Blefaroconjuntivitis de contacto alérgica por timolol / Blepharoconjunctivitis: contact allergy to thymolol

Existen numerosas sustancias capaces de producir dermatitis de contacto alérgica en la zona de los párpados, llegando a ese lugar a través del aire, por medio de las manos o directamente por aplicación en el sitio. Tal es el caso de la dermatitis inducidas por medicaciones oftálmicas. Presentamos un paciente sensibilizado al timolol contenido en las gotas oftálmicas que utilizaba para controlar su glaucoma

Modalidades terapêuticas na doença de Basedow-Graves / Therapeutical approaches in Basedow-Graves disease

Neste artigo säo analisadas as três grandes modalidades terapêuticas do hipertireoidismo - o tratamento clínico, o radioiodo e a cirurgia -, discutindo-se detalhadamente cada uma delas, enfocando seus mecanismos de açäo, vantagens e desvantagens, principais indicaçöes e contra indicaçöes. A abordagem terapêutica também será analisada em grupos especiais como neonatos, crianças e adolescentes, gestantes e idosos

The Influence of Nonselective Beta-Adrenergic Blockade (carteolol) and ACE Inhibitor (captopril) in Plasma Potassium on Maintenance hemodialysis / 대한내과학회지

OBJECTIVES: The degree of hyperkalemia and effects of potassium removal by hemodialysis on the plasma potassium concentration to see the influence of nonselective beta-adrenergic blockade(carteolol) and ACE inhibitor(captopril) on patients in maintenance hemodialysis were evaluated. METHODS: This study was done on 16 patients with end-stage renal disease undergoing maintenance hemodialysis. These patients were classified two groups; group 1-patients with carteolol or captopril(9 patients) and group 2-patients without medication(7 patients). Measurement of plasma potassium and arterial blood gas analyses were performed at pre-dialysis and during hemodialysis(4 hours). To analysis the distribution of potassium kinetics during hemodialysis, dialysis potassium clearance rate was introduced in this study. RESULTS: 1) Among 16 patients studied, the mean age was 43 years old and the ratio of male to female was 2: 1 and the mean duration of hemodialysis was 17.9 months. The underlying cause of end-stage renal disease was chronic glomerulonephritis in the most patients. 2) The mean predialysis plasma potassium concentration of all patients, group 1 on medication, and group 2 without medication was 5.13 +/- 1.04mEq/L, 5.67 +/- 1.01mEq/L and 4.410.55mEq/L, with high significance(p<0.001) between groups 1 and 2. 3) The mean postdialysis plasma potassium concentration of group 1 on medication and group 2 without medication was 348 +/- 0.40mEq/L and 3.39 +/- 0.56mEq/L with insignificance between groups 1 and 2. 4) The pre- and post-dialysis concentration of plasma sodium, pH and bicarbonate between group 1 and group 2 was similar except glucose. 5) Despite the fall in absolute plasma concentration in group 1 more than twice than in group 2, the difference in dialysis potassium clearance rate measured at 1 hour of hemodialysis in group 1 compared to that of group 2 was only 12M. CONCLUSION: These data are consistent with at least a two-compartment distribution of plasma potassium rather than single pool in addition to frequent hyperkalemia on maintenance hemodialysis on nonselective beta-adrenergic blocker or ACE inhibitor contributed to partial impairment of extrarenal transcellular shifts of potassium during inter- and intra-dialytic phase.

A Case of Methimazole Induced Agranulocytosis Treated with Granulocyte Colony Stimulating Factor ( G-CSF ) / 대한내분비학회지

A 31-year-old woman admitted because of fever, chilling and sore throat for 4 days. The symptom was developed after receiving methimazole 20mg per day and carteolol 10mg per day due to Graves disease during last 4 weeks. Physical examination revealed hyperemic enlarged tonsils with whitish plaque. The peripheral blood total neutrophil count was 1,400/mm3 (absolute neutrophil count, ANC 36) and a peripheral blood smear revealed rare neutrophil with lymphocytosis. On the first day of hospitalization, the patient was severely ill with ANC 0, it was decided to administer G-CSF 2ug/kg daily. On the fifth day of hospitalization, ANC in peripheral blood count was persistently zero and bone marrow aspiration and biopsy were performed, which revealed hypocellularity and myeloid hypoplasia. G-CSF given daily for 7days, it was discontinued when the ANC reached 1,539/mm3. The availability of G-CSF may help to shorten the course of agranulocytosis and to reduce its mortality rate.

