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Uterine stimulants
Published in Michael J. O’Dowd, The History of Medications for Women, 2020
The search for a ‘medical’ method of inducing early abortion led to the development of mifepristone (RU 486), an antiprogestogen. Etienne-Emile Baulieu, physician, biochemist and director of France’s National Institute of Health and Medical Research, ‘first conceived RU 486 as an aid to difficult births’ (Sunday Times, 1995) but, by 1982, the drug was found to cause abortion of early human pregnancies. Subsequent trials revealed that a combination of mifepristone and prostaglandin analogue caused complete abortion in 95% of cases, with efficacy being linked to gestational age. Combined administration of mifepristone-prostaglandin became known as ‘medical abortion’ (Heard and Guillebaud, 1992). Frydman and colleagues of France suggested that, based on their experience, mifepristone could be used with safety to induce labor at term when the cervix was found to be unfavorable (Frydman et al., 1991).
How to master MCQs
Published in Chung Nen Chua, Li Wern Voon, Siddhartha Goel, Ophthalmology Fact Fixer, 2017
Latanoprost works by increasing uveoscleral outflow. It causes blood aqueous barrier instability and should be avoided in anterior uveitis. It should also be avoided in aphakic and Pseudophakie patients due to the risk of cystoid macular oedema. Iris hyperpigmentation results from increased production of melanin by the melanocytes. Non-steroidal anti-inflammatory drugs which inhibit the formation of prostaglandins have no effect on latanoprost, which is a prostaglandin analogue.
Main Classes of Drugs
Published in Jerome Z. Litt, Neil H. Shear, Litt's Drug Eruption & Reaction Manual, 2017
Prostaglandin analogBimatoprostGemeprostLatanoprostTafluprostTravoprost
Decreased Expression of Glial-Derived Neurotrophic Factor Receptors in Glaucomatous Human Retinas
Published in Current Eye Research, 2022
Abhigna Akurathi, Erin A. Boese, Randy H. Kardon, Johannes Ledolter, Markus H. Kuehn, Matthew M. Harper
In addition to the ability to lower IOP, these medications may have off-target effects. We have recently evaluated the relationship of brain-derived neurotrophic factor (BDNF) and the BDNF receptor tropomyosin receptor kinase B (TrkB), with the use of glaucoma medications and outcomes derived from patient medical histories in control and glaucomatous eyes. This study identified a relationship between BDNF expression and the use of prostaglandin analogs.4 Additionally, the expression of TrkB was correlated with the use of carbonic anhydrase inhibitors, the use of beta-blockers, and the total number of drugs used for the treatment of glaucoma. TrkB expression also correlated with the last measured intraocular pressure (IOP) from the medical records. In addition to BDNF, several other neurotrophic factors have been investigated for their ability to protect neurons from the effect of neurodegenerative disease. These include Ciliary Neurotrophic Factor (CNTF) and Glial Derived Neurotrophic Factor (GDNF).
Balancing treatments for patients with systemic hypertension and glaucoma
Published in Expert Opinion on Pharmacotherapy, 2020
Aakriti G. Shukla, Reza Razeghinejad, Jonathan S. Myers
For nearly all patients (regardless of systemic comorbidities), our first-line treatments include laser trabeculoplasty if angles are open[58], or topical prostaglandin analogs[59]. Choices for prostaglandin analogs include prostaglandin analog only (latanoprost, bimatoprost, travoprost, tafluprost, and others) as well as a newer nitric oxide-donating prostaglandin analog, latanoprostene bunod. The latter has been associated with a slightly greater IOP-lowering effect and a similar side effect profile as prostaglandin analog alone[60], and can be considered as a first-line option if it is not cost-prohibitive for the patient. Additionally, if the initial choice of therapy is not sufficient, the other first-line option (laser trabeculoplasty or prostaglandin analog) is offered as a second-line agent. Patients with significant cardiac or pulmonary considerations who require third-line therapy may use a combination rho kinase inhibitor and prostaglandin analog[43], carbonic anhydrase inhibitor, or alpha-2 agonist. Surgery may be required at earlier stages of disease to lower IOP and minimize systemic risks due to medications. In keeping with this, an analysis of electronic health records found that high mean systolic blood pressure was associated with significantly increased odds of undergoing glaucoma surgery [61].
Overcoming diagnostic and treatment challenges in uveitic glaucoma
Published in Clinical and Experimental Optometry, 2019
Erin R Sherman, Malinda Cafiero‐chin
Recent data suggest that prostaglandin analogues can be considered as first‐line agents.3 Reported adverse effects created controversy over any use of prostaglandin analogues with UG, let alone first‐line treatment. Exacerbation of inflammation, blood–aqueous barrier disruption, and cystoid macular oedema due to prostaglandin analogue use has been reported. There is a proven increased risk of reactivation of herpes simplex keratitis.2009 In a study by Markomichelakis et al.,2009 the efficacy and safety of latanoprost in 58 patients with UG was compared to a fixed combination of brimonidine and timolol. The authors concluded that latanoprost was a safe and effective alternative for treating IOP in UG patients, especially during quiescent periods.2009 No difference was found in the recurrences of inflammation or cystoid macular oedema. Another study by Taylor et al.2012 determined that the use of prostaglandin analogues does not induce additional conjunctival inflammation. This is important because it has previously been postulated that prostaglandin analogues and chronic conjunctival inflammation had a negative effect on future filtering surgeries. Treatment may start with a topical prostaglandin analogue. If additional treatment is required, a beta‐blocker, carbonic anhydrase inhibitors, or an alpha‐2 agonist may be added. If maximum topical therapy is not sufficient, oral carbonic anhydrase inhibitors 250–1,000-mg should be considered.2016