A patient with glaucoma is being treated with systemic beta blocker. All of the foll,twing can be given to the patient except
Ans. c. Levobunolol Brimonidine, dorzolamide and prostaglandin are topical anti-glaucoma drugs. These drugs do not have systemic side effects, while levobunolol (beta-blocker) is systemic anti-glaucoma drug given orally, having systemic side effects. That is why in patients with glaucoma treated with systemic beta blockers, levobunolol may add on the side effects of beta-blockers, hence avoided in the above mentioned patient. Topical Anti-glaucoma Drugs Adrenergic agonist Non-selective: Epinephrine, Dipivefrine Alpha2-selective: Apraclonidine, Brimonidine Adrenergic antagonist Beta--blocker (Non-selective): Timolol, Levobunolol, Caeolol, Metipranolol, Adapralol Betal-blocker: Betaxolol Miotics (direct parasympatomimetics) Pilocarpine, Physostigmine Ecothiophate, Carbachol, Demacarium Prostaglandin analogues Latanoprost Carbonic anhydrase inhibitors Dorzolamide Systemic Antiglaucoma Drugs Carbonic anhydrase inhibitors Acetazolamide Dichlorphenamide Methazolamide Hyperosmotic agents Mannitol Glycerol
Brimonidine
Dorzolamide
Levobunolol
Prostaglandin