|
Pronunciation |
|
(lee
voe BYOO noe
lole) |
|
|
U.S. Brand
Names |
|
AKBeta®; Betagan®
Liquifilm® |
|
|
Generic
Available |
|
No |
|
|
Synonyms |
|
l-Bunolol Hydrochloride;
Levobunolol Hydrochloride |
|
|
Pharmacological Index |
|
Beta Blocker, Nonselective; Ophthalmic Agent, Antiglaucoma |
|
|
Use |
|
To lower intraocular pressure in chronic open-angle glaucoma or ocular
hypertension |
|
|
Pregnancy Risk
Factor |
|
C |
|
|
Contraindications |
|
Known hypersensitivity to levobunolol; bronchial asthma, severe COPD, sinus
bradycardia, second or third degree A-V block, cardiac failure, cardiogenic
shock |
|
|
Warnings/Precautions |
|
Use with caution in patients with congestive heart failure, diabetes
mellitus, hyperthyroidism; contains metabisulfite. Because systemic absorption
does occur with ophthalmic administration, the elderly with other disease states
or syndromes that may be affected by a beta-blocker (CHF, COPD, etc) should be
monitored closely. |
|
|
Adverse
Reactions |
|
>10%: Ocular: Stinging/burning eyes
1% to 10%:
Cardiovascular: Bradycardia, arrhythmia, hypotension
Central nervous system: Dizziness, headache
Dermatologic: Alopecia, erythema
Local: Stinging, burning
Ocular: Blepharoconjunctivitis, conjunctivitis
Respiratory: Bronchospasm
<1%: Rash, itching, visual disturbances, keratitis, decreased visual
acuity |
|
|
Overdosage/Toxicology |
|
Symptoms of intoxication include cardiac disturbances, CNS toxicity,
bronchospasm, hypoglycemia and hyperkalemia. The most common cardiac symptoms
include hypotension and bradycardia; atrioventricular block, intraventricular
conduction disturbances, cardiogenic shock, and asystole may occur with severe
overdose, especially with membrane-depressant drugs (eg, propranolol); CNS
effects include convulsions, coma, and respiratory arrest is commonly seen with
propranolol and other membrane-depressant and lipid-soluble drugs
Treatment includes symptomatic treatment of seizures, hypotension,
hyperkalemia and hypoglycemia; bradycardia and hypotension resistant to
atropine, isoproterenol or pacing may respond to glucagon; wide QRS defects
caused by the membrane-depressant poisoning may respond to hypertonic sodium
bicarbonate; repeat-dose charcoal, hemoperfusion, or hemodialysis may be helpful
in removal of only those beta-blockers with a small Vd, long
half-life or low intrinsic clearance (acebutolol, atenolol, nadolol, sotalol).
|
|
|
Drug
Interactions |
|
Increased toxicity:
Ophthalmic epinephrine (increased blood pressure/loss of IOP effect)
Quinidine (sinus bradycardia)
Verapamil (bradycardia and asystole have been reported) |
|
|
Mechanism of
Action |
|
A nonselective beta-adrenergic blocking agent that lowers intraocular
pressure by reducing aqueous humor production and possibly increases the outflow
of aqueous humor |
|
|
Pharmacodynamics/Kinetics |
|
Onset of action: Decreases in intraocular pressure (IOP) can be noted within
1 hour
Peak effect: 2-6 hours
Duration: 1-7 days
Elimination: Not well defined |
|
|
Usual Dosage |
|
Adults: Instill 1 drop in the affected eye(s) 1-2
times/day |
|
|
Monitoring
Parameters |
|
Intraocular pressure, heart rate, funduscopic exam, visual field
testing |
|
|
Mental Health: Effects
on Mental Status |
|
May cause dizziness |
|
|
Mental Health:
Effects on Psychiatric
Treatment |
|
May increase the effects of oral beta-blockers |
|
|
Dental Health: Local
Anesthetic/Vasoconstrictor
Precautions |
|
No information available to require special precautions |
|
|
Dental Health:
Effects on Dental Treatment |
|
No effects or complications reported |
|
|
Patient
Information |
|
May sting on instillation, do not touch dropper to eye; visual acuity may be
decreased after administration; night vision may be decreased; distance vision
may be altered; apply finger pressure between the bridge of the nose and corner
of the eye to decrease systemic absorption; assess patient's or caregiver's
ability to administer |
|
|
Nursing
Implications |
|
Apply finger pressure over nasolacrimal duct to decrease systemic
absorption |
|
|
Dosage Forms |
|
Solution, ophthalmic, as hydrochloride: 0.25% (5 mL, 10 mL, 15 mL); 0.5% (2
mL, 5 mL, 10 mL, 15 mL) |
|
Copyright © 1978-2000 Lexi-Comp Inc. All Rights Reserved
|