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Guanethidine (Ismelin) in Ophthalmology: II. Clinical Application in Glaucoma

Guanethidine (Ismelin) in Ophthalmology: II. Clinical Application in Glaucoma Abstract Introduction For several years sympatholytic drugs have been tried for treatment of various types of glaucoma. The substance mostly used is Dibenamine,* introduced in ophthalmology by Christensen and Swan in 1949. Dibenamine is generally given intravenously in doses of 4-5 mg. per kilogram body weight diluted in 300-500 cc. saline. Slow infusion during 60-90 minutes is necessary, since toxic effects occur more frequently when the drug is administered rapidly. After the infusion the vein is flushed with saline to prevent local phlebothrombosis. When Dibenamine is taken orally in doses of 300-400 mg. daily its hypotensive effect is either very slight and transient or absent. Moreover, gastric disturbances restrict the value of oral application. Local application of Dibenamine in the conjunctival sac is ineffective as well as irritating because, being a nitrogen mustard derivative, it causes a chemical inflammation.The hypotensive effect of Dibenamine begins 1-2 hours after infusion, reaching its References 1. N-(2-chloroethyl) dibenzylamine hydrochloride, Smith, Kline & French Laboratories. 2. Ciba N. V., Arnhem, Holland, kindly supplied the Ismelin required for the experiments described in this report. 3. Diethyl p-nitrophenyl phosphate. 4. Bloomfield, S., and Haimovici, H.: Effect of Dibenamine in Chronic Simple Glaucoma , Arch. Ophthal. 43:969, 1950.Crossref 5. Christensen, L., and Swan, K. C.: Adrenergic Blocking Agents in the Treatment of Glaucoma , Trans. Amer. Acad. Ophthal. Otolaryng. 53:489, 1949. 6. Clark, W. B., and Duggan, J. W.: The Use of Dibenamine in the Treatment of Acute Congestive Glaucoma , Amer. J. Ophthal. 34:535, 1951. 7. DeLong, S. L., and Scheie, H. G.: Dibenamine: An Experimental and Clinical Study , Arch. Ophthal. 50:289, 1953.Crossref 8. Friedenwald, J. S., and Buschke, W.: The Role of Epinephrine in the Formation of the Intraocular Fluid , Amer. J. Ophthal. 24:1105, 1941. 9. Grimson, K. S.; Hendrix, J. P., and Reardon, M. J.: Newer Adrenolytic, Sympatholytic, and Ganglionic Blocking Drugs , J.A.M.A. 139:154, 1949.Crossref 10. Keates, E. U.; Krishna, N., and Leopold, I. H.: Ocular Effects of Guanethidine and Its Use in Glaucoma , in Symposium on Guanethidine, Memphis , Tennessee, CIBA Pharmaceutical Products Inc., 1960. 11. Küchle, H. J.: Zur lokalen Wirkung von Guanethidin (Ismelin) auf das gesunde und glaukomkranke Auge , Klin. Mbl. Augenheilk. 139:224, 1961. 12. Kutschera, E.: Klinische Erfahrungen mit Ismelin , Klin. Mbl. Augenheilk. 139:234, 1961. 13. Leydecker, W.: Glaukom , Berlin, Springer-Verlag, 1960. 14. Maxwell, R. A.; Plummer, A. J.; Povalski, H.; Schneider, F.: Concerning a Possible Action of Guanethidine (SU-5864) in Smooth Muscle , J. Pharmacol. Exp. Ther. 129:24, 1960. 15. Miller, S. J. H.: Stellate Ganglion Block in Glaucoma , Brit. J. Ophthal. 37:70, 1953.Crossref 16. Mullen, C. R., and Leopold, I. H.: Adrenergic Blocking Agents in Treatment of Glaucoma , Arch. Ophthal. 46:549, 1951.Crossref 17. Newell, F. W.; Ridgway, W. L., and Zeller, R. W.: The Treatment of Glaucoma with Dibenamine , Amer. J. Ophthal. 34:527 (April, (Pt. 1) ) 1951. 18. Niedermeier, S.: Zur Frage der intraocularen Druckregulierung , Graefe Arch. Ophthal. 150: 665, 1950.Crossref 19. Niedermeier, S.: Zur Therapie mittels Dibenamin bei inflammatorischem Glaukom , Klin. Mbl. Augenheilk. 120:534, 1952. 20. Oosterhuis, J. A.: Guanethidine (Ismelin) in Ophthalmology: I. Observations in Rabbits , Arch. Ophthal. 67:592, 1962.Crossref 21. Primrose, J.: Dibenzyline in Glaucoma , Brit. J. Ophthal. 39:307, 1955.Crossref 22. Stepanik, J.: Das Verhalten des Augendruckes von an Glaucoma simplex erkrankten Augen nach lokaler Anwendung von Guanethidin (Ismelin, Ciba) , Klin. Mbl. Augenheilk. 139: 174, 1961. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Guanethidine (Ismelin) in Ophthalmology: II. Clinical Application in Glaucoma

