We assessed the combined effects of dapiprazole, an alpha-adrenergic receptor blocker, with pilocarpine. direct-acting parasympathomimetics, on reversing mydriasis and cycloplegia in 40 eyes (20 subjects) who received 1% tropicamide or 2.5% phenylephrine for pupillary dilation and cycloplegic refraction. These results were compared to 40 eyes (20 subjects) that received dapiprazole alone. The study was divided into four groups, each of which consisted of 20 eyes that received either 1% tropicamide or 0.5% phenylephrine followed by instillation of 0.5% dapiprazole alone or in combination with 2% pilocarpine. A significant difference in the reduction of pupil size and the increase in accommodative amplitude has been observed between the groups that received dapiprazole alone and those received both dapiprazole and pilocarpine(p<0.001). These results suggest that dapiprazole and pilocarpine eyedrops have additive effects on reversing both mydriasis and cycloplegia after instillation of 1% tropicamide or 2.5% phenylephrine for pupillary dilation and cycloplegic refraction.
Mydriasis* ; Ophthalmic Solutions ; Parasympathomimetics ; Phenylephrine ; Pilocarpine* ; Pupil ; Tropicamide

Latanoprost 0.005% which is a currently available ocular hypotensive agent has been known to produce an additional reduction of intraocular pressure when used in combination with beta adrenergic bloker. The aim of this study was to evaluate the additive effect of this drug in patients with maximum tolerated medical therapy regimen. 48 eyes of 32 patients were categorized into 2 groups as to their type of glaucomas(primary open abgle glaucoma(POAG) vs chronic angle closure glauoma(CACG), and pilocarpine use. POAG group showed 22.3, 24.8, 22.7, 21.0, 21.4% and CACG group showed 17.6, 17.1, 15.7, 17.5, 17.8% of ocular hypotensive effect at post treatment 2 weeks, 4 weeks, 3 months, 6 months, 9 to 12 months, respectively and there was no satistically significant difference between two groups. Pilocarpine using group showed 25.5, 30.5, 26.4, 23.4, 17.8% and non-using group showed 20.6, 18.9, 19.0, 18.7, 25.1% of ocular hypotensive effect at each follow up period. Conclusively, latanoprost 0.005% appeared to be a very effective drug in reducing intraocular pressure in patients with maximum tolerated medical therapy regimen without regard to their type of glaucomas, and use of parasympathomimetics.
Follow-Up Studies ; Glaucoma ; Humans ; Intraocular Pressure ; Parasympathomimetics ; Pilocarpine

Recently, it is reported that preganglionic oculomotor nerve palsies shows denervational supersensitive pupillary responses to dilute parasympathomimetic agents and this phenomenon is in inverse proportion to consciousness level. We measured pupillary diameters of 10 brain death patients(20 eyes) and 10 comatous patients (20 eyes). After we instilled 0.06% pilocarpine to patients that initial pupillary diameter is over 4.0mm(13 eyes in brain death group, 5 eyes in comatous group), we compared pupillary responses of two groups to evaluate whether this helps diagnosis of brain death. If pupillary diameter was changed over 25%(compared to initial diameter), we considered it positive. In comatous group, no one was positive. But in brain death group, 11 cases were positive(84.6%). It revealed significant difference statistically(P<0.05). Mean change of pupillary diameter to 0.06% pilocarpine was 0.46mm(9.35%) in comatous group, and 2.62mm(47.72%) in brain death group. With above results, we concluded that pupillary response to dilute parasympathomimetic agents is a useful indicator for diagnosis of brain death.
Brain Death* ; Brain* ; Consciousness ; Diagnosis ; Humans ; Oculomotor Nerve Diseases ; Parasympathomimetics ; Pilocarpine*

A rapid, sensitive, and selective liquid chromatography-tandem mass spectrometry was developed for the simultaneous determination of lycorine and galanthamine, two major constituents in Lycoris radiata extract, in rat plasma. Liquid-liquid extraction with ethyl ether was carried out using diphenhydramine as the internal standard. The two bioactive alkaloids were separated on a Zorbax SB-C18 reserved-phase column (150 mm × 4.6 mm, i.d., 5 μm) by gradient elution using a mobile phase consisting of methanol with 0.1% formic acid (A) and water with 0.1% formic acid (B) at a flow rate of 0.6 mL/min. All analytes showed good linearity over a wide concentration range (r (2)>0.99) and the lower limit of quantification was 3.00 ng/mL for each analyte. The average extraction recovery of the analytes from rat plasma was more than 82.15%, and the intra-day and inter-day accuracy and precision of the assay were less than 12.6%. The validated method was successfully applied to monitoring the concentrations and pharmacokinetic studies of two Amaryllidaceous alkaloids in rat plasma after an oral administration of Lycoris radiata extract.
Amaryllidaceae Alkaloids ; pharmacokinetics ; Animals ; Chromatography, Liquid ; Galantamine ; pharmacokinetics ; Lycoris ; chemistry ; Male ; Parasympathomimetics ; pharmacokinetics ; Phenanthridines ; pharmacokinetics ; Plant Extracts ; chemistry ; pharmacokinetics ; pharmacology ; Rats ; Rats, Wistar ; Tandem Mass Spectrometry ; methods

Glaucoma is a progressive degenerative disease of the optic nerve head, characterized by a specific pattern of axonal loss and visual field deterioration. This review aims at introducing the different novel pharmacologic agents for its treatment, as well as their mechanisms. Most glaucoma patients require lifelong care and individualized treatment. Intraocular pressure (IOP), which is regulated by aqueous humor production, outflow via the trabecular meshwork (parasympathomimetics only) and uveoscleral outflow pathways, is currently the only treatable target for glaucoma treatment. Conventional glaucoma medications are categorized as β blockers, α agonists, carbonic anhydrase inhibitors, parasympathomimetics, and prostaglandin analogues. The development of basic research-derived novel classes of pharmacologic agents features novel action mechanisms, which are different from those of conventional medications. New classes of recently approved or clinical trial-tested medications include Rho-kinase inhibitors, nitric oxide donors, adenosine agonists, and prostaglandin analogs targeting E-type prostanoid receptors, etc. Their integration and future development will facilitate the expansion and customization of therapeutic options.
Adenosine ; Aqueous Humor ; Axons ; Carbonic Anhydrase Inhibitors ; Glaucoma ; Humans ; Intraocular Pressure ; Nitric Oxide Donors ; Ocular Hypertension ; Optic Disk ; Parasympathomimetics ; Prostaglandins, Synthetic ; rho-Associated Kinases ; Trabecular Meshwork ; Visual Fields