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1.
Asia Pac J Ophthalmol (Phila) ; 8(5): 360-365, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31478936

RESUMO

PURPOSE: Atropine eye drops is an emerging therapy for myopia control. This article reviews the recent clinical trials to provide a better understanding of the use of atropine eye drops on myopia progression. METHODS: All randomized clinical trials of atropine eye drops for myopia progression in the literatures were reviewed. RESULTS: Atropine eye drops 1% conferred the strongest efficacy on myopia control. However, its use was limited by the side effects of blurred near vision and photophobia. ATOM 2 study evaluated 0.5%, 0.1%, and 0.01% atropine on 400 myopic children, and suggested that 0.01% is the optimal concentration with good efficacy and minimal side effects. Since then, the use of atropine eye drops has been transitioned from high-concentration to low-concentration worldwide. Recent Low-concentration Atropine for Myopia Progression (LAMP) study evaluated 0.05%, 0.025%, 0.01% atropine eye drops and placebo group in 438 myopic children. The study firstly provided placebo-compared evidence of low-concentration atropine eye drops in myopia control. Furthermore, both efficacy and side effects followed a concentration-dependent response within 0.01% to 0.05% atropine. Among them, 0.05% atropine was the optimal concentration to achieve best efficacy and safety profile. CONCLUSIONS: Low concentration atropine is effective in myopia control. The widespread use of low-concentration atropine, especially in East Asia, may help prevent the myopia progression for the high-risk children. Further investigations on the rebound phenomenon following drops cessation, and longer-term individualized treatment approach should be warranted.


Assuntos
Atropina/administração & dosagem , Miopia Degenerativa/tratamento farmacológico , Progressão da Doença , Relação Dose-Resposta a Droga , Humanos , Midriáticos/administração & dosagem , Miopia Degenerativa/fisiopatologia , Soluções Oftálmicas , Refração Ocular/efeitos dos fármacos , Refração Ocular/fisiologia
2.
Ann Saudi Med ; 39(4): 279-282, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31381360

RESUMO

A 28-month-old boy mistakenly received intranasal atropine sulfate instead of Otrivin (xylometazoline hydrochloride) for the treatment of adenoid hypertrophy. Later on, he came to the emergency department with anticholinergic manifestations after the administration of multiple drops. The child presented with a tonic-clonic seizure lasting for a few minutes, followed by a brief loss of consciousness, vomiting, agitation, and irritability, all of which were stabilized by a dose of intravenous lorazepam. Subsequently, he was admitted to the pediatric intensive care unit for observation. Afterwards, he developed agitation and unsteady gait, both of which resolved after receiving neostigmine. Eventually, the child became asymptomatic and was discharged home. To the best of our knowledge, only one similar case has been reported in the literature. SIMILAR CASES PUBLISHED: 1.


Assuntos
Atropina/envenenamento , Erros de Medicação , Antagonistas Muscarínicos/envenenamento , Administração Intranasal , Atropina/administração & dosagem , Pré-Escolar , Serviço Hospitalar de Emergência , Humanos , Imidazóis/administração & dosagem , Lorazepam/administração & dosagem , Masculino , Antagonistas Muscarínicos/administração & dosagem
3.
Strabismus ; 27(3): 127-138, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31234691

