Names and pronunciation
(lee′voe-byoo′no-lahl) Betagan
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Drug reference
(lee′voe-byoo′no-lahl) Betagan
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Func. class.: Antiglaucoma
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Chem. class.: β-Blocker
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ACTION: Can decrease aqueous humor and increase outflows
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USES: Treatment of chronic open- angle glaucoma and ocular hypertension
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CONTRAINDICATIONS: Hyper- sensitivity, AV block, heart failure, brady- cardia, sick sinus syndrome, asthma Precautions: Abrupt discontinuation, children, pregnancy, breastfeeding, COPD, depression, diabetes mellitus, myasthenia gravis, hyperthyroidism, pul- monary disease, sulfite sensitivity, angle- closure glaucoma
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SIDE EFFECTS CNS: Insomnia, headache, dizziness CV: Palpitations EENT: Eye stinging/burning, tearing, photophobia RESP: Bronchospasm
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INTERACTIONS β-blocking Increase: effect—oral β-blockers Increase: intraocular pressure reduction— topical miotics, dipivefrin, EPINEPHrine, carbonic anhydrase inhibitors; this may be beneficial Increase: depression of AV nodal conduc- tion, bradycardia, or hypotension—ade- nosine, cardiac glycosides, disopyramide, other antiarrhythmics, class 1C antiar- rhythmic drugs (flecainide, propafenone, moricizine, encainide, quiNIDine), or drugs that significantly depress AV nodal conduction Increase: Antihypertensive effect—other antihypertensives
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DOSAGE AND ROUTES • Adult: Instill 1-2 drops in the affected eyes once a day (0.5% solution), bid (0.25% solution)
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Available forms: Ophthalmic solution 0.25%, 0.5%
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Administer: • For ophthalmic use only L • To prevent contamination, do not touch the tip of the dropper to the eye, fingertips, or other surface • Wash hands before and after use; tilt head back slightly and pull the lower eyelid down with the index finger to form a pouch; squeeze the prescribed number of drops into the pouch; close eyes to spread drops; to avoid excessive systemic absorption, apply finger pressure on the lacrimal sac for 1-2 min after use • If more than one topical ophthalmic drug product is being used, the drugs should be administered at least 5 min apart • To avoid contamination or the spread of infection, do not use dropper for more than one person • Decreased intraocular pressure can take several weeks; monitor IOP after a month
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Assess: • Systemic absorption: when used in the eye, systemic absorption is common with the same adverse reactions and in teractions • Glaucoma: monitor intraocular pressure
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Evaluate: • Therapeutic response: decreasing in- traocular pressure
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CLINICAL CONSIDERATIONS
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Patient and caregiver information: • That product is for ophthalmic use only • Not to touch the tip of the dropper to the eye, fingertips, or other surface to prevent contamination • To wash hands before and after use; tilt the head back slightly and pull the lower eyelid down with the index finger to form a pouch; squeeze the prescribed number of drops into the pouch; close eyes to spread drops; to avoid excessive systemic absorption by applying finger pressure on the lacrimal sac for 1-2 min following use • That if more than one topical ophthal- mic drug product is being used, the drugs should be administered at least 5 min apart • To avoid contamination or the spread of infection by not using dropper for more than one person See Appendix B
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PHARMACOKINETICS Onset 60 min, peak 2-6 hr, duration 24 hr
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• Adult: Instill 1-2 drops in the affected eyes once a day (0.5% solution), bid (0.25% solution)
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