Details About Generic Salt ::  Betaxolo

Main Medicine Class:: Beta-adrenergic blocker   

(BAY-TAX-oh-lahl HIGH-droe-KLOR-ide)
Betoptic, Betoptic S
Class: Beta-adrenergic blocker

 

Drugs Class ::

 Action Blocks beta receptors, primarily affecting cardiovascular system (decreases heart rate, cardiac contractility and BP) and lungs (promotes bronchospasm). Ophthalmic use reduces intraocular pressure, probably by reducing aqueous production.

Indications for Drugs ::

 Indications Hypertension. Ophthalmic preparation: Lowering IOP; ocular hypertension; chronic open-angle glaucoma.

Drug Dose ::

 Route/Dosage

Hypertension

ADULTS: PO 10 to 20 mg/day. ELDERLY: PO Reduce initial dose to 5 mg/day.

Glaucoma

Adults: Ophthalmic 1 to 2 drops bid in affected eye(s). Consider concomitant therapy if IOP is not at satisfactory level.

Contraindication ::

 Contraindications Hypersensitivity to beta-blockers; sinus bradycardia; greater than first-degree heart block; CHF unless secondary to tachyarrhythmia treatable with beta-blockers; overt cardiac failure; cardiogenic shock.

Drug Precautions ::

 Precautions

Pregnancy: Category C. Lactation: Undetermined. Children: Safety and efficacy not established. Anaphylaxis: Deaths have occurred with anaphylactic reactions to beta-blockers; aggressive therapy may be required. Angle-closure glaucoma: To effectively reduce elevated intraocular pressure in angle-closure glaucoma, use with miotic agent. Cessation of therapy: Gradually withdraw over » 2 wk. Carefully observe patients and allow minimal physical activity. CHF: Cautiously administer in patients whose CHF is controlled by digitalis and diuretics. Diabetes mellitus: May mask symptoms of hypoglycemia (eg, tachycardia, BP changes). May potentiate insulin-induced hypoglycemia. Elderly: Dosage reduction may be necessary. Nonallergic bronchospastic disease (eg, chronic bronchitis, emphysema): In general, beta-blockers are not given to patients with bronchospastic diseases. Peripheral vascular disease: May precipitate or aggravate symptoms of arterial insufficiency. Renal/hepatic impairment: Use with caution. Systemic absorption: Ophthalmic betaxolol may produce same adverse reactions seen with systemic use because of absorption. Thyrotoxicosis: May mask clinical signs (eg, tachycardia) of developing or continuing hyperthyroidism. Abrupt withdrawal may exacerbate symptoms of hyperthyroidism, including thyroid storm.

PATIENT CARE CONSIDERATIONS


Drug Side Effects ::

 Adverse Reactions

CV: Hypotension; bradycardia; CHF; cold extremities; second- or third-degree heart block; arrhythmias; syncope. CNS: Insomnia; fatigue; dizziness; depression; lethargy; drowsiness; forgetfulness; headache. DERM: Rash; hives; alopecia. EENT: Dry eyes; blurred vision; tinnitus; slurred speech; dry mouth; sore throat. Ophthalmic use may cause eye discomfort or stinging; tearing; keratitis; blepharoptosis; visual disturbances; diplopia; ptosis. GI: Nausea; vomiting; diarrhea; constipation. GU: Impotence; painful, difficult, or frequent urination. HEMA: Agranulocytosis; thrombocytopenic purpura. HEPA: Elevated liver function tests. META: Acidosis; diabetes; hypercholesterolemia; hyperlipidemia; increased LDH; hypokalemia. RESP: Bronchospasm; dyspnea; wheezing. OTHER: Weight changes; fever; facial swelling; muscle weakness. Ophthalmic betaxolol may produce the same adverse drug reactions seen with systemic use; antinuclear antibodies may develop.

Drug Mode of Action ::  

 Action Blocks beta receptors, primarily affecting cardiovascular system (decreases heart rate, cardiac contractility and BP) and lungs (promotes bronchospasm). Ophthalmic use reduces intraocular pressure, probably by reducing aqueous production.

Drug Interactions ::

 Interactions

Clonidine: May enhance or reverse antihypertensive effect; potentially life-threatening situations may occur, especially on withdrawal. NSAIDs: Some agents may impair antihypertensive effect. Prazosin: May increase postural hypotension. Verapamil: May increase effects of both drugs.

Drug Assesment ::

 Assessment/Interventions

  • Obtain patient history, including drug history and any known allergies. Note CHF, diabetes mellitus, or hyperthyroidism.
  • Ensure that baseline serum lipid and glucose levels have been obtained before initiating treatment with systemic medication.
  • Monitor BP and pulse frequently when starting oral medication or when dosage is changed.
  • In diabetic patient, monitor blood glucose and diabetic medication closely.
  • Carefully monitor patients with CHF or chronic obstructive pulmonary disease who are taking oral form of medication.
OVERDOSAGE: SIGNS & SYMPTOMS
  Bradycardia, CHF, hypotension, bronchospasm, hypoglycemia

Drug Storage/Management ::

 Administration/Storage

  • For ophthalmic solution, pull out lower eyelid to make pocket, administer drop without touching eye, release lower lid, close eye, and apply gentle pressure on inner canthus to avoid systemic absorption.
  • Store ophthalmic form at room temperature. Do not freeze.
  • Store oral form in cool location.

Drug Notes ::

 Patient/Family Education

  • Explain that full effectiveness of drug may not occur for up to 1 to 2 wk after initiation of therapy and that dosage will be tapered slowly before stopping to prevent adverse effects (eg, hypotension, tachycardia, anxiety, angina, MI).
  • Teach patient how to monitor pulse before taking oral medication, and advise to contact physician if pulse remains < 50 bpm.
  • Inform diabetic patient to monitor blood glucose level closely.
  • Advise patient that ophthalmic solution may cause initial burning or stinging when first instilled in eye.
  • Instruct patient to inform physician of any scheduled surgery or dental work; dosage may need to be gradually tapered (and ophthalmic solution discontinued) before surgery or treatment.
  • Explain that measurements of intraocular pressure will need to be performed on a regular basis to assess the therapeutic effect of the ophthalmic medication.
  • Instruct patient to report the following symptoms to physician: Dizziness, decreased pulse, shortness of breath, confusion, rash, or any unusual bleeding.
  • Instruct patient not to take otc medications (including diet aids, cold or nasal preparations [alpha-adrenergic stimulants]) without consulting physician.
  • Advise patient that drug may cause drowsiness, and to use caution while driving or performing other tasks requiring mental alertness.

Disclaimer ::

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