RESUMO

Purpose: To evaluate the refractive outcome and influencing factors following atropine 0.5% eye-drops applied twice daily during 2 ½ days at home and two drops of cyclopentolate 1% (C+C) and one drop of cyclopentolate 1% and one drop of tropicamide 1% (C+T) applied in an outpatient clinic, in hypermetropic children with a dark iris. Methods: Double-blind randomized study including 67 3-6-year-old children receiving C+C in one eye and C+T in the other eye. Two weeks later followed by atropine 0.5% in both eyes. Primary outcome measures were: spherical equivalent (SEQ) following C+C, C+T and atropine, and secondarily SEQ with respect to sex, ethnicity, skin pigmentation (light, medium, dark) and crying. Data on atropine are divided in those with C+C (CC) or C+T (CT) as a first intervention. Results: Mean SEQ±SD for C+C, C+T, atropine-(CC) and atropine-(CT) was +1.74 ± 1.35, +1.77 ± 1.34, +2.15 ± 1.43 and +2.10 ± 1.38 diopter (D). Atropine 0.5% revealed significantly more hypermetropia than C+C and C+T; +0.41 ± 0.43, 95%CI +0.31 to +0.52D and +0.33 ± 0.39, 95%CI +0.24 to +0.34D. No significant difference was present between C+C and C+T; -0.03 ± 0.56, 95%CI -0.16 to +0.11D. Ethnicity and skin-color were strongly associated (r = 0.84, p < .001). Sex was not affecting outcomes (p = .101). Ethnicity was borderline significant (p = .049). Skin-color was a highly significant factor (p = .002). A statistical model combining intervention and skin-color, with light-pigmented subjects receiving atropine-(CC) as reference group (mean SEQ +2.61 ± 1.46D), indicated borderline significantly less hypermetropia in atropine-(CC)-dark: mean decrease (95%CI): -0.81 (-1.66 to +0.05)D and atropine-(CT)-dark -0.87 (-1.70 to -0.03)D, furthermore significantly less hypermetropia in C+C-dark: -1.15 (-1.97 to -0.32)D; C+T-dark: -1.21 (-2.03 to -0.39)D, C+C-medium: -1.02 (-1.81 to -0.24)D and C+T-medium: -0.86 (-1.64 to -0.08)D. Adding crying to the model significantly less hypermetropia was found for subjects crying in all interventions; -0.53 (-0.98 to -0.09)D. Within the interventions, with light-pigmented non-crying subjects as reference group (mean SEQ in atropine, C+C, respectively, C+T: +2.62 ± 1.41, +2.33 ± 1.20 and +2.32 ± 1.20D), showed significantly less hypermetropia in dark-pigmented crying subjects in each individual intervention: atropine -1.10 (-2.01 to -0.19), C+C -1.28 (-2.14 to -0.42) and C+T -1.34 (-2.20 to -0.48)D. For medium pigmented crying subjects this was present in atropine: -0.82 (-1.61 to -0.03)D and C+C: -0.86 (-1.68 to -0.04)D, but not in C+T: -0.58 (-1.25 to +0.09)D. Conclusions: Atropine 0.5% revealed a slight significantly higher hypermetropia. A dark-pigmented skin, especially when crying upon application, resulted in lower hypermetropia in all interventions. C+T provided clinically better results in medium pigmented crying subjects compared to C+C, and equal results compared to atropine 0.5%.


Assuntos
Ambliopia/tratamento farmacológico , Choro/fisiologia , Cor de Olho , Hiperopia/tratamento farmacológico , Midriáticos/administração & dosagem , Refração Ocular/fisiologia , Pigmentação da Pele , Administração Oftálmica , Ambliopia/fisiopatologia , Atropina/administração & dosagem , Criança , Pré-Escolar , Ciclopentolato/administração & dosagem , Método Duplo-Cego , Feminino , Humanos , Hiperopia/fisiopatologia , Masculino , Soluções Oftálmicas , Retinoscopia , Tropicamida/administração & dosagem
4.
Eye Contact Lens ; 45(4): 215-225, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31241603

RESUMO

PURPOSE: To subject a number of commonly held beliefs or areas of confusion in the myopia field to scientific scrutiny. METHOD: A collection of statements about myopia are provided with references to demonstrate that a section of the research or clinical community supports the statement. The topics under discussion are reviewed critically with reference to the literature. RESULTS: The following statements are considered to lack sufficient supporting data to be considered as evidence-based: low-dose (0.01%) atropine slows myopia progression; relative peripheral hyperopia leads to myopia development and progression in children; undercorrection slows myopia progression; percentage treatment effect remains constant with continuing treatment; percentage treatment effect applies across the progression range; hand-held digital devices contribute to the myopia epidemic; more time outdoors slows myopia progression; the impact of outdoor activity on myopia incidence is due to daylight; subclassifications for myopia are effective; and myopia is a condition with a negative dioptric number. CONCLUSION: There are many hypotheses proposed to explain phenomena in the myopia field. Caution should be exercised in adopting conjecture until a robust evidence base is provided in support.


