Co‐prescribing of topical and systemic beta‐blockers in patients with glaucoma: a quality use of medicine issue in Australian practice

Goldberg, Ivan; Adena, Michael

doi:10.1111/j.1442-9071.2007.01573.x

Cited by 20 publications

(9 citation statements)

References 27 publications

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“…The authors concluded that anti-glaucoma pharmacotherapy was frequently prescribed in the context of polypharmacy. Similar observations with an even higher percentage (23%) were reported from Australia in a group of patients aged 75-84 years who were being treated with both topical and systemic beta-blockers [ 50 ]. In such a situation, the efficacy and safety of local and systemic therapies are modified and harmful drug-drug interactions become possible.…”

Section: Introductionsupporting

confidence: 83%

A Single Drop in the Eye – Effects on the Whole Body?

Vaajanen¹,

Vapaatalo²

2017

TOOPHTJ

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Introduction:Although the local adverse effects of ophthalmic drugs, including allergic reactions, are well recognized, less is known about the systemic side- effects of eye drops, especially during pregnancy, breast-feeding and early childhood. Ophthalmologists should also be aware of unusual, in some cases even life-threatening, effects of commonly used eye drops.Conclusion:This brief review outlines the routes of systemic absorption and the kinetics of active components present in eye drops, and identifies the clinically relevant systemic adverse effects.

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Section: Introductionsupporting

confidence: 83%

A Single Drop in the Eye – Effects on the Whole Body?

Vaajanen¹,

Vapaatalo²

2017

TOOPHTJ

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“…Topical beta-blockers used to treat glaucoma are less effective at lowering IOP in patients already taking oral beta-blockers. 129,130 This "double dosing" by topical and oral routes significantly increases the risk of systemic side effects. In most cases, patients using oral betablockers should not receive topical beta-blockers as their initial glaucoma therapy.…”

Section: Beta-adrenergic Antagonistsmentioning

confidence: 99%

Medications Used to Treat Glaucoma

Schacknow

Samples

2010

The Glaucoma Book

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ConclusionOptimal therapy for glaucoma would involve IOP control throughout the 24-h period. However, not all therapies are equally efficacious at all times of the day and night. Understanding of the mechanisms of action of different therapies, along with the knowledge of the circadian changes in aqueous humor dynamics, allows us to predict the therapies that will provide the most consistent IOP reduction. As well, understanding of aqueous humor dynamics may help in the development of future therapies with consistent 24-h IOP control. Bibliography

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“…[33] An Australian study also found a 20% rate of coprescribing of topical and systemic beta-blockers. [34] Several studies have shown that concurrent use of a systemic ß-blocker reduces the efficacy of a topical ß-blocker while increasing the risk of systemic side effects. [20,21,34,35] For this reason, we recommend avoiding concurrent use of topical and systemic beta-blockers.…”

Section: Polypharmacymentioning

confidence: 99%

40 years of topical beta-blockers for glaucoma

Lee¹,

Tatham²

2018

cleverjournal

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The introduction of topical beta-blockers in 1978 was a major breakthrough in the treatment of ocular hypertension and glaucoma, and although no longer first-line, betablockers remain a commonly prescribed and important intraocular pressure (IOP) lowering medication. On the 40 th anniversary of their introduction we critique the current role of topical beta-blockers, with particular regard to their efficacy, side effects, and role in fixed-dose combinations. While beta-blockers are effective at lowering IOP during the day, sleep laboratory studies have shown that they have minimal effect overnight, likely due to the physiological nocturnal reduction in aqueous production. Cardiac and respiratory side effects are especially important to consider in elderly patients with multiple comorbidities or in those using multiple systemic medications, which may affect beta-blocker metabolism. The increasing number of alternative medical and minimally invasive surgical options for glaucoma treatment is likely to see a reduction in beta-blocker prescribing.

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Co‐prescribing of topical and systemic beta‐blockers in patients with glaucoma: a quality use of medicine issue in Australian practice

Cited by 20 publications

References 27 publications

A Single Drop in the Eye – Effects on the Whole Body?

A Single Drop in the Eye – Effects on the Whole Body?

Medications Used to Treat Glaucoma

40 years of topical beta-blockers for glaucoma

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