Development of additive systemic effects when taking β-blockers in patients with glaucoma and concurrent chronic diseases

Close metadata

PURPOSE

To assess the frequency and extent of adverse reactions at simultaneous local and systemic prescription of β-blockers to patients with glaucoma and systemic vascular pathology.

MATERIAL AND METHODS

The study included 112 patients that have been taking β-blockers for at least 6 months. The main group consisted of 39 patients with primary open-angle glaucoma (POAG) in combination with cardiovascular disease; the first comparison group — 36 patients with POAG without systemic vascular pathology; the second comparison group — 37 patients with systemic vascular pathology without glaucoma. In the main and first comparison groups, double instillations of 0.5% timolol or 0.5% betaxolol were used as monotherapy.

RESULTS

Adverse reactions to the long-term usage of β-blockers were found in 82% of the main group patients with cardiovascular diseases. They manifested as bradycardia or bronchospasm (38% patients), combination of bradycardia and vascular hypotension or bronchospasm (18%), or combination of 3—4 types of adverse reactions (26%); in the first and second comparison groups — in 36% and 30%, respectively (p<0.05).

CONCLUSION

The most severe multifactorial adverse reactions developed due to long-term use of combinations of systemic and local β-blockers: 100 mg metoprolol or 10 mg bisoprolol with 0.5% timolol.

Keywords:

beta-blockers

systemic β-blockers

local β-blockers

additive effect

primary open-angle glaucoma

systemic vascular pathology

Authors:

Filimonova E.E.

Khabarovsk branch of S.N. Fyodorov National Medical Research Center «MNTK «Eye Microsurgery»

Sorokin E.L.

Khabarovsk branch of S.N. Fedorov National Medical Research Center “MNTK “Eye Microsurgery”;
Far-Eastern State Medical University

ORCID: 0000-0002-2028-1140

Kogan M.P.

Khabarovsk branch of S.N. Fyodorov National Medical Research Center «MNTK «Eye Microsurgery»

Pashentsev Y.E.

Khabarovsk branch of S.N. Fyodorov National Medical Research Center «MNTK «Eye Microsurgery»

Received:

18.06.2020

Accepted:

27.08.2020

List of references:

