, without modifying central processes. Pupil diameter was measured during the light reaction in 29 normal adults under three processing levels: No Task, during an easy task (Add 1), or a difficult task (Subtract 7). At three separate sessions, the pupil was treated with placebo, tropicamide (blocking the muscarinic sphincter receptor), or dapiprazole (blocking the adrenergic dilator receptor ). With placebo, pupil diameter increased with increasing task difficulty. The light reaction was reduced only in the Subtract 7 condition. Dapiprazole (which decreased overall diameter) showed similar task-related changes in diameter and light reflex as for placebo. Following tropicamide (which increased overall diameter), there was a further increase in diameter only in the difficult task. Findings suggest
of the alpha1-adrenergic blocking agent dapiprazole and that it would be present in organ donors with intact spinal reflexes and no history of hypoxia. In volunteers, pupil size was measured with an infrared pupillometer while brief painful electric stimuli were delivered to the finger. Pain was assessed with a visual analog scale and adjusted with each volunteer to equal 3 on a visual analog scale of 0-10 . Subjects were studied before and after topical application of the alpha1-adrenergic antagonist dapiprazole. In organ donors, the authors measured pupil size after high-intensity tetanic electric stimulation and in dapiprazole-blocked and -unblocked pupils after surgically induced nociception. In volunteers, the pupil dilated 0.43 +/- 0.23 mm after nociceptive stimuli. Dapiprazole eyedrops blocked
following aortic cross-clamp. Dapiprazole eye drops were instilled into the left eye at least 1 h before cross clamp in five cases and pupillary measurements were intermittently taken before and after cross clamp. Pupil size was stable before cross clamp. Following cross clamp, the pupil dilated in all cases, reaching 10.6 mm in one case. Mean dilation was 1.8+/-0.9 mm. Time to peak dilation was 4.3+/-1.4 min and latency of dilation was 1.4+/-1.2 min. Dapiprazole eye drops prevented the pupillary dilation in contralateral eye of the five cases in which it was used. The cause of this sympathetic activity is either a short burst of neuronal activity in the peripheral sympathetic system innervating the dilator muscle, or release of stored norepinephine from the presynaptic terminals, as asphyxia
. The objective of this study was to examine the hypothesis that diazepam may attenuate both the sympathetic and the opposing parasympathetic outflow to the iris, which may mask the miosis. Dapiprazole (sympatholytic) and tropicamide (parasympatholytic) were applied topically, together with the cold pressor test (CPT), to manipulate the sympathetic/parasympathetic balance. Sixteen healthy male volunteers participated in four weekly sessions according to a balanced double-blind protocol. Diazepam 10 mg (two sessions) and placebo (two sessions), associated with either 0.01% tropicamide or 0.5% dapiprazole eyedrops, were administered orally. Pupil diameter, light and darkness reflexes and pupillary sleepiness waves were recorded with infrared video pupillometry, alertness was measured by critical flicker fusion
Effect of dapiprazole, an alpha-adrenergic blocking agent, on aqueous humor dynamics in pigmentary glaucoma. In this investigation the authors studied the effect of dapiprazole, an alpha-adrenergic blocking agent, on aqueous humor dynamics in patients affected with pigmentary glaucoma. Dapiprazole 0.5% eye drops were administered 3 times daily as adjunctive therapy to 16 pigmentary glaucoma patients in addition to timolol 0.5% eye drops twice daily. Computerized tonography was performed before and 3, 12 and 36 months after dapiprazole treatment. Sixteen sex- and age-matched pigmentary glaucoma patients treated with timolol 0.5% eye drops alone were used as a control group. After 36 months of follow-up, the dapiprazole-treated group showed a significant increase in total outflow facility (C
The additive miotic effects of dapiprazole and pilocarpine. Since dapiprazole on alpha-adrenergic agent, produces miosis by paralyzing the dilator muscle, and pilocarpine, a parasympathetic drug, causes miosis by affecting the sphincter, we speculated that the two drugs might have additive effects. The additive miotic actions of pilocarpine 2% and dapiprazole 0.5% were evaluated by comparing the effects of two drugs given together and alone on the reversal of mydriasis induced by tropicamide (0.5%) and phenylephrine (10%) in one eye each of 60 healthy volunteers. Dapiprazole and pilocarpine together induced miosis significantly faster than each drug alone, showing additive effects. Co-administration of dapiprazole and pilocarpine at the end of the eye examination will induce fast pupillary
