 or 0.25%), adrenaline (Eppy/N 1%) or adrenaline precursors (dipivalyl epinephrine or dipivefrin hydrochloride (Propine) 0.1%) and neuronal blockers (timolol maleate (Timoptol) 0.5%) in 165 patients in the clinical situation. All drops were effective in lowering intraocular pressure with an average fall of 6.6 mmHg for timolol (160 eyes), 8.21 mmHg for pilocarpine (79 eyes), 5.77 mmHg for dipivalyl epinephrine (57 eyes), 7.23 mmHg for adrenaline (17 eyes) and 10.5 mmHg for ecothiopate iodide (16 eyes). In chronic simple open-angle glaucoma, ocular hypertension and pseudoexfoliative glaucoma, pilocarpine and timolol were almost equally effective while dipivalyl epinephrine and adrenaline were also effective, but more as additive therapy, though dipivalyl epinephrine may be useful on its own in ocular hypertension. In low-tension glaucoma timolol and dipivalyl epinephrine together seemed best, while in secondary glaucomas all were effective at times, but ecothiopate iodide was best in aphakic glaucoma and fluorometholone (FML Liquifilm) 0.1% was important in inflammatory glaucoma. Side effects were frequent with dipivalyl epinephrine and timolol, with respiratory disease a strong contraindication to timolol.

Echothiophate Iodide↗
PubMed1978

Effects of intraocular miotics on cultured bovine corneal endothelium.

Two cases of severe corneal oedema occurred after the use of intraocular pilocarpine. Experimental investigations were conducted with cultured bovine corneal endothelial cells exposed for 5 minutes to 1% pilocarpine solutions of varying composition. Cells were destroyed in solutions not isotonic with aqueous humour, and calcium-free ionic solutions caused loss of cell adhesion without loss of viability. Low pH or the presence of 1% pilocarpine had no detectable effects; 1% acetylcholine chloride in 5% mannitol (Miochol) also caused cell destruction, and this preparation was found to be considerably hypertonic. The minimum requirements for the formulation of intraocular miotics are discussed.

Acetylcholine↗
PubMed1976

The effect of miotics on the intraocular pressure of conscious owl monkeys.

The intraocular pressure of conscious, unsedated owl monkeys (Aotus trivirgatus) was measured with an applanation tonometer. Untreated eyes of the conscious animals were found to have higher values than those reported for owl monkeys anesthetized with pentobarbitone. Locally applied pilocarpine, carbachol, and oxotremorine gave concentration-related reduction in pressure, oxotremorine being the most potent and having longer duration of effect than the other compounds. Slight reductions were also observed with aceclidine and R. S. 86. These results are discussed in relation to the effects of miotics in man.

Anesthesia, Local↗
PubMed1987

Visual field improvement after neodymium: YAG laser puncture of miotic cysts.

This case report describes the use of a Q-switched neodymium:YAG laser to puncture miotic cysts. Fifteen shots of 0.06 mJ were needed. The pupil dilated more widely following this procedure, resulting in an improvement in the patient's visual field. Intraocular pressure (IOP) was not able to be controlled medically, however, and filtering surgery 20 days post laser treatment was required. IOP control had been poor prior to the laser-treatment, and did not appear to be more following treatment.

Adult↗
PubMed1981

The miotic effect of substance P on the isolated rabbit iris.

The effect of substance P on the rabbit iris was investigated by continuously monitoring the pupil size in vitro. Continuous perfusion with substance P caused a concentration-dependent contraction of the iridial sphincter muscle. The threshold was 2 x 10(-10) M. A concentration-response curve was made for 60 sec exposures of the iris to substance P. Blockade of muscarinic, nicotinic, alpha-, and beta-adrenergic receptors as well as blockade with the putative presynaptic substance P-blocking agent baclofen did not affect the constrictor response to substance P. Pretreatment of the rabbits with indomethacin was also without effect. No effect of substance P was seen on the isolated iridial dilator muscle. Although the miotic response to substance P was observed in a calcium-free perfusion fluid, EGTA added to calcium-free perfusate diminished the effect of substance P. The response of the iris to substance P and the time course of the response make it likely that substance P is involved in the miosis of the nerve-mediated irritative response of the eye.

Adrenergic alpha-Antagonists↗
PubMed1993

A new technique for combined cataract/glaucoma procedures in patients on chronic miotics.

We describe a combined cataract/glaucoma procedure for patients on chronic miotics that includes small-incision phacoemulsification to provide increased predictability of visual outcome and early visual rehabilitation, and an inferior pupilloplasty to facilitate intraoperative visualization. To date, 42 procedures have been performed with excellent results. Complications, although minimal, have included iridolenticular/iridocapsular adhesions, diplopia, rupture of 10-0 polypropylene sutures, peripheral anterior synechia, hyphema, and fibrinoid aqueous.

Cataract Extraction↗
PubMed1997

Pharmacogenetic determinants of codeine induction by rifampin: the impact on codeine's respiratory, psychomotor and miotic effects.

