scholarly journals Betaxolol Ophthalmic Solution as Alternative Treatment for Patients with Timolol Allergy: A Case Report

Reports ◽  
2020 ◽  
Vol 3 (3) ◽  
pp. 21
Author(s):  
Olivia Müllertz ◽  
Jette Jacobsen ◽  
Jacob P. Thyssen ◽  
Anna Horwitz ◽  
Miriam Kolko
Keyword(s):  
Allergic Reaction ◽  
Alternative Treatment ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Ophthalmic Solution ◽  
Blocking Agent ◽  
Case Presentation ◽  
Atopic Patient ◽  
Β Blocker ◽  
Β Blockers

Background: To establish if an allergy towards all β-blockers, as a group, should be assumed, if an allergic reaction is observed while using one specific β-blocking agent. Case presentation: The non-selective β-blocker timolol caused a severe allergic ocular reaction in a non-atopic patient with advanced primary open-angle glaucoma. Results: A patch test confirmed timolol allergy. No allergic reaction to other anti-glaucomatous topical drugs was observed, and treatment with the selective β-blocker betaxolol was successfully initiated. Conclusion: Allergy to the non-selective β-blocker timolol does not necessarily predict allergy to the selective β-blocker betaxolol, and betaxolol should therefore not be excluded as an alternative treatment.

The Distribution of Retinal Venous Pressure and Intraocular Pressure Differs Significantly in Patients with Primary Open-Angle Glaucoma

2021 ◽  
Author(s):  
Richard Stodtmeister ◽  
Wiebke Koch ◽  
Sylvana Georgii ◽  
Karin R. Pillunat ◽  
Eberhard Spörl ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Contact Lens ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Venous Pressure ◽  
Open Angle ◽  
Retinal Venous Pressure ◽  
Number Of Patients ◽  
Β Blocker ◽  
Β Blockers

Abstract Introduction Until now, venous pressure within the eye has widely been equated with intraocular pressure (IOP). Measurements with dynamometers calibrated in instrument units or in force showed that the retinal venous pressure (RVP) may be higher than the IOP in glaucoma patients. In this study, the RVP was measured with a contact lens dynamometer calibrated in mmHg. Methods Study type: cross-sectional. Subjects: Fifty consecutive patients with primary open-angle glaucoma (POAG) who underwent diurnal curve measurement under medication. Age: 69 ± 8 years. Measurement of RVP: contact lens dynamometry. IOP measurement: dynamic contour tonometry. Results Pressures are given in mmHg. In all 50 patients, the IOP was 15.9 (13.6; 17.1) [median (Q1; Q3)], and the RVP was 17.4 (14.8; 27.2). The distribution of the IOP was normal and that of the RVP was right skewed. In the subgroup of 34 patients with spontaneous pulsation of the central retinal vein (SVP), the IOP and therefore, by definition, the RVP was 16.5 (13.7; 17.4). In the subgroup of 16 patients without SVP, the IOP was 14.8 (13.3; 16.4), and the RVP was 31.3 (26.2; 38.8) (p ≤ 0.001). In systemic treatment, the prescribed drugs were (the number of patients is given in parentheses): ACE inhibitors (20), β-blockers (17), angiotensin II-receptor blockers (13), calcium channel blockers (12), diuretics (7). No difference in RVP was observed between patients receiving these drugs and not receiving them, except in the β-blocker group. Here, the 17 patients with systemic β-blockers had a median RVP of 15.6 mmHg and without 20.2 mmHg (p = 0.003). In the 16 patients with a higher RVP than IOP, only one patient received a systemic β-blocker. The median IOP was 15.7 mmHg with systemic β-blockers and 16.1 mmHg without (p = 0.85). Conclusion In a subgroup of 16 of the 50 patients studied, the RVP was greater than the IOP by a highly statistically and clinically significant degree. According to the widely accepted thinking on the pathophysiology of retinal and optic nerve head circulation, the blood flow in these tissues may be much more compromised in this group of patients than has been assumed. They may be identified by a missing SVP. Topical and systemic medications showed no statistically significant influence on the RVP, except for the systemic β-blockers, in which the RVP was lower by 4.6 mmHg than for the patients who did not receive these drugs (p = 0.003).