Intraocular dapiprazole for the reversal of mydriasis after extracapsular cataract extraction with intraocular lens implantation. Part II: Comparison with acetylcholine. Intraocular dapiprazole for reversing mydriasis during extracapsular cataract extraction with intraocular lens (IOL) implantation has been compared to intraocular acetylcholine. Ninety patients were enrolled in a double-blind study and divided into three groups of 30 eyes; each group received balanced salt solution (control), 0.25% dapiprazole, or 1% acetylcholine. Pupillary diameter recordings were performed immediately before and a few minutes after drug injection, and two, four and eight hours after surgery. Goldmann tonometry was performed the day before and 6 and 24 hours after surgery. Contact endothelial cell count
Intraocular dapiprazole for the reversal of mydriasis after extracapsular cataract extraction with intraocular lens implantation. Part I: Dose-response correlation. Dapiprazole, an alpha-blocking miotic drug, was used intracamerally at the end of extracapsular cataract extraction with posterior chamber intraocular lens (IOL) implantation. The double-blind study included 120 patients divided into four groups of 30 eyes; the groups received balanced salt solution, 0.125%, 0.25%, or 0.5% intraocular dapiprazole after IOL implantation and before suturing. Pupillary diameter recordings were performed immediately before and a few minutes after drug injection and two, four, and eight hours after surgery. The results showed a significant reversal of mydriasis by intraocular dapiprazole, especially
Effects of the association of alpha and beta-blocking agents in glaucoma. Twenty patients with POAG and early visual field changes, already under treatment with 0.5% timolol were randomly assigned to additional topical treatment with 0.5% dapiprazole or placebo. After six months of treatment no differences were observed between the groups for what concerns visual field. After six months of treatment visual field, visual flicker discrimination and contrast sensitivity proved to be constant without differences between the groups. On the contrary, mean IOP was found to be significantly lower in the dapiprazole group.
Dapiprazole compared with clonidine and a placebo in detoxification of opiate addicts. The activity of dapiprazole, clonidine and a placebo were studied to reduce abstinence symptoms and modify the psychological outline during a withdrawal period in heroin addicts. Forty heroin addicts were treated in a double-blind design and, within two weeks, relapse in heroin use was higher in the placebo group (8/10) in comparison with the dapiprazole (1/20) and clonidine (0/10) groups. During treatment clonidine was able to reduce depression and paranoid-ideas scores, whereas dapiprazole reduced depression, anxiety, hostility, phobic anxiety, obsessiveness and psychoticism. Side-effects were mild and it may be concluded that both dapiprazole and clonidine are effective and safe drugs
Dapiprazole clinical efficiency for counteracting tropicamide 1%. We evaluated the clinical usefulness of dapiprazole in reversing the effects of tropicamide 1.0%. Our study was random, masked with placebo, and used one eye of each subject as a control. Thirty subjects were given dapiprazole as directed by the manufacturer 30 min after being dilated by one drop each of proparacaine 0.5 %, tropicamide 1.0%, and then 5 min later another drop of tropicamide 1.0%. Pupil diameter, amplitude of accommodation, conjunctival injection, and intraocular pressure were evaluated. Each of these variables was measured: (1) before instillation of the diagnostic agents; (2) before the instillation of dapiprazole; and (3) at 30, 60, 120, and 180 min after the final instillation of dapiprazole. The average
Efficacy of dapiprazole with hydroxyamphetamine hydrobromide and tropicamide. Clinical interest in ophthalmic agents to reverse pharmacologically induced mydriasis safely has been attempted for over fifty years. These agents may aid practitioners in assisting the younger patient to regain unable near visual function. We evaluated the usefulness of dapiprazole in a private clinical setting. Our study was doubled masked, randomized and used one eye of each subject as a control. Twenty-six consecutive subjects were given dapiprazole as directed by its manufacturer. This administration of dapiprazole followed bilateral pupil dilation with proparacaine 0.5%, hydroxyamphetamine 1.0% and tropicamide 0.25%. Pupil diameter, amplitude of accommodation, intraocular pressure and conjunctival injection
The effect of dapiprazole on accommodative amplitude in eyes dilated with 0.5 percent tropicamide. Dapiprazole 0.5 percent (REV-EYES) eyedrops have recently become commercially available in the U.S. to reverse the diagnostic mydriasis produced by various concentrations and combinations of tropicamide and phenylephrine. Although a previous study has shown that dapiprazole increased accommodative amplitude after the administration of tropicamide, no attempt was made to control for differences in pupil size. In the present single masked study, the accommodative amplitudes of forty-eight age-matched subjects previously dilated with 0.5% tropicamide were measured through a 3 millimeter artificial pupil following random instillation of dapiprazole in one eye and a placebo drop in the other eye. Area