Assuntos
Atropina/administração & dosagem , Computadores de Mão , Hiperopia/complicações , Midriáticos/administração & dosagem , Miopia/etiologia , Miopia/prevenção & controle , Criança , Progressão da Doença , Exposição Ambiental , Medicina Baseada em Evidências , Óculos/efeitos adversos , Humanos
5.
Invest Ophthalmol Vis Sci ; 60(7): 2623-2630, 2019 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-31226711

RESUMO

Purpose: To explore the effect of topical atropine on axial eye growth and emmetropization in infant marmosets. Methods: Atropine was applied to one eye from the age of 7 to 56 days in two dose regimens, High (0.1-1% twice daily, increasing with age) or moderate (Mod) (0.1% once daily). Both eyes of the marmosets were refracted, and axial dimensions were measured ultrasonically, at 14, 28, 42, 49, 56, 70, 105, 168, and 279 days of age. The time course of each measured variable was analyzed using multilevel mixed-effects modeling realized in R. Results: The logistic growth curves fitted to anterior segment depth (ASD) did not differ significantly between the dose regimens, but xmid, the age at which growth was half-maximal, and scal, the time constant of the exponential term in the logistic growth curve equation, differed significantly between the ASD of atropinized and untreated eyes (P = 0.03 and P < 0.0001, respectively), with the ASD of atropinized eyes shorter than that of untreated eyes. The splines fitted to lens thickness did not vary significantly with dose, but differed significantly (P < 0.0001) between the atropinized and untreated eyes, with the atropinized lenses thicker. Vitreous chamber depth (VCD) was not significantly different, but the variance of VCD was significantly greater (P < 0.001) in the atropinized compared with the untreated eyes. Refractive error (RE) became relatively myopic in atropinized eyes. The variance of RE in atropinized eyes was significantly greater (P < 0.0001) than in untreated eyes. Conclusions: Atropine caused the infant marmoset lens to move forward and thicken, a relative myopia, and increases in the between-animals variance in VCD, which could be considered a failure of emmetropization.


Assuntos
Atropina/administração & dosagem , Comprimento Axial do Olho/efeitos dos fármacos , Olho/crescimento & desenvolvimento , Antagonistas Muscarínicos/administração & dosagem , Miopia/etiologia , Acomodação Ocular/efeitos dos fármacos , Acomodação Ocular/fisiologia , Administração Oftálmica , Animais , Animais Recém-Nascidos , Callithrix , Emetropia/fisiologia , Masculino , Miopia/fisiopatologia , Soluções Oftálmicas , Retinoscopia , Corpo Vítreo/efeitos dos fármacos
6.
AAPS PharmSciTech ; 20(6): 229, 2019 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-31227930

RESUMO

Atropine sulfate (AS) fast-disintegrating sublingual tablets (FDSTs) were tested for AS sublingual permeation's feasibility as a potential alternative dosage form to treat organophosphates (OP) toxicity. More than 12,000 OP pesticide toxicity cases were reported in the USA from 2011 to 2014. AS is the recommended antidote for OP toxicity; however, it is only available as an ATROPEN® auto-injector, an IM injection, for self-administration, which is associated with several drawbacks and limitations. Six AS FDST batches were formulated and characterized. Two tablet sizes, group A weighing 150 mg and group B weighing 50 mg, were formulated with three different AS doses: 2 mg (A1 and B1), 4 mg (A2 and B2), and 8 mg (A3 and B3). AS in vitro diffusion and sublingual permeation were investigated in Franz cells using a cellulose membrane and an excised porcine sublingual membrane. The effect of AS load and tablet size on sublingual permeation was also evaluated. All batches passed quality control tests. AS FDSTs' size and AS load had a significant effect on tablet disintegration time and drug dissolution, which significantly impacted AS concentration gradient across the diffusional membrane. Group B FDSTs (smaller tablets) resulted in a significantly higher initial permeation (JAUC0-15) compared to group A FDSTs. Also, the cumulative AS (JAUC0-90) and AS influx (J) increased linearly with increasing AS dose. These AS FDSTs have the potential to be explored in vivo to determine the required bioequivalent sublingual AS dose as an alternative dosage form for the treatment of OP toxicity.