Comparison of Two Fixed Beta-Blocker-Pilocarpine Combinations

1997 ◽  
Vol 7 (4) ◽  
pp. 351-356 ◽  
Author(s):  
◽  
A. M. Bron ◽  
C. P. Garcher ◽  
D. Sirbat ◽  
C. M. Allaire ◽  
...  
Keyword(s):  
Ocular Hypertension ◽  
Beta Blocker ◽  
Statistical Difference ◽  
Primary Open Angle Glaucoma ◽  
Fixed Combination ◽  
Open Angle Glaucoma ◽  
Ophthalmic Solution ◽  
Open Angle ◽  
Efficacy And Safety ◽  
Group A

Purpose To compare the efficacy and safety of a newly developed ophthalmic solution containing carteolol 2% and pilocarpine (2% (CBS341A) with a timolol 0.5% and pilocarpine 2% fixed combination. Patients and Methods. A randomized, double-masked, multicenter study was conducted in 209 patients with primary open-angle glaucoma or ocular hypertension, whose intraocular pressure (IOP) was higher than 21 mm Hg on bet-blocker twice a day alone. The test medications were administered twice daily for 4 months. IOP was measured at 9 and 11 a.m. at the beginning of the study (with beta-blocker alone) and after one and four months of treatment. Adverse effects were recorded. Results Both combinations caused a similar, statistically significant decrease in IOP. At four months, in the CBS341A group a 2.4 mm Hg (9%) reduction in IOP was achieved at 9 a.m. and 4.1 mm Hg (17.3%) at 11 a.m. compared with respectively 3 mm Hg (11%) and 4.5 mm Hg (19.5%) in the timolol-pilocarpine group. No statistical difference was observed between the two groups in safety and efficacy. Conclusions The carteolol-pilocarpine combination appears as safe and as effective as the timolol-pilocarpine combination in the medical treatment of primary open-angle glaucoma or ocular hypertension.

scholarly journals Successful treatment of severe adrenaline-resistant anaphylactic shock with glucagon in a patient taking a beta-blocker: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yu Murakami ◽  
Shohei Kaneko ◽  
Haruka Yokoyama ◽  
Hironori Ishizaki ◽  
Motohiro Sekino ◽  
...  
Keyword(s):  
Anaphylactic Shock ◽  
Severe Aortic Stenosis ◽  
Fluid Loading ◽  
Case Presentation ◽  
Transcatheter Aortic Valve ◽  
Severe Hypotension ◽  
Β Blocker ◽  
Aortic Valve Implantation ◽  
Β Blockers ◽  
Valve Implantation

Abstract Background The efficacy of glucagon for adrenaline-resistant anaphylactic shock in patients taking β-blockers is controversial. However, understanding the efficacy of glucagon is important because adrenaline-resistant anaphylactic shock is fatal. We present a case of severe adrenaline-resistant anaphylactic shock in a patient taking a β-blocker, and glucagon was effective in improving hemodynamics. Case presentation An 88-year-old woman with severe aortic stenosis and taking a selective β-1 blocker underwent transcatheter aortic valve implantation under general anesthesia. Postoperatively, she received 100 mg sugammadex, but 2 min later developed severe hypotension and bronchospasm. Suspecting anaphylactic shock, we intervened by administering adrenaline, fluid loading, and an increased noradrenaline dose. Consequently, the bronchospasm improved, but her blood pressure only increased minimally. Therefore, we administered 1 mg glucagon intravenously, and the hypotension resolved immediately. Conclusions Glucagon may improve hemodynamics in adrenaline-resistant anaphylactic shock patients taking β-blockers; however, its efficacy must be further evaluated in more cases.