Reversal of mydriasis by dapiprazole. The effect of topical dapiprazole, an alpha-adrenergic receptor blocker, in reversing mydriasis was studied in 50 subjects who received tropicamide 1% and phenylephrine 2.5%. There was a significant difference in the decrease in pupil size between the eye that received dapiprazole and the control eye. This study suggests that dapiprazole 0.5% eye drops
Dapiprazole's effect upon accommodative recovery: is it due entirely to changes in depth of field? We conducted a study to evaluate the ability of dapiprazole 0.5% ophthalmic solution to reverse accommodative loss brought about by mydriatic drugs having mild cycloplegic effects. To accomplish this, we analyzed data from several earlier randomized, masked clinical studies. Our composite data include over 90 subjects dilated with tropicamide. Tropicamide was used alone in 1% concentration, as well as in combination with phenylephrine, 2.5% and in the proprietary preparation, Paremyd (Allergan Pharmaceuticals). Accommodative amplitude and pupillary diameter were measured before instilling dilating drops and then again one-half hour later, immediately before instilling either dapiprazole
Comparison of the effects on pupil size and accommodation of three regimens of topical dapiprazole. Patients who have their pupils dilated for an eye examination traditionally have to wait several hours before their pupils return to normal size and their blurred vision (caused by paralysis of accommodation) resolves. Earlier studies with dapiprazole have demonstrated an accelerated reversal of dilatation. Three regimens of dapiprazole were studied to determine the effects on pupil diameter and accommodation after mydriasis produced by 2.5% phenylephrine and 0.5% tropicamide. Test regimens included one drop and 1 + 1 drop regimens, compared with a 2 + 2 drop reference regimen. Dapiprazole was administered in one eye and placebo in the other. Mean change from baseline was analysed for pupil
[Dapiprazol antagonizes tropicamide- and phenylephrine-induced mydriasis in the elderly]. Dapiprazole eye drops were applied 1 h after topical tropicamide or phenylephrine instillation in 30 elderly subjects. Pupil diameter normalized much earlier than in controls receiving placebo. Dapiprazole constricted the tropicamide-dilated pupil by 1 mm after 1 h and normalized the pupil diameter
Effects of peripheral sympathetic blockade with dapiprazole on the fear-inhibited light reflex. Fear (e.g. associated with the threat of an electric shock) causes an increase in initial pupil diameter (IPD) and a decrease in the amplitude of the light reflex response. There is evidence for dissociation between the two responses to threat: only the reduction in light reflex response amplitude is sensitive to the anxiolytic drug diazepam. We examined the effects of peripheral sympathetic blockade with the alpha(1)-adrenoceptor antagonist dapiprazole on both responses to threat on the basis of the hypothesis that only the response of the IPD will be affected, whereas the response of the light reflex will remain unaffected. Twelve healthy volunteers (Experiment 1) and eight healthy volunteers
Brimonidine versus dapiprazole: Influence on pupil size at various illumination levels. To evaluate the influence of dapiprazole versus brimonidine on pupil size at various illumination levels. Department of Ophthalmology, Johannes Gutenberg-University, Mainz, Germany. In randomized prospective study, 19 healthy volunteers received 2 ophthalmic solutions, dapiprazole and brimonidine, 1 in each eye, for intraindividual comparison. Before and after application, pupil diameter was measured using an infrared binocular pupillometer at 3 illumination levels (0.03, 0.82, and 6.4 lux). Only slight pupil dilation was observed under scotopic conditions after application of both agents. After 20 minutes, the median reduction in pupil width was 1.4 mm for brimonidine and 0.9 mm for dapiprazole
-adrenergic antagonist dapiprazole, and its effects were compared with those of tropicamide, with and without dapiprazole in a double-masked, randomized, crossover design. Ibopamine dilated the pupil from a diameter of 3.7 +/- 0.64 (mean +/- SD, n=24) to 7.7 +/- 0.70 mm. Ibopamine, during its peak mydriasis, was associated with a very large increase in the rate of clearance of topically applied fluorescein from the cornea and anterior chamber, an effect that was not associated with tropicamide during its peak mydriasis. The mydriatic effect of ibopamine was completely blocked by dapiprazole, and the increase in fluorescein clearance was partially blocked. When mydriasis was blocked, ibopamine increased fluorescein clearance by 13% (P<0.0001), which was interpreted as an increased rate of aqueous humor