Nygaard H A, Høvding G
Seksjon for geriatri Institutt for samfunnsmedisinske fag, Bergen.
Tidsskr Nor Laegeforen. 1997 May 30;117(14):2019-21.
The review is based on a survey of studies on adverse reactions related to topical administration of beta-blockers for glaucoma. Locally applied beta-blocking agents are partially resorbed from the nasal mucosa. Concentrations which give rise to systemic effects occur invariably. Several reports exist of congestive heart failure, arrhythmias, severe respiratory symptoms, depression, hallucinations and confusion provoked by topical use of beta-blockers, especially timolol. It is impossible to estimate from the literature how often the various adverse effects occur. One has the impression, however, that adverse effects in the pulmonary and central nervous systems have not been fully considered. Between 1986 and 1995 the Norwegian Medicines Control Authority received reports on adverse reactions related to topical use of beta-blockers in 17 patients. Six of these patients had cardiovascular and four of them severe respiratory symptoms. The latter group also included three fatal cases. The adverse effects seem to occur most frequently in the elderly, and it has been suggested that timolol should not be used in elderly people. Adverse effects related to treatment with topical beta-blockers are probably underreported in Norway.
本综述基于对青光眼局部应用β受体阻滞剂相关不良反应研究的调查。局部应用的β受体阻滞剂可从鼻粘膜部分吸收。必然会出现引起全身效应的浓度。有几份报告称，局部使用β受体阻滞剂，尤其是噻吗洛尔，会引发充血性心力衰竭、心律失常、严重呼吸道症状、抑郁、幻觉和意识混乱。从文献中无法估计各种不良反应的发生频率。然而，人们感觉肺部和中枢神经系统的不良反应尚未得到充分考虑。1986年至1995年间，挪威药品管理局收到了17例与局部使用β受体阻滞剂相关不良反应的报告。其中6例患者有心血管症状，4例有严重呼吸道症状。后一组还包括3例死亡病例。不良反应似乎在老年人中最常出现，有人建议老年人不应使用噻吗洛尔。在挪威，与局部应用β受体阻滞剂治疗相关的不良反应可能报告不足。
