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June 1962

Guanethidine (Ismelin) in Ophthalmology: II. Clinical Application in Glaucoma

Author Affiliations

Amsterdam, Netherlands
University Eye Clinic, Wilhelmina Gasthuis, Head: Prof. Dr. A. Hagedoorn.

Arch Ophthalmol. 1962;67(6):802-810. doi:10.1001/archopht.1962.00960020802016

Introduction  For several years sympatholytic drugs have been tried for treatment of various types of glaucoma. The substance mostly used is Dibenamine,* introduced in ophthalmology by Christensen and Swan in 1949. Dibenamine is generally given intravenously in doses of 4-5 mg. per kilogram body weight diluted in 300-500 cc. saline. Slow infusion during 60-90 minutes is necessary, since toxic effects occur more frequently when the drug is administered rapidly. After the infusion the vein is flushed with saline to prevent local phlebothrombosis. When Dibenamine is taken orally in doses of 300-400 mg. daily its hypotensive effect is either very slight and transient or absent. Moreover, gastric disturbances restrict the value of oral application. Local application of Dibenamine in the conjunctival sac is ineffective as well as irritating because, being a nitrogen mustard derivative, it causes a chemical inflammation.The hypotensive effect of Dibenamine begins 1-2 hours after infusion, reaching its

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