Topical Ophthalmic β‐Adrenergic Blockade for the Treatment of Glaucoma and Ocular Hypertension
- 1 August 1994
- journal article
- research article
- Published by Wiley in The Journal of Clinical Pharmacology
- Vol. 34 (8), 795-803
- https://doi.org/10.1002/j.1552-4604.1994.tb02042.x
Abstract
Since the late 1970s, topical β‐adrenergic blockers have been the drugs of choice in treating ocular hypertension and associated glaucoma. The currently available drugs are timolol, betaxolol, levobunolol, metipranolol, and carteolol. All reduce intraocular pressure by decreasing the production of aqueous humor. Although these drugs are applied locally in the eye, they may enter the general circulation and reach concentrations high enough to cause systemic effects, including alterations in heart rate and rhythm, bronchoconstriction, dyslipidemia, and central nervous system abnormalities. Interactions with other drugs may also occur. Ocular β‐ blockers differ in β1‐selectivity (betaxolol is β1‐selective, whereas the other drugs are nonselective) and in intrinsic sympathomimetic activity (ISA) or partial agonist properties (only carteolol possesses ISA). These differences give betaxolol and carteolol potential advantages in minimizing certain side effects. The advantage of betaxolol vis‐à‐vis systemic side effects is more clearly established than that of carteolol. Further systematic study is needed to determine what advantages, if any, are conferred by the presence of ISA.Keywords
This publication has 52 references indexed in Scilit:
- Ocular ??-Blockers in Glaucoma ManagementDrugs & Aging, 1992
- Ocular CarteololDrugs & Aging, 1992
- Ocular BetaxololDrugs, 1990
- Penbutolol and Carteolol: Two New Beta-Adrenergic Blockers with Partial AgonismThe Journal of Clinical Pharmacology, 1990
- Bronchial and Cardiovascular Effects of Ocular Topical B‐antagonists in Asthmatic Subjects: Comparison of Timolol, Carteolol, and MetipranololThe Journal of Clinical Pharmacology, 1989
- Ocular MetipranololDrugs, 1988
- Measuring Drug-Induced Eye Irritation: A Simple New Clinical AssayThe Journal of Clinical Pharmacology, 1985
- Pindolol: A New β-Adrenoceptor Antagonist with Partial Agonist ActivityNew England Journal of Medicine, 1983
- β-Adrenoceptor Antagonists: New Drugs and New IndicationsNew England Journal of Medicine, 1981
- Clinical pharmacology of the new beta-adrenergic blocking drugs. Part 2. Physiologic and metabolic effectsAmerican Heart Journal, 1979