Drug therapy of glaucoma with adrenergic and anti-adrenergic agents

Abstract

This paper presents a survey for practitioners: The antagonism between the cholinergic and the adrenergic systems originally seemed clear and easy to understand. With the increasing differentiation of the peripheral adrenergic receptors alone into presynaptic alpha 2 and beta 2 and postsynaptic alpha 1, beta 1, and beta 2 subtypes, the current explanation of the antagonism as a simple process, the regulation and correction of aqueous humor dynamics, is increasingly being questioned. For example, the distribution of adrenergic receptors in the extraocular muscles is different in various species of mammals; both stimulation and blockage of beta 2-adrenoreceptors induce a fall in intraocular pressure. With the introduction of adrenergic and antiadrenergic agents into the treatment of the glaucomas, more and more questions arise concerning sympathomimetic action and interaction at subcellular level.