The Effect of beta-bocker on Postural Change of IOP

The intraocular pressures(IOP) were measured in both eyes of 30 healthy volunteers in sitting, supine, and 30 degrees head down positions One eye was pretreated with 1% carteolol or placebo(Tears naturale)applied in a masked, randomised fashion, while the other served as control. Although IOP changes in response to carteolol and to postural changes were significant(P<0.01), carteolol did not significantly alter relative changes in IOP from positional changes This results suggests that the overall pressure lowering effect may offer some protection to patients with glaucoma.

Eficácia e segurança do carteolol a 2 por cento no tratamento da hipertensäo ocular crônica / Efficacy and safety of the 2 percent carteolol solution for the treatment of chronic ocular hypertension

Foram avaliadas a eficácia como agente hipotensor ocular e a segurança do colírio de maleato de timolol a 0,5//, em 34 indivíduos portadores de hipertensäo ocular ou glaucoma primário de ângulo aberto, por 12 semanas. Os resultados obtidos mostraram equivalência das duas drogas como agentes hipotensores oculares, nos diferentes momentos de estudo. A soluçäo de hidrocloreto de carteolol a 2//, assim como a de maleato de timolol a 0,5//, näo mostrou efeitos colaterais locais ou cardiovasculares

Effect of Carteolol Hydrochloride on Sodium-Potassium Activated ATPase in Cattle Lena Epithelial Cell Membrane

The effect of Carteolol hydrocholride on the Na-K ATPase of anterior capsule and epithelium of cattle lens has been investigated. The experiments were also designed to determine the action of Carteolol hydrochloride on the Na-K ATPase activity in anterior capsule and epithelium of cattle lens. The following results were observed. 1. The predominent location of Na-K ATPase was located in the epithelim and NaK ATPase was closely related with active trasport system of sodium and potassium in the lens epithelium. 2. The activity of Na-K ATPase of cattle lens epithelium was alomst totally inhibited by Ouabain. 3. Beta-adrenergic blocking agent(Carteolol hydrochloride) in the epithelium of cattle lens was shown to be actively transported by the ATPase. 4. The Na-K ATPase activity of cattle lens epithelium was inhibited by Carteolol hydrochloride.

Clinical Trial on the Hypotensive Effect of Carteolol

The clinical trial was carried out with carteolol in 30 patients with essential hypertension. The results were as follows : 1) Before medication and after 2,4,6 and 8 weeks of medications, the overall average systolic and diastolic blood pressure were 175+/-17.7/105+/-9.3, 144+/-8.9/92+/-6.9, 143+/-11.2/90+/-6.6, 141+/-8.4/88+/-6.9, and 142+/-9.0/88+/-7.1 mmHg. As a result, blood pressure significantly fell with carteolol treatment. 2) In 80+/- of all cases, marked or moderate degree of hypotnesive effect was observed within 2 weeks of treatment. 3) Before medication and after 2, 4, 6 and 8 weeks of medication, the overall average heart rates were 75+/-11.8, 73+/-9.0, 71+/-8.7, 71+/-8.2 and 71+/-8.6 beats/minute. There was no significant changes in heart rates before and after treatment. 4) Dizziness or fatigability were complained in 4 patients (13+/-) each while receiving carteolol. These side effects were mild in 3 patients, but one patient discontinued treatment due to dizziness. On the basis of these results, carteolol was evaluated to be promising hypotensive drug.

Clinical Study on the Effect of Carteolol in Patients with Cardiac Neurosis

Fiftyeight patients with cardiac neurosis were studied to evaluate the effects of Carteolol 10mg/day. Systolic blood pressure was declined to 122.7+/-17.2mmHg from 137.1+/-23.2mmHg, diastolic blood pressure was declined to 79.6+/-11.1mmHg from 88.2+/-17.5mmHg. Pulse rate was decreased from 83.0+/-10.2 to 73.9+/-6.8per minute. The most frequent subjective symptom was palpitation (74.1%) and effectiveness of therapy for subjective symptom was 91.4%, for usefulness was 93.1%. There was no significant serious side reaction observed. We concluded that Carteolol therapy for the patients with cardiac neurosis could be useful and safe with a small dosage.

