Topical pharmacologic agents such as cocaine, phenylephrine, apraclonidine
, or hydroxyamphetamine can be used to confirm a diagnosis of HS. Cocaine acts by blocking the reuptake of norepinephrine in the neuromuscular junction of the iris dilator muscle, causing the pupil in a normal eye to dilate, while incomplete dilation is seen in HS.,
Treatment of blepharospasm with apraclonidine
. J Neurol Sci 2017;372:57.
(12) Cocaine and hydroxyamphetamine are not readily available in Australia; however, phenylephrine has been used in birds and apraclonidine
has been suggested as a more-accessible alternative.
Brimonidine 0.15% versus Apraclonidine
0.5% for prevention of intraocular pressure elevation after anterior segment laser surgery.
All patients were advised 1% prednisolone acetate eye drops four times and apraclonidine
hydrochloride 0.5% two times daily for a week.
Drug class listed Drug name in publication Actual drug class Apraclonidine
Adrenergic agonist [Alpha.sub.2]-agonist Brimonidine (ophthalmic) Adrenergic agonist [Alpha.sub.2]-agonist; antiglaucoma Dapiprazole Miotic Alpha-blocker Dipivefrine Prostaglandin Prodrug of epinephrine Naphazoline (ophthalmic) Decongestant [Alpha.sub.1]-agonist; vasoconstrictor; imidazoline derivative Tetryzoline (ophthalmic) Decongestant Adrenergic agonist; vasoconstrictor; imidazoline derivative
Can be pro-inflammatory in CMO, reactivate herpes simplex Apraclonidine
lopidine Sympathomimetics 0.5% 5mL BC alpha2 Aqonists 1.0% unlicensed for Preservative free Stinging/burning, glaucoma allergy, blurring Brimonidine tartrate Brimonidine Tartrate Conjunctival 0.2% 5mL BC erythema, dry mouth, 0.2% 5mL Alphagan headache, drowsiness, Neuro-protective BC fatigue, dizziness, in NTG gastro intestinal symptoms Acetazolamide Diamox Carbonic anhydrase 250mg tablet inhibitors 500mg powder for Diamox SR Electrolyte injection 250mg Sustained release disturbances.
Half an hour before and just after the SLT application, apraclonidine
1% was administered to prevent IOP spikes.
(2,4,6) Mechanism Drug Class Preparations of Action Reduction Adrenergic Brimonidine of Aqueous agonists Apraclonidine
Inflow [beta]-blockers Non-selective Timolol Levobunolol Carteolol Selective [beta]-blockers Betaxolol Carbonic Systemic anhydrase Acetazolamide inhibitors Methazolamide Dichlorphenamide Topical Dorzolamide Brinzolamide Increase Cholinergics Pilocarpine in Aqueous Increase Carbachol Outflow trabecular outflow Prostaglandins Latanoprost (xalatan) and other lipid Travoprost (travatan) receptor agonists Increase Bimatoprost (lumigan) uveoscleral Unoprostone outflow Table 2: The Demographic Data of the Patients of POAG Selected for the Study Bimatoprost Timolol Maleate No.
Sympathomimetics (alpha-adrenergic agonists) include apraclonidine
(Iopidine), which has no human eye data, and brimonidine (Alphagan P), which has one case report in pregnancy and breastfeeding showing no fetal or nursing infant harm.
(Iopidine) is used most often in a higher concentration before and after some kinds of glaucoma laser surgery to prevent or control a rise in eye pressure that is common after the procedure.