WordNet

a complex consisting of an organic base in association with hydrogen chloride

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/01/30 16:20:50」(JST)

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Apraclonidine (INN), also known as Iopidine, is a sympathomimetic used in glaucoma therapy. It is an α₂-adrenergic agonist and a weak alpha-1 adrenergic receptor agonist.

Topical apraclonidine is administered at a concentration of 1% for the prevention and treatment of postsurgical intraocular pressure elevation and 0.5% for short-term adjunctive therapy in patients on maximally tolerated medical therapy who require additional redirection of intraocular pressure. One drop is usually added one hour prior to laser eye surgery and another drop is given after the procedure is complete.

Clinical uses

Apraclonidine is indicated for the short-term adjunctive treatment of patients on maximally tolerated medical therapy who require additional reduction. Patients on maximally tolerated medical therapy who are treated with apraclonidine to delay surgery should have frequent follow-up examinations and treatment should be discontinued if the intraocular pressure rises significantly.

Apraclonidine may be useful in the diagnosis of Horner's syndrome. In Horner's syndrome, the sympathetic innervation to the pupillary dilator muscle is lost. The affected pupil is thus miotic and the pupillary dilator responds to denervation by increasing alpha-1 receptors. Apraclonidine is useful in this case due to its weak alpha-1 adrenergic properties. When applied to the denervated (and thus hyper-sensitive) pupillary dilator muscle, a super-normal dilatory response is generated in which the pupil dilates to a degree greater than that which would be seen in a non-denervated muscle. This causes the reversal of anisocoria that is characteristic of Horner's.

Topical apraclonidine can also decrease IOP in glaucoma patients by increasing trabecular outflow, in a similar way to clonidine, ^[1] but without the cardiovascular side effects.

External links

Iopidine prescribing information (from the FDA website)
Simple information on Apraclonidine

References

^ Toris, C. B.; Tafoya, M. E.; Camras, C. B.; Yablonski, M. E. (1995). "Effects of Apraclonidine on Aqueous Humor Dynamics in Human Eyes". Ophthalmology 102 (3): 456. doi:10.1016/S0161-6420(95)31000-7. edit

Chen P, Chen J, Lu D, Chen Y, Hsiao C (2006). "Comparing efficacies of 0.5% apraclonidine with 4% cocaine in the diagnosis of horner syndrome in pediatric patients". J Ocul Pharmacol Ther 22 (3): 182–7. doi:10.1089/jop.2006.22.182. PMID 16808679.
Aslanides l, Tsiklis N, Ozkilic E, Coskunseven E, Pallikaris l, Jankov M (2006). "The effect of topical apraclonidine on subconjunctival hemorrhage and flap adherence in LASIK patients". J Refract Surg 22 (6): 585–8. PMID 16805122.
Koc F, Kansu T, Kavuncu S, Firat E (2006). "Topical apraclonidine testing discloses pupillary sympathetic denervation in diabetic patients". J Neuroophthalmol 26 (1): 25–9. doi:10.1097/01.wno.0000204648.79744.71. PMID 16518162.
Garibaldi D, Hindman H, Grant M, Iliff N, Merbs S (2006). "Effect of 0.5% apraclonidine on ptosis in Horner syndrome". Ophthal Plast Reconstr Surg 22 (1): 53–5. doi:10.1097/01.iop.0000196322.05586.6a. PMID 16418668.
Onal S, Gozum N, Gucukoglu A (2005). "Effect of apraclonidine versus dorzolamide on intraocular pressure after phacoemulsification". Ophthalmic Surg Lasers Imaging 36 (6): 457–62. PMID 16355950.

UpToDate Contents

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1. 閉塞隅角緑内障 angle closure glaucoma
2. ホルネル症候群 horners syndrome
3. 瞳孔不同患者へのアプローチ approach to the patient with anisocoria
4. 原発性乳児緑内障 primary infantile glaucoma
5. 急性持続性視力喪失が認められた成人に対するアプローチ approach to the adult with acute persistent visual loss

English Journal

[OCT measurement of the impact of Nd:YAG laser capsulotomy on foveal thickness.]

Giocanti-Auregan A, Tilleul J, Rohart C, Touati-Lefloc'h M, Grenet T, Fajnkuchen F, Chaine G.SourceService d'ophtalmologie, hopital Avicenne, universite Paris XIII, 125, rue de Stalingrad, 93009 Bobigny cedex, France.
Journal francais d'ophtalmologie.J Fr Ophtalmol.2011 Sep 1. [Epub ahead of print]
INTRODUCTION: Posterior capsular opacification is the commonest complication of cataract surgery. It is treated with Nd:YAG laser capsulotomy. However, after treatment, cases of cystoid macular edema have been reported. The purpose of this study was to measure the foveal thickness change after Nd:YA
PMID 21889816

Early diagnosis of horner syndrome using topical apraclonidine.

Cooper-Knock J, Pepper I, Hodgson T, Sharrack B.SourceDepartment of Neurology, Sheffield Teaching Hospitals NHS Trust, University of Sheffield, Sheffield, United Kingdom.
Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society.J Neuroophthalmol.2011 Sep;31(3):214-6.
The diagnosis of Horner syndrome (HS) using apraclonidine eye drops is an alternative to the use of topical cocaine drops. A number of reports have described the efficacy of apraclonidine testing, but there is some debate over its sensitivity in the acute setting. We describe a patient with HS secon
PMID 21566530

Japanese Journal

アプラクロニジンが著効した続発緑内障の1例

小島綾子,佐藤由紀,松倉修司,河合憲司
緑内障 = Journal of Japan Glaucoma Society 13(1), 95-98, 2003-08-20
NAID 10011599684

アプラクロニジンが著効した続発緑内障の1例

小島綾子,佐藤由紀,松倉修司,河合憲司
あたらしい眼科 = Journal of the eye 20(7), 1015-1018, 2003-07-30
NAID 10017017282

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★リンクテーブル★

リンク元	「アプラクロニジン」
関連記事	「hydrochloride」

「アプラクロニジン」

Apraclonidine
Systematic (IUPAC) name
	2,6-dichloro-N- (4,5-dihydro-1H-imidazol-2-yl) benzene-1,4-diamine
Clinical data
Trade names	Iopidine
AHFS/Drugs.com	monograph
MedlinePlus	a608005
Legal status	Rx only;
Routes	Ophthalmic solution
Pharmacokinetic data
Protein binding	98.7%
Half-life	8 hours
Identifiers
CAS number	66711-21-5
ATC code	S01EA03
PubChem	CID 2216
DrugBank	DB00964
ChemSpider	2130
UNII	843CEN85DI
KEGG	D07461
ChEBI	CHEBI:2788
ChEMBL	CHEMBL647
Chemical data
Formula	C9H10Cl2N4
Molecular mass	245.108 g/mol
	SMILES Clc1c(c(Cl)cc(N)c1)N/C2=N/CCN2;
	InChI InChI=1S/C9H10Cl2N4/c10-6-3-5(12)4-7(11)8(6)15-9-13-1-2-14-9/h3-4H,1-2,12H2,(H2,13,14,15) ; Key:IEJXVRYNEISIKR-UHFFFAOYSA-N ;
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