Hypetensive Effect of Carteolol Hydrochloride(Mikelan(R)) In Normal Volunteers: Comparative Study with Timolol

Carteolol hydrochloride was compared with Timolol in view of the hypotensive effect. Forty-five normal volunteers(90 eyes) of the third decade were evaluated. Forty volunteers of experimental group were devided into two groups, -Carteolol group and Timolol one-. Carteolol group was subdevided into 1% and 2% group and Timolol one was subgrouped into 0.25% and 0.5% group, respectively. The remaining five volunteers(10 eyes) were used as control group. Double masked single dose study was done by instilling each eye solution into the one eye selected randomly. The intraocular pressure, pupil size, visual acuity, blood pressure, and pulse rate were measured before the instillation of eye solution at first and 30 minutes, 1, 2, 4, 6, and 24 hours after instillation and the statistical significance was estimated using the paired t-test. The following results were obtained: 1. In both groups of 1% and 2% Carteolol, the IOP reduction was noted since 1 hour after instillation and each maximum reduction of IOP was noted at 4 hours after instillation (29.2 +/- 5.0%, 40.4 +/- 5.0%, respectively). Instillation of higher concentrations of Carteolol and Timolol resulted in more significant pressure reduction. 2. Statistically significant IOP reduction was also noted in the contralateral eyes in each group. 3. The pupil size, visual acuity, blood pressure, and pulse rate were not significantly changed after the instillation of Carteolol ophthalmic solution and no remarkable local complication were also noted.

Effects of Beta-blocking Agent Carteolol on Healthy Volunteers and Glaucoma Patients

The effects of topically applied cartoelol, a beta-adrenergic blocking drug, on intraocular pressure, pupil diameter, pulse rate, and blood pressure and adverse effects were studied in fifteen healthy volunteers and six ocular hypertension, and fifteen chronic open angle glaucoma patients. In control study, the fifteen healthy volunteers were enrolled. Carteolol hydrochloride ophthalmic solution in concentrations of 1%, 2% was instilled, and the IOP, pulse rate, blood pressure, and pupillary diameter were measured before and after 1, 2, 4, 6, 8, and 12 hours. The same method was repeated to evaluate the early effects at six ocular hypertensions and fifteen chronic open angle glaucoma patients. And to evaluate the long term effects, carteolol(one or two percent) was instilled twice daily and IOP, pulse rate, blood pressure, and pupillary diameter were checked before and 1, 2, 4, and 8 weeks after the instillation in ocular hypertension and chronic open angle glaucoma patients. Two concentrations of carteolol were used; 1%, 2%, if their first intraocular pressure were measured above 25 mmHg, the 2% carteolol was used, and if their pressure were measured below 25mmHg, 1% carteolol was used. The results were as follows: 1. The early intraocular pressure reduction effect in healthy volunteers was significant statistically except at 12 hours, and the maximum intraocular reduction was noted at 4 hours (23.3% and 24.3%) respectively. 2. The early intraocular pressure reduction effect in ocular hypertension and POAG-patients was significant statistically except at 1 hour and the maximum intraocular reduction was noted at 4 hours (30.8% and 33.8%), respectively. 3. The long term intraocular pressure reduction effect was significant statistically and the maximum IOP reduction was noted at 2 weeks (29.2% and 31.8%) respectively and 3 patients received the additional therapy. 4. The systemic blood pressure and pulse rate were slightly decreased but not significant statistically and no ocular change was demonstrated by routine ophthalmie examinations following the administration of carteolol solution. On the basis of the results both 1% and 2% carteolol are considered to be optimal to be clinically used in patients with glaucoma.

Clinical Observation on Antihypertenisive Effect of Carteolol Hydrochloride

The antihypertensive effect of carteolol hydrochloride was observed in 20 cases of essential hypertension, and following results were obtained. 1. Mean drops in systolic and diastolic blood pressure by carteolol hydrochloride were 13mmHg and 9mmHg. The results of antihypertensive therapy revealed good control in 25%, fair control in 35%, poor in 20% and failure in 20% of the cases. 2. After the administration of carteolol hydrochloride, no drop in average heart rate was observed. 3. The side effect of carteolol was mild indigestion in two cases.