ELLIOTT M. KANNER and HOWARD I. SAVAGE
The nonselective adrenergic agonist epinephrine has been used for the treatment of chronic glaucoma for nearly a century. The discovery of distinct adrenergic receptor classes, termed alpha- and beta-adrenergic receptors, led to the development of potent new ocular hypotensive agents, principally the beta-adrenergic antagonists and the alpha-adrenergic agonists.1 Beta blockers are discussed in chapter 3 of this monograph. Pharmacologic manipulation of alpha-adrenoreceptor subtypes (termed alpha-1, alpha-2, and imidazole receptors) has provided ophthalmologists with several potent ocular hypotensive agents, with varying local and systemic side effects. These alpha-adrenergic agents include clo-nidine and its two derivatives, apraclonidine and brimonidine.
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