Adverse Effects Experienced by Patients Taking Timolol

McMahon, Charles D.; Shaffer, Robert N.; Hoskins, H. Dunbar; Hetherington, John

doi:10.1016/0002-9394(79)90674-3

Cited by 209 publications

(64 citation statements)

References 6 publications

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“…They can exert serious systemic adverse effects from blockade of β 1 -adrenergic receptors of the heart and β 2 -adrenergic receptors of the respiratory smooth muscle. Bradycardia, cardiac block, lower blood pressure, congestive heart failure and bronchospasm have been reported following topical nonselective β-blockers in humans (McMahon et al 1979, Juzych et al 1997. Therefore, in people topical β-blockers are contraindicated in patients with asthma, severe chronic obstructive pulmonary disease, bradycardia, severe heart block and overt cardiac failure (Bartlett et al 2008).…”

Section: Side Effectsmentioning

confidence: 99%

Autonomic drugs in the treatment of canine and feline glaucoma – Part II: Medications that lower intraocular pressure by reducing aqueous humour production

Maślanka

2014

Polish Journal of Veterinary Sciences

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One characteristic of the most common types of glaucoma is increased intraocular pressure (IOP), which has a damaging effect on optic nerve axons, leading to progressive loss of retinal ganglion cells. Therefore, ocular hypotensive drugs are the mainstay of pharmacological therapy for glaucoma. This review article, which is the second part of a two-part series, is dedicated to autonomic drugs which lower IOP by decreasing the aqueous humour production. These agents are subdivided into two groups: β-adrenergic antagonists and selective α 2 -adrenergic agonists. This paper summarizes the current state of knowledge on the mechanism of action of these drugs and their effect on IOP in dogs and cats. Moreover, it discusses their possible undesirable side effects of these medications and presents the current ideas about their role and position in the medical management of glaucoma in small animals.

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Section: Side Effectsmentioning

confidence: 99%

Autonomic drugs in the treatment of canine and feline glaucoma – Part II: Medications that lower intraocular pressure by reducing aqueous humour production

Maślanka

2014

Polish Journal of Veterinary Sciences

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“…In addition, cardiac side effects include bradycardia, hypotension, decreased myocardial contractility, and heart failure [28][29]. Adverse ocular affects of topical β-blockers are minimal, but in some cases timolol was reported to cause hyperemia of the conjunctiva, burning, stinging or superficial punctate keratitis [30,31], and reduced tear flow [32]. …”

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confidence: 99%

Pharmacogenetics of Ophthalmic Topical β-Blockers

Sidjanin

McCarty

Patchett

et al. 2008

Personalized Medicine

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Glaucoma is the second leading cause of blindness worldwide. The primary glaucoma risk factor is elevated intraocular pressure. Topical β-blockers are affordable and widely used to lower intraocular pressure. Genetic variability has been postulated to contribute to interpersonal differences in efficacy and safety of topical β-blockers. This review summarizes clinically significant polymorphisms that have been identified in the β-adrenergic receptors (ADRB1, ADRB2 and ADRB3). The implications of polymorphisms in CYP2D6 are also discussed. Although the candidate-gene approach has facilitated significant progress in our understanding of the genetic basis of glaucoma treatment response, most drug responses involve a large number of genes, each containing multiple polymorphisms. Genome-wide association studies may yield a more comprehensive set of polymorphisms associated with glaucoma outcomes. An understanding of the genetic mechanisms associated with variability in individual responses to topical β-blockers may advance individualized treatment at a lower cost. Keywordsβ-adrenergic receptor; β-blocker; CYP2D6; glaucoma; IOP; polymorphisms; timolol GlaucomaGlaucoma is a group of heterogeneous ocular diseases defined by a progressive loss of the retinal ganglion cells, excavation or cupping of the optic nerve head, visual-field defects and, ultimately, blindness. With 70 million people affected with various forms of glaucoma, it is the second leading cause of blindness worldwide [1]. The primary risk factors include elevated intraocular pressure (IOP), aging, race and family history. In the general US population, it has been estimated that glaucoma affects 1-1.5% of people aged over 40-65 years, and 2-7% of those aged over 65 years. Prevalence varies with ethnicity; for example, the percentage of African-Americans affected with glaucoma ranges from 1.5 to 3.6% for those aged 40-65 years, and from 4.6 to 9.8% in individuals aged over 65 years [2]. †Author for correspondence. Although glaucoma is defined as a progressive optic neuropathy, it is associated with functional and structural impairments of the trabecular meshwork, optic nerve head and retinal ganglion cells (Figures 1 & 2). The ciliary body, positioned behind the iris, secretes aqueous humor that flows into the anterior chamber ( Figure 2). The role of the aqueous humor is to nourish the avascular ocular tissues of the anterior segment: the posterior cornea, the trabecular meshwork and the lens. In addition, the aqueous humor collects metabolic biproducts and drains out into the trabecular meshwork at the periphery of the anterior chamber, called the anterior chamber angle (Figure 2). In total, 10% of the aqueous humor outflows from the anterior chamber through the ciliary body via uveoscleral outflow. The IOP is a measurement of the aqueous humor pressure inside the eye and ranges from 10 to 21 mmHg. Elevated IOP is the most common clinical risk factor associated with the onset and progression of glaucoma, and generally results from compromised drai...

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“…The reason for this spe cial attention is the almost miraculous low ering of intraocular pressure in certain cases [4], But this impressive normalization of the parameters of aqueous humor dynamics is threatened by occasional adverse side effects [5,6], These side effects appear to be rever sible and seldom of clinical significance [5,6], however, since timolol maleate is still a relatively new drug, additional adverse reac tions are probably still to be discovered.…”

Section: Introductionmentioning

confidence: 99%