de Dieuleveult C, Queinnec M C, Pinaud M, Souron R
Département d'Anesthésiologie, Hôtel-Dieu, Nantes.
Ann Fr Anesth Reanim. 1989;8(1):46-50. doi: 10.1016/s0750-7658(89)80142-x.
The isoproterenol dose-response curve was used to assess quantitatively the degree of systemic beta-adrenoceptor blockade induced by metipranolol (Bétanol) and betaxolol (Bétoptic) eye drops. The study was carried out in twelve healthy volunteers, aged 22 +/- 1.4 yr. In a randomized double-blind trial, each volunteer received, on separate occasions at least one week apart, one drop in each eye of either placebo (physiological saline) or either of the ophthalmic beta-blockers. The intraocular pressure (Pio), heart rate (fc), arterial systolic (Pasys) and diastolic (Padia) pressures were measured before instillation of the eye drops after 15 to 30 min rest, and 3 h afterwards. The isoproterenol dose-response curve was studied 3 h after instillation of the drops. The CD25 (the amount of isoproterenol needed to increase fc by 25 b.min-1) was obtained by extrapolation on the least square linear regression curve. Both beta-blockers gave a significant fall in Pio compared with placebo, metipranolol more than betaxolol (p less than 0.02). There was also a significantly greater fall in fc with both metipranolol and betaxolol than with placebo. There were no changes in Pasys and Padia. CD25 was significantly increased with both beta-blocker eye drops as compared with placebo (p less than 0.05 for betaxolol; p less than 0.01 for metipranolol), but there was no difference between the two. Systemic absorption after topical application of ocular beta-blockers was thus confirmed for both metipranolol and betaxolol. However, the degree of beta-adrenoceptor blockade was weaker than that observed with other older ocular beta-blockers (timolol and carteolol).(ABSTRACT TRUNCATED AT 250 WORDS)
用异丙肾上腺素剂量反应曲线定量评估美替洛尔(倍他洛尔)和倍他洛尔(倍他洛尔眼药水)滴眼液引起的全身β-肾上腺素能受体阻滞程度。该研究在12名年龄为22±1.4岁的健康志愿者中进行。在一项随机双盲试验中,每位志愿者在至少相隔一周的不同时间,每只眼睛滴入一滴安慰剂(生理盐水)或两种眼科β受体阻滞剂中的一种。在滴眼剂滴入前、休息15至30分钟后以及3小时后测量眼压(Pio)、心率(fc)、动脉收缩压(Pasys)和舒张压(Padia)。在滴入滴眼剂3小时后研究异丙肾上腺素剂量反应曲线。通过对最小二乘线性回归曲线进行外推获得CD25(使fc增加25次/分钟所需的异丙肾上腺素量)。与安慰剂相比,两种β受体阻滞剂均使Pio显著下降,美替洛尔比倍他洛尔更明显(p<0.02)。美替洛尔和倍他洛尔使fc下降的幅度也明显大于安慰剂。Pasys和Padia没有变化。与安慰剂相比,两种β受体阻滞剂滴眼液均使CD25显著增加(倍他洛尔p<0.05;美替洛尔p<0.01),但两者之间没有差异。因此,证实了局部应用眼科β受体阻滞剂后美替洛尔和倍他洛尔均有全身吸收。然而,β-肾上腺素能受体阻滞程度比其他较老的眼科β受体阻滞剂(噻吗洛尔和卡替洛尔)观察到的要弱。(摘要截断于250字)