Assuntos
Atropina/administração & dosagem , Atropina/uso terapêutico , Intoxicação por Organofosfatos/tratamento farmacológico , Comprimidos/administração & dosagem , Administração Sublingual , Animais , Difusão , Permeabilidade , Suínos
7.
Mymensingh Med J ; 28(2): 470-473, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31086169

RESUMO

Organophosphorus compounds (OPC) are widely used insecticides. Such poisoning is very rare in neonate. A 23 days old infant was admitted with severe respiratory distress, excessive secretion from nose and mouth, bluish discoloration of extremities and poor feeding for 4 hours. He was pale, cyanosed and lethargic with gasping respiration. Frothing was coming through mouth and nose. There was watering of eyes, pupils were pin pointed and light reflex was sluggish. The baby was hypothermic, hypotonic with altered sensorium. Capillary refill time was <3 sec. The neonate was gasping; there was crepitation over lung fields. Precordium and abdomen was normal. An odor of OPC was smelt on clothing and secretions of the infant. The baby was wrapped with a cloth that was ware during pesticide spraying in the field. In addition to general measures, decontamination of skin and clothing and gastric lavage was done. Empirical antibiotic, injection atropine and pralidoxime were given. Patient showed clinical improvement with disappearance of cholinergic signs. The baby was discharged on 7th day of admission after full recovery.


Assuntos
Antídotos/administração & dosagem , Atropina/administração & dosagem , Inseticidas/envenenamento , Intoxicação por Organofosfatos/tratamento farmacológico , Compostos Organofosforados/toxicidade , Compostos de Pralidoxima/administração & dosagem , Antídotos/uso terapêutico , Atropina/uso terapêutico , Humanos , Recém-Nascido , Masculino , Compostos Organofosforados/efeitos adversos , Compostos de Pralidoxima/uso terapêutico , Resultado do Tratamento
8.
Niger J Clin Pract ; 22(5): 609-615, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31089014

RESUMO

Objective: The effect of sugammadex on consciousness is not yet fully understood. This prospective, randomized, double-blind, multicenter study was performed to compare the effects of intravenous (IV) sugammadex and neostigmine + atropine reversals on time-to-consciousness during intraoperative wake-up tests in patients undergoing spinal surgery. Subjects and Methods: A total of 66 American Society of Anesthesiologists I-II patients aged 10-25 years undergoing spinal surgery were recruited. In all patients, bispectral index (BIS), motor-evoked potential (MEP), somatosensory-evoked potentials (SSEP), and train-of-four (TOF) scores were monitored. Patients received the same total IV anesthesia protocol with a propofol-remifentanil mixture. Patients were randomly allocated into two groups. During wake-up test, when the TOF count reached 2 (T2), either sugammadex 2 mg.kg-1 in group S or neostigmine 0.04 mg.kg-1 + atropine 0.01 mg.kg-1 in group N were administered. BIS90, SSEP90, MEP90 was recorded when TOF ratio reached 90, whereas time-to-consciousness (Timecons) was recorded when the patient responded to verbal commands. Results: BIS90 (77.4 ± 4.7, 74.8 ± 3.7), SSEP90(36 ± 9.9, 29.7 ± 8.5), and MEP90 (465.3 ± 34.8, 431.3 ± 28.2) values were significantly greater in group S than in group N (P < 0.05 for each variables). Timecons was significantly shorter with sugammadex than with the neostigmine + atropine combination (P < 0.05). Conclusion: Using IV sugammadex 2 mg.kg-1 reversal provides faster responses to verbal commands than neostigmine-atropine combination during the intraoperative wake-up test in patients undergoing spinal surgery because the time to consciousness was significantly shorter. This difference was thought to be related with faster return of neuromuscular transmission because the TOF ratio was >0.9 well before return of consciousness in both groups.


Assuntos
Atropina/farmacologia , Inibidores da Colinesterase/farmacologia , Estado de Consciência/efeitos dos fármacos , Neostigmina/farmacologia , Parassimpatolíticos/farmacologia , Sugammadex/farmacologia , Administração Intravenosa , Adolescente , Adulto , Analgésicos Opioides , Anestesia Geral , Anestésicos Intravenosos , Atropina/administração & dosagem , Criança , Inibidores da Colinesterase/administração & dosagem , Monitores de Consciência , Método Duplo-Cego , Potencial Evocado Motor , Potenciais Somatossensoriais Evocados , Feminino , Humanos , Masculino , Neostigmina/administração & dosagem , Monitoração Neuromuscular , Parassimpatolíticos/administração & dosagem , Propofol , Estudos Prospectivos , Remifentanil , Sugammadex/administração & dosagem , Fatores de Tempo , Adulto Jovem
12.
Indian J Ophthalmol ; 67(4): 461-463, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30900574