Our objective was to examine the effect of rifampin on codeine's pharmacodynamics and pharmacokinetics in extensive (EMs) and poor (PMs) metabolizers of debrisoquin. Fifteen healthy, nonsmoking males, 9 EMs and 6 PMs of debrisoquin, received codeine (120 mg) before and after rifampin (600 mg/d) for 3 weeks. The effects of codeine on respiration, pupil diameter and psychomotor performance were measured before codeine administration and during each study day. The pharmacokinetics of codeine were determined from the respective plasma and urine concentrations. Before the administration of rifampin, the pharmacodynamic effects of codeine were more prominent in the EMs (P < .01). Rifampin significantly enhanced codeine oral clearance by increasing its metabolic clearances through N-demethylation and glucuronidation in both phenotypes, but its O-demethylation was induced only in EMs. Relative to base-line values, codeine N-demethylation was induced to a greater extent, resulting in a marked reduction in the plasma concentrations of codeine and codeine metabolites and elevated plasma concentrations of norcodeine, norcodeine-glucuronide, and normorphine. The reduction in morphine plasma concentration was associated in the EMs with a significant attenuation of codeine's respiratory and psychomotor effects, whereas its miotic effect was unaltered. In PMs, codeine's respiratory and psychomotor effects were unaltered by rifampin, but its pupillary effect was reduced. Codeine O-demethylation to produce morphine can be significantly induced by rifampin, but this induction is phenotypically determined. However, because (relative to base-line values) rifampin enhanced codeine N-demethylation more than codeine O-demethylation, morphine plasma concentrations were reduced-and hence codeine's pharmacodynamic effects were attenuated-in EMs of debrisoquin.

Adult↗
PubMed1995

The additive miotic effects of dapiprazole and pilocarpine.

BACKGROUND: Since dapiprazole on alpha-adrenergic agent, produces miosis by paralyzing the dilator muscle, and pilocarpine, a parasympathetic drug, causes miosis by affecting the sphincter, we speculated that the two drugs might have additive effects. METHODS: The additive miotic actions of pilocarpine 2% and dapiprazole 0.5% were evaluated by comparing the effects of two drugs given together and alone on the reversal of mydriasis induced by tropicamide (0.5%) and phenylephrine (10%) in one eye each of 60 healthy volunteers. RESULTS: Dapiprazole and pilocarpine together induced miosis significantly faster than each drug alone, showing additive effects. CONCLUSION: Co-administration of dapiprazole and pilocarpine at the end of the eye examination will induce fast pupillary constriction, which might be useful in preventing the development of an acute attack of angle-closure glaucoma in patients with anatomically narrow angles.

Adolescent↗
PubMed2003

Disposition and miotic effects of oral alfentanil: a potential noninvasive probe for first-pass cytochrome P4503A activity.

BACKGROUND AND OBJECTIVES: Systemic clearance of the opioid alfentanil after intravenous administration is an excellent in vivo probe for hepatic cytochrome P4503A (CYP3A) activity and drug interactions. Alfentanil effect (miosis) is a surrogate for plasma alfentanil concentrations, and alfentanil effect kinetics may be a suitable noninvasive probe for hepatic CYP3A. Oral alfentanil might be a probe for first-pass CYP3A activity; however, it is not used clinically, and oral alfentanil disposition is unknown. This investigation evaluated the disposition and miotic effects of oral alfentanil. METHODS: Ten healthy volunteers were studied in a dose-escalation fashion, receiving 23, 30, 43, and 75 microg/kg oral alfentanil on different days. Dark-adapted pupil diameter was measured at the time of venous blood sampling. Alfentanil was quantified by liquid chromatography-mass spectrometry. Plasma concentrations of alfentanil and pupil diameter change versus time data were analyzed by noncompartmental modeling. RESULTS: Alfentanil was rapidly absorbed (time to maximum concentration [T(max)], 0.7 +/- 0.5 hour). Mean values for area under the plasma concentration-time curve extrapolated to infinity (AUC( infinity )) (27 +/- 14, 38 +/- 22, 57 +/- 31, and 105 +/- 59 ng x h x mL(-1)) and maximum concentration (16 +/- 8, 23 +/- 16, 31 +/- 18, and 50 +/- 22 ng/mL) were linear with dose, although there was considerable interindividual variability. T(max), elimination half-life (1.0 +/- 0.2 hours), total body clearance after oral administration (20 +/- 18 mL x kg(-1) x min(-1)), and dose-normalized AUC(infinity ) were independent of dose. Dose-dependent alfentanil disposition was mirrored by commensurate changes in clinical effect, although miosis was variable and not detectable in all subjects at the lowest dose. Mean miosis AUC (AUEC) and peak miosis were log-dose linear. Effect half-life (1.3 +/- 0.9 hours) was similar to plasma half-life. CONCLUSION: Oral alfentanil is rapidly absorbed, exhibits linear and dose-independent kinetics, and undergoes substantial first-pass metabolism. Oral alfentanil may be a suitable probe for first-pass CYP3A activity. Alfentanil effect (miosis) may be an acceptable surrogate for plasma alfentanil concentrations. Oral alfentanil effect may be a noninvasive surrogate for conventional pharmacokinetics. Further studies are warranted to determine whether oral alfentanil and alfentanil effect kinetics may be a suitable noninvasive in vivo probe for first-pass CYP3A activity.