STUDY ON EFFICACY AND SAFETY OF RIPASUDIL HYDROCHLORIDE IN TREATMENT OF NEWLY DIAGNOSED PRIMARY OPEN ANGLE GLAUCOMA

2021 ◽  
pp. 81-83
Author(s):  
Debalina Ghanta ◽  
Sudeshna Roy ◽  
Taneema Samanta
Keyword(s):  
Adverse Effects ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Coiled Coil ◽  
Ophthalmic Solution ◽  
Primary Treatment ◽  
Current Treatment ◽  
Open Angle ◽  
Newly Diagnosed ◽  
Dence Interval

Aim: The study aims at evaluating the lowering effect of Intraocular pressure (IOP) and tolerability of Ripasudil(0.4%) ophthalmic solution, a selective rho kinase1 inhibitor, as monotherapy in newly diagnosed primary open angle glaucoma patients. Background: Glaucoma is a chronic progressive optic neuropathy causing irreversible blindness around the world. Current treatment strategy stems from concept of lowering IOP, which is a key modiable risk factor. Ripasudil also known as K 115,is the world's rst Rho-associated coiled-coil-containing protein Kinase 1(ROCK1) inhibitor that lowers IOP by directly acting on trabecular meshwork,increasing conventional outow. Methods: This prospective, interventional study included 53 patients of newly diagnosed primary open angle glaucoma.0.4% Ripasudil ophthalmic solution was instilled twice a day as the primary treatment. The primary endpoint was the degree of IOPreduction after 6 months of treatment, whereas the secondary end points were percentage of patients reaching the predened target IOP and incidence of adverse effects. Results: We examined 53 eyes of 53 primary open angle glaucoma patients. The IOP reduction (relative percentage IOP reduction)from baseline was -2.3 mm Hg(-1.7 to -2.9 mm Hg,95%condence interval ,P<0.001).The predetermined target IOPwas achieved by 54.7% population(29 among 53 patients).The most common adverse effects noted were conjunctival hyperaemia (54.7% of patients),allergic conjunctivitis(35.8% of patients) punctate keratitis(11.32% of patients), blepharitis(15.09% of patients), headache(24.5% of patients), bradycardia(9.43% of patients). Conclusion: Administration of 0.4% Ripasudil ophthalmic solution monotherapy revealed IOPlowering effect and acceptable safety prole in POAG patients. As ROCK inhibitors are novel anti-glaucoma drug, more data and studies are needed to establish best practices for the treatment of the patients.

scholarly journals The solid-state structure of the β-blocker metoprolol: a combined experimental and in silico investigation

2019 ◽  
Vol 75 (2) ◽  
pp. 87-96 ◽  
Author(s):  
Patrizia Rossi ◽  
Paola Paoli ◽  
Laura Chelazzi ◽  
Luca Conti ◽  
Andrea Bencini
Keyword(s):  
Solid State ◽  
Surface Analysis ◽  
Crystal Packing ◽  
Variable Temperature ◽  
Blocking Agent ◽  
Hirshfeld Surface ◽  
Hirshfeld Surface Analysis ◽  
Scanning Calorimetry ◽  
Β Blocker ◽  
Β Blockers

Metoprolol {systematic name: (RS)-1-isopropylamino-3-[4-(2-methoxyethyl)phenoxy]propan-2-ol}, C15H25NO3, is a cardioselective β1-adrenergic blocking agent that shares part of its molecular skeleton with a large number of other β-blockers. Results from its solid-state characterization by single-crystal and variable-temperature powder X-ray diffraction and differential scanning calorimetry are presented. Its molecular and crystal arrangements have been further investigated by molecular modelling, by a Cambridge Structural Database (CSD) survey and by Hirshfeld surface analysis. In the crystal, the side arm bearing the isopropyl group, which is common to other β-blockers, adopts an all-trans conformation, which is the most stable arrangement from modelling data. The crystal packing of metoprolol is dominated by an O—H...N/N...H—O pair of hydrogen bonds (as also confirmed by a Hirshfeld surface analysis), which gives rise to chains containing alternating R and S metoprolol molecules extending along the b axis, supplemented by a weaker O...H—N/N—H...O pair of interactions. In addition, within the same stack of molecules, a C—H...O contact, partially oriented along the b and c axes, links homochiral molecules. Amongst the solid-state structures of molecules structurally related to metoprolol deposited in the CSD, the β-blocker drug betaxolol shows the closest analogy in terms of three-dimensional arrangement and interactions. Notwithstanding their close similarity, the crystal lattices of the two drugs respond differently on increasing temperature: metoprolol expands anisotropically, while for betaxolol, an isotropic thermal expansion is observed.

Sign in / Sign up

Export Citation Format

Share Document