RESUMO

Purpose: To develop a consensus statement for use of dilute atropine in control of myopia progression in children based on review of existing literature, opinions and suggestions of the members of the Group of Paediatric Ophthalmologist and Strabismologists, Mumbai (GPOS). Methods: Literature review, group discussions, questionnaire study and consensus building by supermajority voting. Results: About 65% of paediatric ophthalmologists in Mumbai have started prescribing atropine sulphate 0.01% as routine in their patients showing myopia progression. Majority of the respondents who have used it for >1 year in their patient population are extremely happy with the results. About 47% respondents expressed concerns regarding some yet unknown side effects of long-term use in our patient population. Majority of the respondents agree that it is safe and have rarely encountered side effects with its use. Conclusion: Atropine sulphate 0.01% is a safe and effective treatment for myopia control. Most trained paediatric ophthalmologists recommend its use in children with progressive simple myopia.


Assuntos
Atropina/administração & dosagem , Consenso , Miopia Degenerativa/tratamento farmacológico , Guias de Prática Clínica como Assunto , Refração Ocular/fisiologia , Progressão da Doença , Humanos , Midriáticos/administração & dosagem , Miopia Degenerativa/fisiopatologia , Soluções Oftálmicas , Refração Ocular/efeitos dos fármacos , Resultado do Tratamento
13.
Arch. Soc. Esp. Oftalmol ; 94(3): 145-148, mar. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-178318

RESUMO

Paciente varón de 18 años el cual presentaba lesión en el ojo izquierdo por arma de fuego. Permaneció inconsciente 2 días en una zona agrícola, luego fue llevado a un hospital local donde se le extrajeron larvas. En el ojo izquierdo presentó una agudeza visual de no percepción de luz, heridas con pérdida de sustancia en los párpados superior e inferior, atalamia, hipotonía, edema corneal, herida con exposición uveal y salida de larvas en zona II. Se le practicó evisceración del ojo izquierdo


An 18 year-old male patient presented with an injury to the left eye caused by a firearm. He remained unconscious for 2 days in an agricultural area, had a visual acuity of non-perception of light, wounds with loss of substance in upper and lower eyelid, atalamia, hypotonia, corneal oedema, wound with uveal exposure and exit of larvae in zone II. He was subjected to evisceration of the left eye


Assuntos
Humanos , Masculino , Adolescente , Miíase/diagnóstico , Miíase/tratamento farmacológico , Traumatismos Oculares/complicações , Evisceração do Olho/métodos , Traumatismos Oculares/parasitologia , Fatores de Risco , Acuidade Visual , Órbita/diagnóstico por imagem , Prednisolona/administração & dosagem , Atropina/administração & dosagem , Cetorolaco/administração & dosagem , Ciprofloxacino/administração & dosagem , Clindamicina/administração & dosagem , Oxitetraciclina/administração & dosagem
14.
Invest Ophthalmol Vis Sci ; 60(2): 488-499, 2019 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-30707221

RESUMO

Myopia is fast becoming a global public health burden with its increasing prevalence, particularly in developed countries. Globally, the prevalence of myopia and high myopia (HM) is 28.3% and 4.0%, respectively, and these numbers are estimated to increase to 49.8% for myopia and 9.8% for HM by 2050 (myopia defined as -0.50 diopter [D] or less, and HM defined as -5.00 D or less). The burden of myopia is tremendous, as adults with HM are more likely to develop pathologic myopia (PM) changes that can lead to blindness. Accordingly, preventive measures are necessary for each step of myopia progression toward vision loss. Approaches to prevent myopia-related blindness should therefore attempt to prevent or delay the onset of myopia among children by increased outdoor time; retard progression from low/mild myopia to HM, through optical (e.g., defocus incorporated soft contact lens, orthokeratology, and progressive-additional lenses) and pharmacological (e.g., low dose of atropine) interventions; and/or retard progression from HM to PM through medical/surgical treatments (e.g., anti-VEGF therapies, macula buckling, and scleral crosslinking). Recent clinical trials aiming for retarding myopia progression have shown encouraging results. In this article, we highlight recent findings on preventive and early interventional measures to retard myopia, and current and novel treatments for PM.


