|Year : 1989 | Volume
| Issue : 4 | Page : 179-181
A clinical study of effect of oral atenolol on normal intraocular pressure and systemic blood pressure
Jugal Kishore Chauhan, YC Mishra, Kamlesh Khilnani
Rasta Uniyara Rao, Chandpole Bazar, Jaipur-302 001. (Rajasthan), India
Jugal Kishore Chauhan
Rasta Uniyara Rao, Chandpole Bazar, Jaipur-302 001. (Rajasthan)
Source of Support: None, Conflict of Interest: None
Atenolol is a newer betablocker, widely used as an antihypertensive drug. It cause a large and rapid fall in IOP when used orally and topically. A total of 33 patients both having normal and raised IOP were included in the study. The drug was given in a dose of 50 mg. tab. orally once a day for 7 days at 8 A.M. and IOP recorded after 24 hours, 72 hours and on 7th day. It produces significant and sustained fall in IOP in both normal and raised IOP patients besides lowering of systematic B.P. and pulse rate. The IOP on patients with systemic hypertension with Atenolol will be reduced and stoppage of therapy may cause glaucoma damage.
Keywords: IOP - Intra Ocular Pressure BP - Blood Pressure
|How to cite this article:|
Chauhan JK, Mishra Y C, Khilnani K. A clinical study of effect of oral atenolol on normal intraocular pressure and systemic blood pressure. Indian J Ophthalmol 1989;37:179-81
Atenolol (Tenormin, I.C.I. 66082) is a new betablocker which is unique in lacking both sympathomimetic and membrane stabilizing effect and cardio selective in nature. At present it is widely used to treat hypertension and has been shown to have an action both orally and topically on the eye, causing a large and rapid fall of intra ocular pressure.
| Material and methods|| |
The study is conducted in the Departments of Internal Medicine and Ophthalmology. A total of 33 patients out of which 30 cases were having normal IOP and 3 cases with glaucoma suspect were included in this study.
Case having hypertension, coronary artery disease, migraine and vascular headaches were selceted. Cases having established heart block, bronchial asthma, C.O.P.D & patients on beata blocker were excluded form the study.
Patients having base line intra ocular presure beween 20-24 mm of Hg by applanation tonometery i.e. glaucoma suspects were separately noted and detailed history and ocular examination was done to rule out established glucoma. The same recording is done at 24 hours, 72 hours, and on the 7th day after starting the drug. The drug is given 50 mg. Orally once a day at 8.00 A.M.
Similarly case number two & three indicates that there was a decrease of 20.3 % of IOP after 24 hours, and this fall further increased upto 26.8 % after 72 hours and on the 7th day.
| Discussion|| |
In the present study 30 patients with normal IOP and 3 glaucoma suspects with IOP ranging from 20-24 mm Hg. of both sexes and various age groups ranging from 1574 years were subjected to administration of 50 mg Atenolol one a day orally and the drug was continued for a total period of 7 days.
The IOP on an average registered a fall of 25.2 per cent on the first day and 28.8 per cent on the third day. The fall of IOP was maintained upto 7 days and the-average fall in this group on the seventh day was observed to be 29.8 percent.
It, therefore, appears that the fall is quick and specific on the very first day and the further decline of IOP is of a smaller magnitude and more gradual. In the year 1975 Watterll found a decreasing effect of IOP by Atenolol in the minimum dose necessary to produce a decrease in BP. The decrease was immediate, significant and lasted throughout the period of administration (8 days) Many other workers 3, 4, 5 noted similar findings.
In the present study the response on systemmic blood pressure was as significant as that on intra -ocular pressure.
In the present work three glaucoma suspects were included. The effect of the drug was same in normal IOP cases as well as in glaucoma suspects. These potential cases of glaucoma would have remained undiagnosed without prior investigation for glaucoma. In case this drug is changed by the physician the IOP which is likely to increase, will damage the disc and subsequently produce field and visual loss which will be irreversible.
No definite hypothesis has been arrived at the mechanism of action of this drug in lowering the intra occular pressure. More extensive experimental and clincal work is necssary to postulate a definite hypothesis regarding the mechanism of action of this drug . Whether it is through adrenergic receptor which equlates the blood flow in the ciliary process and intra secleral venous plexus there by changing the flow rate of aqueous humour or by an unknown mechanism that decreases the rate of aqueous humour formation, is still inconclusive.
| References|| |
Barret,A.M., Carter, J., Fitzeald, JD., Hull, R. and Le Count, D.: A new type of cardio selcetive adrenoceptive blocking drug. Br. Jr. Pharmacol., 48,340, 1973.
Karin Watteril, and M Pandolfi: Effect of oral administration of various bet blocking agents on the intra-ocular pressure in the healthy volunteers. Exp. Eye. Res., 21, 451-456, 1975.
Elliot, M.J., Culler, P.M. and Phillips, Cl: Ocular hypotensive effect of Atenolol (Tenorium ICI) Br. J. Ophthal. 59, 296-300, 1975.
E Stenkula, K Watrell. : A doss response study of oral atenolo administered onee daily in patients with raised intra-ocular pressure. Graafes Arch. Clin. Exp. Ophthalmol. 218,96-98.1982
Milas K. tutton et al.: Comparison of ocular hypotensive effect of 3 dosages of oral Atenolo. Br. J. Ophthalmol. 67,664-667,1983.
[Table - 1], [Table - 2], [Table - 3], [Table - 4]