Administration, Oral↗
PubMed1970

Positive correlation between initial pupil diameter and amplitude of miotic response to pilocarpine in rabbits and to carbachol in man.

A linear correlation between amplitude of miotic response and initial pupil diameter has been demonstrated in rabbits using various concentrations of pilocarpine HC1. The same correlation was found when published results in humans using carbachol were examined and it is likely that the correlation also applies to pilocarpine in humans. No such correlation was observed with physostigmine.

Animals↗
PubMed1984

Effects of the substance P antagonist, (D-Arg1, D-Pro2, D-Trp7,9, Leu11)-SP on the miotic response to substance P, antidromic trigeminal nerve stimulation, capsaicin, prostaglandin E1, compound 48/80 and histamine.

The effects of the substance P analogue (D-Arg1, D-Pro2, D-Trp7,9, Leu11)-SP on the ocular inflammatory responses (miosis, vasodilation, protein leakage into the aqueous humour and eye pressure rise) to antidromic trigeminal nerve stimulation (trigeminal stimulation), intracameral injections of substance P (SP), capsaicin, prostaglandin E1 (PGE1), compound 48/80 and histamine were investigated in albino rabbits. The effects of nerve blockade with tetrodotoxin and blockade of histamine receptors on the responses to compound 48/80 and histamine were also investigated. Histamine H1 receptors were blocked with clemastin and H2 receptors with cimetidin. Formation of endogenous prostaglandins was prevented with indomethacin. The pupil size and the eye pressure were measured. The aqueous humour was collected immediately after the animal was killed, and analyzed for protein concentration. (D-Arg1, D-Pro2, D-Trp7,9, Leu11)-SP had no significant miotic effect, but tended to cause a break-down of the blood-aqueous barrier. Miosis caused by SP, trigeminal stimulation, capsaicin, PGE1, compound 48/80 or histamine was blocked by (D-Arg1, D-Pro2, D-Trp7,9, Leu11)-SP. Histamine miosis was significantly reduced by blockade of nerve conduction or histamine receptors, while miosis caused by compound 48/80 was not. Nerve blockade abolished the rise in intraocular pressure caused by compound 48/80. Our results indicate that (D-Arg1, D-Pro2, D-Trp7,9, Leu11)-SP is a specific SP blocker in the sphincter pupillae muscle. They are strong evidence for the hypothesis that trigeminal stimulation and capsaicin cause miosis by release of SP or a related substance (SPLI), and it seems likely that the miosis caused by PGE1 and compound 48/80 is also caused by SPLI release. Histamine miosis is probably mediated both by SP receptors and histamine receptors in the pupillary sphincter muscle.

Alprostadil↗
PubMed1989

Miotic Adie's pupils.

Two young adults, aged 24 and 31, had a long history of small, poorly reactive pupils. There was no history of large pupils, and a review of old photographs confirmed 10 and 5 years, respectively, of miosis. Both were found to have bilateral tonic pupils that were supersensitive to diluted pilocarpine. Although it is possible that they had an unusually early onset of bilateral Adie's syndrome with dilated pupils that was not noticed, it is suggested that some patients might have primary miotic Adie's pupils without ever passing through a mydriatic phase.

Adie Syndrome↗
PubMed1975

Optic discoscopy through a miotic pupil.

A technique is described whereby visualization of the posterior pole of the retina is accomplished through a very miotic pupil. The technique is simple and quick to perform. A wide field of view is maintained as well as stereopsis.

Constriction↗
PubMed1992

Inhibition of outflow facility and accommodative and miotic responses to pilocarpine in rhesus monkeys by muscarinic receptor subtype antagonists.

The muscarinic receptor subtype antagonists 4-diphenylacetoxy-N-methylpiperidine methobromide (4-DAMP), 11-[(2-[diethylamino)methyl]-1- piperidinyl)acetyl]-5,11-dihydro-6H-pyrido[2,3- b][1,4]benzodiazepine-6-one (AF-DX 116) and pirenzepine were used to inhibit the outflow facility and accommodative and miotic responses to near-maximal intracameral doses of pilocarpine in the living rhesus monkey eye. The pharmacologic M3 antagonist 4-DAMP was the most potent inhibitor of all three responses, with IC50 values of 41.7 nM for outflow facility (vs. 40.9 microM pilocarpine), 19.8 nM for accommodation (vs. 40.9 or 81.8 microM pilocarpine) and 3.2 nM for miosis (vs. 4.1 microM pilocarpine). The M1 antagonist pirenzepine was at least 30-fold less potent, with IC50 values of 2.2 microM for outflow facility, 1.4 microM for accommodation and 0.1 microM for miosis. The M2 antagonist AF-DX 116 was the least potent by far, with IC50 values of 15.5 microM for outflow facility, 14.2 microM for accommodation and 1.5 microM for miosis. The results suggest that these three functional responses to pilocarpine are all mediated through an M3 receptor subtype.

Accommodation, Ocular↗