Kiseleva OA, Yakubova LV, Bessmertny AM. Beta-blockers in modern glaucoma therapy. Review. Oftalmologiya. 2013;10(2):20-23. (In Russ.). https://doi.org/10.18008/1816-5095-2013-2-20-23
Neroev VV, Kiseleva OA, Bessmertny AM. The main results of a multicenter study of epidemiological features of primary open-angle glaucoma in the Russian Federation. Rossiiskii oftalmologicheskii zhurnal. 2013;6(3):43-46. (In Russ.).
Agafonova TYu, Sobyanin NA, Gavrilova TV. Progression of primary open-angle glaucoma in type 2 diabetes: comorbidity issue. RMJ. Clinicheskaya oftalmologiya. 2017;(1):22-25. (In Russ.). https://doi.org/10.21689/2311-7729-2017-17-1-22-25
Astakhov YuS, Akopov EL, Nefedova DM. Vascular risk factors in primary open-angle glaucoma. RMJ. Clinicheskaya oftalmologiya. 2008;(2):68-70. (In Russ.).
Martsevich SYu. Beta-adrenoblockers: evidence based principles of therapy. Kardiologiya. 2002;4:82-85. (In Russ.).
Kislyak OA, Leontyeva MS. Patient with arterial hypertension and associated clinical conditions: treatment. Systemnye hypertensii. 2012;3:14-17. (In Russ.).
Kiseleva OA, Kosakyan SM, Yakubova LV, Vasilenkova LV. Interaction of antiglaucomatous drugs in patients with chronic concomitant diseases. RMJ. Clinicheskaya oftalmologiya. 2016;1:16-19. (In Russ.).
Sychjov DA, Moshetova LK. Clinical and pharmacological aspects of combined pathology: cardiovascular diseases and glaucoma. Natsional’nyy zhurnal Glaukoma. 2014;2:99-104. (In Russ.).
Ostroumova OD, Maksimov ML. The safety of bisoprolol in patients with combined pathology. Consilium medicum. 2012;1:64-66. (In Russ.).
Ponomareva AI, Kompaniets OG, Makukhin VV, et al. Priorities of choice of antihypertensive drug in patients with combined cardiopulmonary pathology and metabolic syndrome. Consilium medicum. 2014;10:116-120. (In Russ.).
Oganezova LG. Bisoprolol — the optimal beta-blocker for the treatment of cardiovascular diseases. RMJ. 2012;20(11):560-562. (In Russ.).
Kogan MP, Esina MA. Features of selection and preparation of patients with diabetes mellitus type 2 for surgical treatment in ophthalmosurgery. Sovremennye tekhnologii v oftal’mologii. 2016;2:144-147. (In Russ.).
Kogan MP, Novikova VV, Sorokin EL, Egorov VV. The frequency and structure of diabetes mellitus among patients of the Khabarovsk branch of the Federal State Institution «MNTK «Eye Microsurgery», the specifics of their selection and preparation for ophthalmosurgery. Zdravookhraneniye Dal’nego Vostoka. 2010;4:39-43. (In Russ.).
Kogan MP, Novikova VV, Utkin SI, Egorov VV, Sorokin EL. Assessment of severity of somatic condition of patients with type 2 diabetes mellitus before performing ophthalmic surgery and features of their preoperative preparation. Vestnik Orenburgskogo gosudarstvennogo universiteta. 2013;4:139-144. (In Russ.).
Kogan MP, Novikova VV, Utkin SI, Egorov VV, Sorokin EL. Ophthalmosurgery premedication in patients with diabetes mellitus type 2 appreciating severity of their somatic condition. Zdravookhraneniye Dal’nego Vostoka. 2013;3:22-26. (In Russ.).
Egorov EA, Egorov AE, Eliseeva TO, Egorova TE. Undesirable effects of hypotensive treatment of glaucoma. Literary review. RMJ. Klinicheskaya oftalmologiya. 2011;12(3):111-113. (In Russ.).
Onishchenko AL, Kolbasko AV, Zakharova AV, Onishchenko EG, Zhilina NM. Ocular hypotensive effect of systemic beta-blockers in patients with primary glaucoma and arterial hypertension. Vestnik oftal’mologii. 2017;133(2): 46-50. (In Russ.). https://doi.org/10.17116/oftalma2017133246-50
2018 ESC/ESH Guidelines for the management of arterial hypertension. The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the EuropeanSociety of Hypertension (ESH). Rossiyskiy kardiologicheskiy zhurnal = Russian Journal of Cardiology. 2018; 23(12):143-228. (In Russ.). https://doi.org/10.15829/1560-4071-2018-12-143-228
Clinicheskaya farmakologiya. Natsional’noye rukovodstvo [Clinical Pharmacology: National Guidelines]. Eds Belousov Yu.B., Kukes V.G., Lepahin V.K., Petrov V.I. M.: GEOTAR-Media; 2009. (In Russ.).
Global’naya strategiya diagnostiki, lecheniya I profilaktiki khronicheskoy obstruktivnoy bolezni legkikh (peresmotr 2014 g.) [Global strategy for the diagnosis, treatment and prevention of chronic obstructive pulmonary disease (2014 revision)]. Ed. Belevskiy A.S. M.: Russian Respiratory Society; 2014. (In Russ.).
Federal clinical guidelines for the diagnosis and treatment of chronic obstructive pulmonary disease. Pulmonologiya. 2014;3:15-61. (In Russ.).
Sherstneva LV, Podgornaya NN. Systemic side effects of antiglaucoma drugs and their significance in geriatric practice. Klinicheskaya gerontologiya. 2006; 7:33-34. (In Russ.).
Egorov EA, Astakhov YuS, Stavitskaya TV. Oftal’mofarmakologiya [Ophthalmopharmacology]. M.: GEOTAR-Med; 2004. (In Russ.).
Erichev VP. The main directions of antihypertensive treatment of patients with primary glaucoma. Russkiy oftal’mologicheskiy zhurnal. 2000;1(1):18-21. (In Russ.).
Kuroedov AV. Prospects of combined antiglaucoma drugs usage (literary review). RMJ. Klinicheskaya oftalmologiya. 2007;8(4):176-180. (In Russ.).
Onishchenko AL, Kolbasko AV, Safronova MA, Tarash OS, Dimaksyan MV. Experimental study on ocular hypotensive efficacy of parenteral metoprolol. Vestnik oftal’mologii. 2015;131(4):79-82. (In Russ.). https://doi.org/10.17116/oftalma2015131479-82
Goldberg I, Adena MA. Co-precribing of topical and system beta-blockers in patients with glaucoma: a quality use of medical issure in Australian practice. Clin Exper Ophthalmol. 2007;35(8):700-705. https://doi.org/10.1111/j.1442-9071.2007.01573.x
Goldberg I, Moloney G, McCluckey P. Topical ophthalmic medications: what potential for systemic side effects and interactions with other medications?). Med J Aust. 2008;189(7):356-357. https://doi.org/10.5694/j.1326-5377.2008.tb02077.x
Rekomendatsii ESC po vedeniyu patsientov s ostrym infarktom miokardy s podyemom segmenta ST 2017. Accessed November 28, 2019. (In Russ.). https://scardio.ru/rekomendacii/rekomendacii_esc_close/
Rekomendatsii amerikanskoy kollegii kardiologov I amerikanskoy assotsiatsii serdtsa po vedeniyu patsiyentov s ostrym infarktom miokardy s podyemom segmenta ST na EKG. Accessed November 28, 2019. (In Russ.). https://cyberleninka.ru/article/n/rekomendatsii-amerikanskoy-kollegii-kardiologov-i-amerikanskoy-assotsiatsii-serdtsa-po-vedeniyu-patsientov-s-ostrym-infarktom-miokarda/viewer

Close metadata