Sharir M, Zimmerman T J
Department of Ophthalmology and Visual Sciences, Kentucky Lions Eye Research Institute, University of Louisville, School of Medicine, Louisville.
J Assoc Acad Minor Phys. 1994;5(2):62-7.
The purpose of this study was to assess whether nasolacrimal occlusion improves the therapeutic index of various antiglaucoma medications. Use of nasolacrimal occlusion resulted in better efficacy and safer usage. Nasolacrimal occlusion used with 2% pilocarpine, 1.5% carbachol, 0.25% timolol maleate, or 1% epinephrine every 12 hours gave the maximal response for these drugs. Applying 0.25% timolol and 1.5% carbachol every 12 hours gave the maximal response for this combination. Nasolacrimal occlusion did not alter the effect of 0.1% dipivefrin, and since the corneal penetration of this prodrug is 17 times that of epinephrine, 0.05% dipivefrin every 12 hours might be an adequate dosage for maximal effect. Our findings suggest that most of the commercially used antiglaucoma agents can achieve the same maximal effect with lower concentrations and less frequent administration (never exceeding every 12 hours). Nasolacrimal occlusion should markedly decrease systemic absorption and side effects following topical treatment.
本研究的目的是评估鼻泪管阻塞是否能提高各种抗青光眼药物的治疗指数。使用鼻泪管阻塞可提高疗效并使用药更安全。每12小时将鼻泪管阻塞与2%毛果芸香碱、1.5%卡巴胆碱、0.25%马来酸噻吗洛尔或1%肾上腺素联合使用，可使这些药物产生最大反应。每12小时应用0.25%噻吗洛尔和1.5%卡巴胆碱可使该组合产生最大反应。鼻泪管阻塞不改变0.1%地匹福林的效果，由于这种前药的角膜渗透率是肾上腺素的17倍，每12小时应用0.05%地匹福林可能是产生最大效果的合适剂量。我们的研究结果表明，大多数市售抗青光眼药物在较低浓度和较不频繁给药（从不超过每12小时一次）的情况下可达到相同的最大效果。鼻泪管阻塞应能显著减少局部治疗后的全身吸收和副作用。