Assuntos
Atropina/administração & dosagem , Reagentes para Ligações Cruzadas/uso terapêutico , Miopia/prevenção & controle , Miopia/terapia , Procedimentos Cirúrgicos Oftalmológicos , Procedimentos Ortoceratológicos , Cegueira/prevenção & controle , Lentes de Contato Hidrofílicas , Progressão da Doença , Humanos , Antagonistas Muscarínicos/administração & dosagem , Miopia/patologia , Miopia Degenerativa/patologia , Miopia Degenerativa/prevenção & controle , Miopia Degenerativa/terapia
15.
Graefes Arch Clin Exp Ophthalmol ; 257(6): 1061-1078, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30706134

RESUMO

PURPOSE: The purpose of this review is to provide an update on current management and recent research for amblyopia treatment. Part I will review patching, atropine penalization, and pharmacological treatments. Part II will focus on perceptual learning, video gaming, and binocular dichoptic approaches. METHODS: A literature search was performed in PubMed, ClinicalTrials.gov , Google Scholar, and reference lists of retrieved articles until December 20, 2018, for all papers containing "amblyopia treatment" or "amblyopia therapy." We have included RCTs, prospective observational studies, prospective and retrospective cohort studies, pilot studies, and review articles. RESULTS: The mainstay of treatment for amblyopia has been based on increasing visual stimulation of the amblyopic eye by occlusion, atropine, or optical penalization of the dominant eye. It has been established that refractive adaptation alone can significantly enhance visual acuity. However, the duration of optical correction varies between studies and the effectiveness of spectacle wear over early beginning of patching is still under investigation. Additionally, by means of occlusion dose monitors, it was found that adherence to occlusion affects the outcome, as a dose-response relationship exists between adherence and visual acuity. Treatment efficiency declines with age; however, recent evidence indicates cortical plasticity beyond the "critical period" and recommends that an attempt at treatment should be offered to all amblyopic children regardless of age, including those in later childhood. Novel approaches targeted to the restoration of binocular functions, such as perceptual learning, video gaming, and dichoptic training, have shown small effects on visual acuity and have failed to demonstrate non-inferiority over standard treatments. CONCLUSIONS: On review, significant evidence for the successful management of amblyopia, with occlusion therapy and atropine, has been found. However, the management of amblyopia remains challenging, mainly due to compliance issues and suboptimal treatment outcomes during occlusion and atropine penalization. Recent studies have found evidence of new ways of treating amblyopia particularly in regard to binocular treatment although these remain under investigation. Further robust clinical trials on these new treatment modalities are still warranted in order to establish their role in treating amblyopia.


Assuntos
Ambliopia/terapia , Atropina/administração & dosagem , Óculos , Refração Ocular/fisiologia , Visão Binocular/fisiologia , Acuidade Visual , Ambliopia/fisiopatologia , Humanos , Midriáticos/administração & dosagem , Soluções Oftálmicas , Privação Sensorial , Resultado do Tratamento
16.
Pharmacol Rep ; 71(2): 225-232, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30785060

RESUMO

BACKGROUND: Muscarinic receptor antagonists are a usual treatment for chronic airway diseases, with increased bronchoconstriction, like asthma and chronic obstructive pulmonary disease. These diseases are usually accompanied by airway remodeling, involving airway smooth muscle cell (ASMC) proliferation. The purpose of this study was to examine the effect of the muscarinic receptor modulator gallamine on rabbit tracheal ASMC proliferation. METHODS: ASMCs were incubated with gallamine (1 nM-10 mM), atropine (1 fM-10 mM), and/or acetylcholine (1 nM-1 mM), in the presence or absence of FBS (1% or 10%). Cell proliferation was estimated by incorporation of radioactive thymidine, the Cell Titer AQueous One Solution method and cell number counting after Trypan blue exclusion. The mechanisms mediating cell proliferation were studied using the PI3K and MAPK inhibitors LY294002 (20 µM) and PD98059 (100 µM), respectively. Cell phenotype was studied by indirect immunofluorescence for α-actin, Myosin Heavy Chain and desmin. RESULTS: ASMC incubation with the muscarinic receptor allosteric modulator gallamine or the muscarinic receptor antagonist atropine increased methyl-[3H]thymidine incorporation and cell number in a dose-dependent manner. ASMC proliferation was mediated via PI3K and MAPK activation and was transient. Gallamine antagonized the mitogenic effect of 1% FBS. Furthermore, gallamine had a similar effect on contractile ASMCs, without synergizing with or affecting acetylcholine induced proliferation, or altering the percentage of ASMCs expressing contractile phenotype marker proteins. CONCLUSIONS: Gallamine, in the absence of any agonist, has a transient mitogenic effect on ASMCs, regardless of the cell phenotype, mediated by the PI3K and the MAPK signaling pathways.


