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Permanent Bilateral Blindness Following the use of Hexamethonium Chloride

Permanent Bilateral Blindness Following the use of Hexamethonium Chloride Abstract Hexamethonium chloride is a quaternary ammonium halide. Its formula is: Sometimes the bromide is employed and in England the iodide is preferred, but the chloride is the most commonly used salt. In the United States hexamethonium is sold as Methium (Warner-Chilcott Laboratories), Hexameton (Burroughs Wellcome & Company), Esomid (Ciba Pharmaceutical Products, Inc.), Bistrium (E. R. Squibb & Sons), and others. It is also combined with such antihypertensive drugs as hydralazine (Apresoline) and rauwolfine. The tetra-, penta-, and hexamethonium compounds act by blocking both the sympathetic and the parasympathetic ganglia. The block, which is carried out by competition, occurs at the synapse. Vasoconstriction and autonomie tone are thereby reduced or abolished. In addition to use of hexamethonium in hypertension, the drug is being widely used in surgery, particularly in extensive operations, to diminish bleeding. As might be expected in a drug that may cause a fall of blood pressure from 260/160 References 1. It has been used mixed in the same syringe with insulin in the treatment of hypertensive diabetics with "diabetic nephropathy." 9 2. Galen, W., and Duke, J.: Outpatient Treatment of Hypertension with Hexamethonium and Hydralazine , South. M. J. 47:858 ( (Sept.) ) 1954.Crossref 3. Rjzinnov-Jessen, V.: Hexamethonium Treatment of Arterial Hypertension , Danish M. Bull. 1:106 ( (Aug.) ) 1954. 4. Hilker, R.; Rhoads, P., and Billings, C.: Clinical Use of Hydralazine and Hexamethonium in Treatment of Hypertension , J. A. M. A. 153:5 ( (Sept. 5) ) 1953.Crossref 5. Beaconsfield, P.: Dangers in Use of Hexamethonium in Medicine and Surgery , Presse méd. 60:811 ( (May 31) ) 1952. 6. Smith, K.; Fowler, P., and Edmunds, V.: Hypertension and Its Control by Hexamethonium , Brit. M. J. 2:1243 ( (Nov. 27) ) 1954.Crossref 7. Schroeder, H., and Morrow, L.: The Control of Arterial Hypertension by Hyphex , M. Clin. North America 37:991 ( (July) ) 1953. 8. Moyer, J.; Snyder, H. B.; Johnson, I.; Mills, L. C, and Miller, S. L: Results with Oral Hexamethonium Alone and in Combination with 1-Hydrazinophthalazine (Apresoline) in the Therapy of Hypertension , Am. J. M. Sc. 225:379 ( (April) ) 1953.Crossref 9. Moser, M.; Syner, J.; Malitz, S., and Mattingly, T.: Acute Psychosis as a Complication of Hydralazine Therapy in Essential Hypertension , J. A. M. A. 152:1329 ( (Aug. 1) ) 1953.Crossref 10. Gurling, K.: Evaluation of an Androgen, Methylandrostenediol, in the Treatment of Diabetic Retinopathy , Brit. J. Ophth. 39: 151 ( (March) ) 1955. 11. Goldsmith, A., and Hewer, A.: Unilateral Amaurosis with Partial Recovery After Using Hexamethonium Iodide , Brit. M. J. 2:759 ( (Oct. 4) ) 1952.Crossref 12. Cameron, A., and Burn, R.: Hexamethonium and Glaucoma , Brit. J. Ophth. 36:482 ( (Sept.) ) 1952.Crossref 13. Rycroft, B., and Romanes, G.: Preliminary Report on Use of Methonium Compounds and General Anaesthesia in Ophthalmic Surgery , Brit. J. Ophth. 36:29 ( (Jan.) ) 1952.Crossref 14. Couadau, A., and Campan, L.: Effects of Various Anesthetics, Curare and Ganglioplegic Drugs , Arch. opht. 12:287, 1952. 15. Barnett, A.: Ocular Effects of Methonium Compounds (Quaternary Ammonium Compounds) , Brit. J. Ophth. 36:593 ( (Nov.) ) 1952.Crossref 16. McMichael, J.: Lessons from Hexamethonium Studies in Malignant Hypertension, in Hypertension , edited by G. E. W. Wolstenholme, Ciba Foundation Symposium , Boston, Little, Brown & Company, 1954, p. 193. 17. Goodman, L. S., and Gilman, A.: The Pharmacological Basis of Therapeutics , Edition 2, New York, The Macmillan Company, 1955. 18. Paton, W., and Zaimis, E.: Methonium Compounds , Pharmacol. Rev. 4:219 ( (Sept.) ) 1952. 19. Shackman, R.; Graber, I.; Melrose, D., and Smith, J.: Haemodynamics of Methonium Hypotension During Anaesthesia , Anaesthesia 7:217 ( (Oct.) ) 1952.Crossref 20. Duke-Elder, W. S.: Text-Book of Ophthalmology , Vol. Ill, St. Louis, C. V. Mosby Company, 1941, p. 2556. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives of Ophthalmology American Medical Association