Archives of Ophthalmology , Volume 67 (6) – Jun 1, 1962

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Publisher
American Medical Association
Copyright
Copyright © 1962 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1962.00960020802016
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Abstract

Abstract Introduction For several years sympatholytic drugs have been tried for treatment of various types of glaucoma. The substance mostly used is Dibenamine,* introduced in ophthalmology by Christensen and Swan in 1949. Dibenamine is generally given intravenously in doses of 4-5 mg. per kilogram body weight diluted in 300-500 cc. saline. Slow infusion during 60-90 minutes is necessary, since toxic effects occur more frequently when the drug is administered rapidly. After the infusion the vein is flushed with saline to prevent local phlebothrombosis. When Dibenamine is taken orally in doses of 300-400 mg. daily its hypotensive effect is either very slight and transient or absent. Moreover, gastric disturbances restrict the value of oral application. Local application of Dibenamine in the conjunctival sac is ineffective as well as irritating because, being a nitrogen mustard derivative, it causes a chemical inflammation.The hypotensive effect of Dibenamine begins 1-2 hours after infusion, reaching its References 1. N-(2-chloroethyl) dibenzylamine hydrochloride, Smith, Kline & French Laboratories. 2. Ciba N. V., Arnhem, Holland, kindly supplied the Ismelin required for the experiments described in this report. 3. Diethyl p-nitrophenyl phosphate. 4. Bloomfield, S., and Haimovici, H.: Effect of Dibenamine in Chronic Simple Glaucoma , Arch. Ophthal. 43:969, 1950.Crossref 5. Christensen, L., and Swan, K. C.: Adrenergic Blocking Agents in the Treatment of Glaucoma , Trans. Amer. Acad. Ophthal. Otolaryng. 53:489, 1949. 6. Clark, W. B., and Duggan, J. W.: The Use of Dibenamine in the Treatment of Acute Congestive Glaucoma , Amer. J. Ophthal. 34:535, 1951. 7. DeLong, S. L., and Scheie, H. G.: Dibenamine: An Experimental and Clinical Study , Arch. Ophthal. 50:289, 1953.Crossref 8. Friedenwald, J. S., and Buschke, W.: The Role of Epinephrine in the Formation of the Intraocular Fluid , Amer. J. Ophthal. 24:1105, 1941. 9. Grimson, K. S.; Hendrix, J. P., and Reardon, M. J.: Newer Adrenolytic, Sympatholytic, and Ganglionic Blocking Drugs , J.A.M.A. 139:154, 1949.Crossref 10. Keates, E. U.; Krishna, N., and Leopold, I. H.: Ocular Effects of Guanethidine and Its Use in Glaucoma , in Symposium on Guanethidine, Memphis , Tennessee, CIBA Pharmaceutical Products Inc., 1960. 11. Küchle, H. J.: Zur lokalen Wirkung von Guanethidin (Ismelin) auf das gesunde und glaukomkranke Auge , Klin. Mbl. Augenheilk. 139:224, 1961. 12. Kutschera, E.: Klinische Erfahrungen mit Ismelin , Klin. Mbl. Augenheilk. 139:234, 1961. 13. Leydecker, W.: Glaukom , Berlin, Springer-Verlag, 1960. 14. Maxwell, R. A.; Plummer, A. J.; Povalski, H.; Schneider, F.: Concerning a Possible Action of Guanethidine (SU-5864) in Smooth Muscle , J. Pharmacol. Exp. Ther. 129:24, 1960. 15. Miller, S. J. H.: Stellate Ganglion Block in Glaucoma , Brit. J. Ophthal. 37:70, 1953.Crossref 16. Mullen, C. R., and Leopold, I. H.: Adrenergic Blocking Agents in Treatment of Glaucoma , Arch. Ophthal. 46:549, 1951.Crossref 17. Newell, F. W.; Ridgway, W. L., and Zeller, R. W.: The Treatment of Glaucoma with Dibenamine , Amer. J. Ophthal. 34:527 (April, (Pt. 1) ) 1951. 18. Niedermeier, S.: Zur Frage der intraocularen Druckregulierung , Graefe Arch. Ophthal. 150: 665, 1950.Crossref 19. Niedermeier, S.: Zur Therapie mittels Dibenamin bei inflammatorischem Glaukom , Klin. Mbl. Augenheilk. 120:534, 1952. 20. Oosterhuis, J. A.: Guanethidine (Ismelin) in Ophthalmology: I. Observations in Rabbits , Arch. Ophthal. 67:592, 1962.Crossref 21. Primrose, J.: Dibenzyline in Glaucoma , Brit. J. Ophthal. 39:307, 1955.Crossref 22. Stepanik, J.: Das Verhalten des Augendruckes von an Glaucoma simplex erkrankten Augen nach lokaler Anwendung von Guanethidin (Ismelin, Ciba) , Klin. Mbl. Augenheilk. 139: 174, 1961.

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Jun 1, 1962

References