Assuntos
Proliferação de Células/efeitos dos fármacos , Trietiodeto de Galamina/farmacologia , Antagonistas Muscarínicos/farmacologia , Miócitos de Músculo Liso/efeitos dos fármacos , Acetilcolina/administração & dosagem , Acetilcolina/farmacologia , Remodelação das Vias Aéreas/efeitos dos fármacos , Animais , Atropina/administração & dosagem , Atropina/farmacologia , Relação Dose-Resposta a Droga , Trietiodeto de Galamina/administração & dosagem , Sistema de Sinalização das MAP Quinases/efeitos dos fármacos , Antagonistas Muscarínicos/administração & dosagem , Contração Muscular/efeitos dos fármacos , Miócitos de Músculo Liso/citologia , Fenótipo , Fosfatidilinositol 3-Quinases/metabolismo , Coelhos , Receptores Muscarínicos/efeitos dos fármacos , Receptores Muscarínicos/metabolismo , Transdução de Sinais/efeitos dos fármacos , Traqueia/citologia , Traqueia/efeitos dos fármacos
17.
Vet Ophthalmol ; 22(4): 448-461, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30716184

RESUMO

OBJECTIVE: To compare the effects of topical 0.005% latanoprost (L) vs combined 0.005% latanoprost and 1% atropine (LA) on control of postoperative ocular hypertension (POH), development of posterior synechiae formation, pupil size, and blindness after phacoemulsification surgery in dogs. ANIMAL STUDIED: Dogs with postoperative ocular hypertension were included in the study: L-group, latanoprost (eight dogs, 14 eyes) and LA-group, latanoprost and atropine (nine dogs, 15 eyes). PROCEDURES: Complete ophthalmic examinations including tonometry were performed at 1, 7, and 21 days following phacoemulsification. RESULTS: No significant differences were found between the measured intraocular pressure (IOP) at days 1 and 7 postphacoemulsification surgery in the L-group and the LA-group (P = 0.26 [14.12 ± 1.76 mmHg vs 16.96 ± 1.68 mmHg] and P = 0.71 [15.45 ± 1.43 mmHg vs 16.20 ± 1.36 mmHg], respectively). No significant differences were found between pupil sizes at day 7 for the two groups (P = 0.25 [13.83% vs 24.77%]). No significant differences were found between odds of posterior synechiae formation at day 21 (P = 0.92) with a probability ± SE for L-group vs LA-group at 0.27 ± 0.14 vs 0.25 ± 0.13. No significant differences were found in odds of postoperative blindness between groups (P = 0.58) with a probability ± SE of 0.21 ± 0.11 vs 0.13 ± 0.09, respectively for L and LA. CONCLUSIONS: Combined topical latanoprost and atropine in dogs maintains normal postoperative IOPs but does not seem to cause increased mydriasis compared to latanoprost alone.


Assuntos
Atropina/uso terapêutico , Doenças do Cão/tratamento farmacológico , Latanoprosta/uso terapêutico , Hipertensão Ocular/veterinária , Soluções Oftálmicas/uso terapêutico , Facoemulsificação/veterinária , Complicações Pós-Operatórias/veterinária , Animais , Atropina/administração & dosagem , Cegueira/etiologia , Cegueira/prevenção & controle , Cegueira/veterinária , Catarata/veterinária , Cães , Quimioterapia Combinada/veterinária , Feminino , Latanoprosta/administração & dosagem , Implante de Lente Intraocular/veterinária , Masculino , Hipertensão Ocular/tratamento farmacológico , Hipertensão Ocular/etiologia , Facoemulsificação/efeitos adversos , Complicações Pós-Operatórias/tratamento farmacológico , Estudos Retrospectivos
18.
Intern Med ; 58(12): 1713-1721, 2019 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-30799340

