Adrenergic Agonists and Glaucoma Medications
Brimonidine and Apraclonidine for Eye Problems
May 16, 2009
If anyone needs to apply more than one kind of eye-drop, he may have to apply each drug in a specific order. A person may use the color of the cap to help him recall when to apply each kind of eye-drop.
In case you're applying more than one kind of eye-drop, wait five minutes between the two eye-drop medicines.
Purpose of Adrenergic Agonists
Virtually all adrenergic agonists decrease the pressure in the eyeballs by limiting how much fluid (aqueous humor) the eyeballs contain. They also raise the level of fluid that runs out of the eyes.
These drugs may be taken in combination with other prescription drugs to deal with glaucoma.
Brimonidine and apraclonidine are given to care for excessive pressure in the eyeballs in individuals with chronic glaucoma. They are also prescribed to avoid excessive pressure inside the eye following laser therapy for glaucoma. For daily use, brimonidine (Alphagan) is becoming more popular than apraclonidine (Iopidine) since it is less likely to result in an allergy. A few drugstores no longer stock apraclonidine eye-drops.
Decreasing the pressure inside the eyeballs foreshortens the risks of injury to the optic tract, avoiding additional vision loss.
Dipivefrin is changed to epinephrine once it is inside a person. Since the latest adrenergic agonists are more efficient and have fewer side effects, dipivefrin is seldom given. Epinephrine is seldom prescribed because brimonidine and apraclonidine are just as potent with lesser side effects.
Side Effects of Adrenergic Agonists for Glaucoma
- Inflammation and burning of the eyes.
- Allergy in the eyes (severe itching).
- Xerostomia (dry mouth) is somewhat common with the latest drugs but generally gets better over time.
- Sleepiness, jumpiness, and headaches (cephalalgias).
- Fast or atypical heartbeat.
- Elevated blood pressure.
Adrenergic agonists (particularly epinephrine) can broaden and dilate the pupils. This may result in closed-angle glaucoma in individuals who have bad drainage from their eyes.
Brimonidine shouldn't be taken if an individual is using a MAOI (monoamine oxidase inhibitor) medication for dealing with depression. Individuals who are using tricyclics and those with serious liver, heart, or kidney condition may not be allowed to use brimonidine.
Epinephrine drops constrain the blood vessels on the eyeball surface, bringing the red out of the white region of the eye. After two to three hours, the blood vessels dilate (expand) and the eye gets red once again. Unfortunately, patients might be tempted to abuse this drug in order to keep their eyes from turning red.
Brimonidine and apraclonidine can bring about allergy issues in certain individuals when taken over a long time.
These drugs should be used with care in older patients and persons who suffer from high blood pressure, diabetes, an overactive thyroid (hyperthyroidism), or cardiopathy (heart disease).
More from this Author:
References:
Philippe Denis, Antoine Lafuma, and Gilles Berdeaux. (2008). "Costs and persistence of alpha-2 adrenergic agonists versus carbonic anhydrase inhibitors, both associated with prostaglandin analogues, for glaucoma..." Clinical Ophthalmology. (2); 2: 321-329.
Apatachioae, I, and Chiselita, D. (1999)." Alpha-2 adrenergic agonists in the treatment of glaucoma." Oftalmologia. (47); (2) : 35-40.
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