Permanent Bilateral Blindness Following the use of Hexamethonium Chloride

BRUCE, GORDON M.
A.M.A. Archives of Ophthalmology , Volume 54 (3) – Sep 1, 1955
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Publisher
American Medical Association
Copyright
Copyright © 1955 American Medical Association. All Rights Reserved.
ISSN
0096-6339
DOI
10.1001/archopht.1955.00930020428014
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Abstract

Abstract Hexamethonium chloride is a quaternary ammonium halide. Its formula is: Sometimes the bromide is employed and in England the iodide is preferred, but the chloride is the most commonly used salt. In the United States hexamethonium is sold as Methium (Warner-Chilcott Laboratories), Hexameton (Burroughs Wellcome & Company), Esomid (Ciba Pharmaceutical Products, Inc.), Bistrium (E. R. Squibb & Sons), and others. It is also combined with such antihypertensive drugs as hydralazine (Apresoline) and rauwolfine. The tetra-, penta-, and hexamethonium compounds act by blocking both the sympathetic and the parasympathetic ganglia. The block, which is carried out by competition, occurs at the synapse. Vasoconstriction and autonomie tone are thereby reduced or abolished. In addition to use of hexamethonium in hypertension, the drug is being widely used in surgery, particularly in extensive operations, to diminish bleeding. As might be expected in a drug that may cause a fall of blood pressure from 260/160 References 1. It has been used mixed in the same syringe with insulin in the treatment of hypertensive diabetics with "diabetic nephropathy." 9 2. Galen, W., and Duke, J.: Outpatient Treatment of Hypertension with Hexamethonium and Hydralazine , South. M. J. 47:858 ( (Sept.) ) 1954.Crossref 3. Rjzinnov-Jessen, V.: Hexamethonium Treatment of Arterial Hypertension , Danish M. Bull. 1:106 ( (Aug.) ) 1954. 4. Hilker, R.; Rhoads, P., and Billings, C.: Clinical Use of Hydralazine and Hexamethonium in Treatment of Hypertension , J. A. M. A. 153:5 ( (Sept. 5) ) 1953.Crossref 5. Beaconsfield, P.: Dangers in Use of Hexamethonium in Medicine and Surgery , Presse méd. 60:811 ( (May 31) ) 1952. 6. Smith, K.; Fowler, P., and Edmunds, V.: Hypertension and Its Control by Hexamethonium , Brit. M. J. 2:1243 ( (Nov. 27) ) 1954.Crossref 7. Schroeder, H., and Morrow, L.: The Control of Arterial Hypertension by Hyphex , M. Clin. North America 37:991 ( (July) ) 1953. 8. Moyer, J.; Snyder, H. B.; Johnson, I.; Mills, L. C, and Miller, S. L: Results with Oral Hexamethonium Alone and in Combination with 1-Hydrazinophthalazine (Apresoline) in the Therapy of Hypertension , Am. J. M. Sc. 225:379 ( (April) ) 1953.Crossref 9. Moser, M.; Syner, J.; Malitz, S., and Mattingly, T.: Acute Psychosis as a Complication of Hydralazine Therapy in Essential Hypertension , J. A. M. A. 152:1329 ( (Aug. 1) ) 1953.Crossref 10. Gurling, K.: Evaluation of an Androgen, Methylandrostenediol, in the Treatment of Diabetic Retinopathy , Brit. J. Ophth. 39: 151 ( (March) ) 1955. 11. Goldsmith, A., and Hewer, A.: Unilateral Amaurosis with Partial Recovery After Using Hexamethonium Iodide , Brit. M. J. 2:759 ( (Oct. 4) ) 1952.Crossref 12. Cameron, A., and Burn, R.: Hexamethonium and Glaucoma , Brit. J. Ophth. 36:482 ( (Sept.) ) 1952.Crossref 13. Rycroft, B., and Romanes, G.: Preliminary Report on Use of Methonium Compounds and General Anaesthesia in Ophthalmic Surgery , Brit. J. Ophth. 36:29 ( (Jan.) ) 1952.Crossref 14. Couadau, A., and Campan, L.: Effects of Various Anesthetics, Curare and Ganglioplegic Drugs , Arch. opht. 12:287, 1952. 15. Barnett, A.: Ocular Effects of Methonium Compounds (Quaternary Ammonium Compounds) , Brit. J. Ophth. 36:593 ( (Nov.) ) 1952.Crossref 16. McMichael, J.: Lessons from Hexamethonium Studies in Malignant Hypertension, in Hypertension , edited by G. E. W. Wolstenholme, Ciba Foundation Symposium , Boston, Little, Brown & Company, 1954, p. 193. 17. Goodman, L. S., and Gilman, A.: The Pharmacological Basis of Therapeutics , Edition 2, New York, The Macmillan Company, 1955. 18. Paton, W., and Zaimis, E.: Methonium Compounds , Pharmacol. Rev. 4:219 ( (Sept.) ) 1952. 19. Shackman, R.; Graber, I.; Melrose, D., and Smith, J.: Haemodynamics of Methonium Hypotension During Anaesthesia , Anaesthesia 7:217 ( (Oct.) ) 1952.Crossref 20. Duke-Elder, W. S.: Text-Book of Ophthalmology , Vol. Ill, St. Louis, C. V. Mosby Company, 1941, p. 2556.

