Related Experiment Video
Updated: Jul 31, 2026
08:30
Glaucoma-inducing Procedure in an In Vivo Rat Model and Whole-mount Retina Preparation
Published on: March 12, 2016
Systemic adverse effects of ophthalmic beta-blockers
J A Vander Zanden1, R J Valuck, C L Bunch
1Department of Pharmacy Practice, School of Pharmacy, UCHSC, 4200 E. Ninth Ave., Box C-238, Denver, CO 80262-0238, USA.
The Annals of Pharmacotherapy
|January 17, 2002
Summary
Ophthalmic beta-blockers may cause respiratory and cardiovascular adverse effects, including bronchospasm and bradycardia. Evidence does not support routine metabolic adverse effects, but further research is needed for other conditions.
Area of Science:
- Pharmacology
- Ophthalmology
- Clinical Pharmacy
Background:
- Ophthalmic beta-blockers are widely prescribed for glaucoma and ocular hypertension.
- Systemic absorption can lead to adverse effects, necessitating careful patient selection and monitoring.
- Existing literature on these effects requires systematic review to inform clinical practice.
Purpose of the Study:
- To synthesize evidence on systemic adverse effects of ophthalmic beta-blockers.
- To develop a pilot contraindication/warning system for electronic health records.
- To enhance patient safety in the Veterans Affairs healthcare system.
Main Methods:
- Comprehensive literature search of MEDLINE and International Pharmaceutical Abstracts (1966-2000).
- Systematic review of article titles, abstracts, and keywords for relevance.
- Evidence grading based on established criteria to assess contraindications.
Main Results:
- Strong evidence links ophthalmic beta-blockers to bronchospasm (Grade A1).
- Moderate evidence associates them with cardiovascular effects like bradycardia (Grade B1).
- Less common central nervous system effects (e.g., depression) are reported; metabolic effects are not routinely associated.
Conclusions:
- Contraindications for ophthalmic beta-blockers are supported for respiratory and cardiovascular diseases.
- Insufficient evidence exists for contraindications in other disease states.
- The developed methodology aids in evaluating and applying evidence for drug adverse effects.
Related Concept Videos
01:27Adrenergic Antagonists: Pharmacological Actions of β-Receptor Blockers
β-receptor blockers significantly impact the cardiovascular system by counteracting catecholamine-induced sympathetic responses. These medications decrease heart rate, contractility, and cardiac output, potentially leading to cardiac depression, life-threatening bradycardia, and death. Therapeutically, β-blockers function as mild antihypertensives and are utilized in treating angina pectoris and cardiac arrhythmias. However, nonselective β-blockers inhibit β2-receptors in bronchial smooth...
01:25Glaucoma: Overview
Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...
01:27Open Angle Glaucoma: Treatment
In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
Drugs such as carbonic anhydrase inhibitors, α2- and...
Drugs such as carbonic anhydrase inhibitors, α2- and...
01:12Local Anesthetics: Adverse Effects
While local anesthetics are generally safe and well-tolerated, they can occasionally cause adverse effects that vary in severity. Local anesthetics can induce toxicity at two distinct levels. They can either produce local effects through direct contact with the neural elements or be absorbed into the bloodstream from the injection site, leading to systemic effects.
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...
01:28Antihypertensive Drugs: Types of β-Blockers
β receptors are classified into three subclasses: β1, β2, and β3. β1 receptors are primarily located in the heart and kidneys. When they get activated, they increase heart rate, contractility, and renin release. This process enhances blood pressure and aids in stress management. In contrast, β2 receptors are situated mainly in the lungs, blood vessels, and skeletal muscles. Upon activation, they trigger smooth muscle relaxation, causing bronchodilation and vasodilation. This widens airways and...
01:23Ophthalmic Drug Delivery Systems
Ophthalmic drug delivery faces major limitations due to poor absorption across the corneal membrane. This process is primarily driven by diffusion and is influenced by two main factors: the physicochemical properties of the drug and tear drainage. Most ophthalmic drugs, such as pilocarpine, epinephrine, atropine, and local anesthetics, are weak bases. They are typically formulated at an acidic pH to enhance chemical stability. However, this leads to high ionization, reducing their ability to...