Which of the following beta blockers used in the treatment of glaucoma pose or poses the least risk for patients with asthma and chronic obstructive pulmonary disease? (Select all that apply.)
a. Betaxolol
b. Carteolol
c. Levobetaxolol
d. Metipranolol
e. Timolol
ANS: A, C
Only two ophthalmic beta blockers, betaxolol and levobetaxolol, are beta1 selective and therefore are preferred for patients with asthma and chronic obstructive pulmonary disease (COPD), because they pose the least risk to these patients.
Carteolol, metipranolol, and timolol are nonselective, which means that they block both beta1 and beta2 receptors. Blockade of beta2 receptors in the lung can lead to bronchospasm in patients with reactive airway disease.
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