Journal

A.M.A. Archives of Ophthalmology – American Medical Association

Published: Sep 1, 1955

References

  • Outpatient Treatment of Hypertension with Hexamethonium and Hydralazine
    Galen , W., and Duke, J.
  • Hexamethonium Treatment of Arterial Hypertension
    Rjzinnov-Jessen , V.
  • Clinical Use of Hydralazine and Hexamethonium in Treatment of Hypertension
    Hilker , R.; Rhoads, P., and Billings, C.
  • Dangers in Use of Hexamethonium in Medicine and Surgery
    Beaconsfield , P.
  • Hypertension and Its Control by Hexamethonium
    Smith , K.; Fowler, P., and Edmunds, V.
  • The Control of Arterial Hypertension by Hyphex
    Schroeder , H., and Morrow, L.
  • Results with Oral Hexamethonium Alone and in Combination with 1-Hydrazinophthalazine (Apresoline) in the Therapy of Hypertension
    Moyer , J.; Snyder, H. B.; Johnson, I.; Mills, L. C, and Miller, S. L
  • Acute Psychosis as a Complication of Hydralazine Therapy in Essential Hypertension
    Moser , M.; Syner, J.; Malitz, S., and Mattingly, T.
  • Evaluation of an Androgen, Methylandrostenediol, in the Treatment of Diabetic Retinopathy
    Gurling , K.
  • Unilateral Amaurosis with Partial Recovery After Using Hexamethonium Iodide
    Goldsmith , A., and Hewer, A.
  • Hexamethonium and Glaucoma
    Cameron , A., and Burn, R.
  • Preliminary Report on Use of Methonium Compounds and General Anaesthesia in Ophthalmic Surgery
    Rycroft , B., and Romanes, G.
  • Effects of Various Anesthetics, Curare and Ganglioplegic Drugs
    Couadau , A., and Campan, L.
  • Ocular Effects of Methonium Compounds (Quaternary Ammonium Compounds)
    Barnett , A.
  • Ciba Foundation Symposium
    McMichael , J.
  • The Pharmacological Basis of Therapeutics
    Goodman , L. S., and Gilman, A.
  • Methonium Compounds
    Paton , W., and Zaimis, E.
  • Haemodynamics of Methonium Hypotension During Anaesthesia
    Shackman , R.; Graber, I.; Melrose, D., and Smith, J.
  • Text-Book of Ophthalmology
    Duke-Elder , W. S.

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