RESUMO

Objective The updated guidelines of 2015 for cardiopulmonary resuscitation (CPR) do not recommend the routine use of atropine for cardiopulmonary arrest. Methods The study population included out-of-hospital cardiac arrest (OHCA) patients with non-shockable rhythm who were encountered at a Japanese community hospital between October 1, 2012 and April 30, 2017. Results At the outcome, the epinephrine with atropine and epinephrine-only groups had a similar survival rate to that at hospital admission (28.7% vs. 26.7%: p=0.723). The odds ratio (OR) for the survival to hospital admission after the administration of atropine with epinephrine was 1.33 (95% CI 1.09-1.62; p<0.01), while that after the administration of epinephrine was 0.64 (95% CI: 0.55-0.74, p<0.01). The ORs for the survival to hospital admission for patients with pulseless electrical activity in the epinephrine-alone group and the atropine with epinephrine group were 0.62 (95% CI 0.49-0.78; p<0.01) and 1.35 (95% CI 0.99-1.83; p=0.06), respectively, and those for such patients with asystole in the epinephrine-alone group and the atropine with epinephrine group were 0.64 (95% CI 0.53-0.76; p<0.01) and 1.39 (95% CI 1.10-1.77; p<0.01), respectively. The OR for the survival to hospital admission after the administration of atropine sulfate (1 mg) was 2.91 (95% CI 1.49-5.67; p<0.01), while that for the survival to hospital admission after the administration of 0, 2 and ≥3 mg atropine sulfate was 0.38 (95% CI 0.29-0.50; p<0.01), 1.54 (95% CI 0.58-4.08; p=0.38) and 0.23 (95% CI 0.09-0.60; p<0.01), respectively. Conclusion The addition of atropine (within 2 mg) following epinephrine was a comprehensive independent predictor of the survival to hospital admission for non-shockable (especially asystole) OHCA adults.


Assuntos
Atropina/uso terapêutico , Reanimação Cardiopulmonar/métodos , Serviços Médicos de Emergência/métodos , Epinefrina/uso terapêutico , Parada Cardíaca Extra-Hospitalar/mortalidade , Parada Cardíaca Extra-Hospitalar/terapia , Idoso , Idoso de 80 Anos ou mais , Arritmias Cardíacas/etiologia , Atropina/administração & dosagem , Epinefrina/administração & dosagem , Feminino , Hospitais Comunitários , Humanos , Masculino , Razão de Chances , Parada Cardíaca Extra-Hospitalar/complicações , Parada Cardíaca Extra-Hospitalar/tratamento farmacológico , Taxa de Sobrevida
20.
Doc Ophthalmol ; 138(2): 85-95, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30680489

RESUMO

PURPOSE: Daily administration of 0.01% atropine eye drops is a promising approach for myopia control. The mechanism of action is believed to involve the dopaminergic system of the retina, triggering an increased release of dopamine. Previous studies in psychiatric condition such as major depression suggest that pattern electroretinogram (PERG) amplitudes are modulated by changes in retinal dopamine. It is thus plausible that atropine eye drops could have an effect on PERG amplitudes. The present study was designed to test this, assessing the difference in amplitude between contrast levels and the ratio of amplitudes between check sizes as primary endpoints. METHODS: We included 14 participants with no more than ± 2 diopters of ametropia and visual acuity of at least 1.0. One eye was chosen randomly in each participant for atropine application (14 days, one drop of 0.01% atropine solution once daily before bedtime). We recorded two sets of steady-state PERG recordings: one with different contrasts (25% and 98%) and one with different check sizes (0.8° and 17°). Near-point distance, near visual acuity, and pupil diameter were measured additionally. RESULTS: The recordings to different contrasts did not show atropine-related changes of PERG amplitude. A small increase by 6% of the amplitude difference between contrast levels with atropine application was not significant (p = 0.08). Raw amplitudes in the check size condition increased with atropine by 17% (p < 0.01) and 10% (p < 0.03) for small and large checks, respectively, without a significant concomitant effect on the amplitude ratio. Pupil size was significantly affected (median increase 0.5 mm, p < 0.002). However, neither of the experimental conditions was associated with a significant correlation between pupil size and PERG effects. CONCLUSION: The effects on PERG primary endpoints after the 14-day period of atropine administration were small, especially compared to effect sizes in major depression, and statistically insignificant. Effects on raw amplitude were inconsistent. The present results suggest that retinal processing as reflected by PERG does not sizably change following a treatment regimen with atropine that is typical for myopia control.


Assuntos
Atropina/administração & dosagem , Eletrorretinografia/efeitos dos fármacos , Midriáticos/administração & dosagem , Miopia/prevenção & controle , Adulto , Dopamina/metabolismo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Soluções Oftálmicas , Retina/fisiologia , Acuidade Visual , Adulto Jovem
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