Brimonidine is a selective alpha2 adrenergic receptor agonist indicated for the treatment of glaucoma and ocular hypertension.
Hi everyone today in this video let us discuss brimonidine what is this drug bremonidean this drug is available in the form of an ester tartarite so this brimonidine tartared is one of the alpha to adrenergic receptor agonist this star can be used as eye drops in the treatment of glaucoma where there is increase in droplet pressure resulting in the blurring of
Vision increased pressure and pain within the anterior chamber of the eye which if it is untreated it may result in the loss of vision so in such conditions bremonidine can be given to reduce the intraocular pressure similarly this can also be used to control the ocular hypertension where there is increased blood pressure in the eye resulting in the increased pain
And redness of the eye again in such conditions brimonity can be given as eye drops to reduce the ocular blood pressure and here we can identify the suffix kneading we have similar drugs like clonidine aproclonadine all of these drugs are alpha two adrenergic receptor agonists but here bremonine is having somewhat more specificity and it is considered as third
Generation alpha two receptor agonist so brimordine is more selective towards alpha two receptors compared with alpha one receptors that’s why this trek is more specific in the treatment of glaucoma as well as ocular hypertension so today in this video we are going to see how this drug acts what are the important precautions side effects doses all these things we
Will discuss in this video now let us see how this drug acts within the eye sympathetic system play an important role now adrenergic neurons store one of the important neurotransmitter that is the norepinephrine this norepinephrine can be released and it can act on post synaptic neurons which are equipped with adrenergic receptors such as beta-2 receptors these
Beta2 receptors are excitatory in nature resulting in the sympathetic stimulation so when the action potential reaches to the presynaptic neurons norepinephrine can be released and it can act on beta2 receptors so this results in the excitation leading to increased formation of aqueous humor so within the anterior chamber of the eye aqua tumor is more collected
Resulting in the increase in droplet pressure so this may result in the impaired vision double vision blood vision and finally it may also lead to the loss of vision if it is untreated so beta2 receptors play an important role in production of aqueous humor but this symbiotic stimulation is controlled by alpha two receptors which are located presynaptically on
The international neurons now brimonine is one of the drag which acts as alpha 2 receptor agonist so it can bind to these receptors resulting in their activation by activation of alpha receptors they can inhibit one of the pathway adenylyl cyclase pathway so when this adrenaline cyclist is going to be inhibited atp is not converted into cyclic amp so cyclic amp
Levels are going to be reduced within the presynaptic neurons in options of cyclic kmp calcium channels cannot work properly so calcium cannot enter into the presynaptic neurons so it cannot produce any exocytosis at the same time the potassium channels are going to be activated so potassium can go outside resulting in the hyperpolarization of the presynaptic
Neurons in this way presynaptic neurons are inhibited resulting in the decreased release of norepinephrine so when the norepinephrine is not released it cannot stimulate the beta receptors so this leads to decreased production of aqueous humor with the decreases of aqua tumor along with its improved drainage the intraocular pressure can be reduced within the
Anterior chamber of the eye so this results in the relief of symptoms in the patients with glaucoma in this way brimonidine is going to inhibit the sympathetic stimulation which also results in the decreased ocular blood pressure so this can also be used in the treatment of ocular hypertension now let us see the precautions one of the important precaution of
Brimonidine is that this drug can produce some vascular insufficiency so in the patients with already any vascular disorders this premoniting should be carefully given so this drug may increase cerebral insufficiency coronary insufficiency resulting the poor circulation within the brain as well as to the systemic blood vessels which may impair the functionality
Of many of the organs similarly brimonity should be carefully given in the patients with any symptoms of depression where the depressive symptoms are further increased with vascular insufficiency and in the patients with any reynolds disease where small veins are going to be blocked so that the blood is not going to be pumped into the heart again in such patients
Primordine should be carefully given and in the patients with any orthostatic hypotension this drug may produce the hypotension resulting in the increased falling sensation or in the patients with any thrombotic anxieties where the blue discoloration of the blood vessels supplying to the fingers can be observed due to formation of thrombosis in all such patients
This brimonidine should be carefully given what are the side effects the important side effects are locally observed within the eye so you can produce some burning sensation stinging ocular hyperemia resulting in the reading of the eye it can produce some headache blurring of the vision it can also produce some water dryness even ocular dryness can be produced
Ocular proritus it can produce some itching sensation within the eye which persists for some time after the administration and other side effects include fatigue ocular straining and muscular pain can be observed with this bremonidine now let us see the chemical nature of this type so this is the structure of bremonidine here you can observe a six plus six
Membering system so let us give the numbering we can start the numbering from this nitrogen so this is one two three four five and six now simply this ring is the quinoxylan ring so we can write the suffix as quinoxyline now to this quinoxillin at the fifth position bromine group is present so fibroma sixth portion amino group is present six amino but to this
Amine this ring is going to be attached this ring is nothing but imidazoline ring so we can write this as imidazoline 2i that is a complete name of brimonidine how it is given this study is available as eye drops or ophthalmic solution at a strength of 0.2 percent it is also available as 0.15 percent even it is available as a gel formulation where it can be
Applied on the skin to reduce the facial erythema as eye drops it can be used in the management of glaucoma and ocular hypertension where the dose of the drag is given as one drop in the eye three times daily so that’s about this bremonide in tartar rate which is a more specific alpha receptor agonist compared with clonidine and apraclonadine so this drug act
Locally on the eye where it is going to reduce the sympathetic stimulation within the ophthalmic neurons thereby it can reduce the formation of aqueous humor stimulated through the beta to heterogenic receptors even this drug is not acting on the beta-2 receptors but it can inhibit the release of norepinephrine by acting on presynaptic alpha receptors which are
Inhibitory in nature so by inhibiting the symbiotic stimulation it can reduce the formation of aqueous tumor as well as it can also reduce the blood pressure so it can be used in the treatment of glaucoma as well as ocular hypertension but this truck should be carefully given in the patients with any vascular insufficiency as this drug reduce the blood pressure
And you can impair the circulation in such patients so that’s about the strike primordine tata rate hope you have enjoyed this video if you like this video please subscribe to our channel share this video with your friends post your comments in the comment box thank you for watching this video
Transcribed from video
Brimonidine tartrate eye drops By egpat