Betaxolol hypotension

It is nonselective agent with no local anaesthetic activity and having excellent ocular hypotensive effect preferred for ophthalmic use. It is useful in chronic wide-angle and aphakic glaucoma. Levobunolol and betaxolol are other agents used as ophthalmic preparation used in glaucoma. 

Nadolol is noteworthy for its very long duration of action its spectrum of action is similar to that of timolol. Timolol is a nonselective agent with no local anesthetic activity. It has excellent ocular hypotensive effects when administered topically in the eye. Levobunolol (nonselective) and betaxolol (E -selective) are also used for topical ophthalmic application in glaucoma the latter drug may be less likely to induce bronchoconstriction than nonselective antagonists. Carteolol is a nonselective 13-receptor antagonist. 

The potential ocular hypotensive effects of P-adrenoceptor antagonists (P-blockers) were first evaluated in the 1970s. This section highlights five agents currently marketed in the United States timolol, levobunolol, betaxolol, metipranolol, and carteolol (Table 10-1). 

As with other P-blockers, the ocular hypotensive mechanism of betaxolol is a reduction in aqueous production. Although effective in reducing aqueous humor production, betaxolol is less effective than levobunolol or timolol. Both timolol and levobunolol are more effective ocular hypotensive agents than betaxolol by approximately 2 mm Hg in lOP control. 

The safety profile and efficacy of 2% dorzolamide hydrochloride (Trusopt) eye-drops have been evaluated. It was as effective as pilocarpine 2% and its ocular hypotensive efficacy was comparable with that of betaxolol 0.5%. The patients reported less interference with quahty of life with dorzolamide than pilocarpine, particularly in regard to limitations in their ability to drive, read, and perform moderate activities. Long-term use was not associated with important electrolyte disturbances or the systemic effects commonly observed with oral carbonic anhydrase inhibitors (1-3). 

Comparative studies In 105 children who were treated with either betaxolol hydrochloride ophthalmic suspension 0.25% or timolol maleate ophthalmic gel-forming solution 0.25% and 0.5% after randomization, adverse events were mostly non-seri-ous and mild to moderate in intensity [26 ]. No patient stopped treatment because of adverse events, which were hyperemia of the eye, discomfort, irritation of the eye, discharge from the eye, lid margin crusting, pruritus of the eye, a sticky sensation, bradycardia, and hypotension. 

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