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| | | #REDIRECT [[Carteolol#Warnings]] |
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| __NOTOC__
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| {{Carteolol}}
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| {{CMG}}; {{AE}} {{SS}}
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| ==Warnings and Precautions==
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| ===WARNINGS===
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| Ocupress Ophthalmic Solution has not been detected in plasma following ocular instillation. However, as with other topically applied ophthalmic preparations, Ocupress may be absorbed systemically. The same adverse reactions found with systemic administration of beta-adrenergic blocking agents may occur with topical administration. For example, severe respiratory reactions and cardiac reactions, including death due to [[Bronchospasm]] in patients with [[asthma]], and rarely death in association with cardiac failure, have been reported with topical application of beta-adrenergic blocking agents (see CONTRAINDICATIONS).
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| ====Cardiac Failure====
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| Sympathetic stimulation may be essential for support of the circulation in individuals with diminished myocardial contractility, and its inhibition by beta-adrenergic receptor blockade may precipitate more severe failure.
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| ====In Patients Without a History of Cardiac Failure====
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| Continued depression of the myocardium with beta-blocking agents over a period of time can, in some cases, lead to cardiac failure. At the first sign or symptom of cardiac failure, Ocupress should be discontinued.
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| ====Non-allergic [[Bronchospasm]]====
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| In patients with non-allergic [[Bronchospasm]] or with a history of non-allergic [[Bronchospasm]] (e.g., [[chronic bronchitis]], [[emphysema]]), Ocupress should be administered with caution since it may block [[bronchodilation]] produced by endogenous and exogenous [[catecholamine]] stimulation of beta2 receptors.
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| ====Major Surgery====
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| The necessity or desirability of withdrawal of beta-adrenergic blocking agents prior to major surgery is controversial. Beta-adrenergic receptor blockade impairs the ability of the heart to respond to beta-adrenergically mediated reflex stimuli. This may augment the risk of general anesthesia in surgical procedures. Some patients receiving beta-adrenergic receptor blocking agents have been subject to protracted severe [[hypotension]] during [[anesthesia]]. For these reasons, in patients undergoing elective surgery, gradual withdrawal of beta-adrenergic receptor blocking agents may be appropriate.
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| If necessary during surgery, the effects of beta-adrenergic blocking agents may be reversed by sufficient doses of such agonists as [[isoproterenol]], [[dopamine]], [[dobutamine]] or [[levarterenol]] (see OVERDOSAGE).
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| ====Diabetes Mellitus====
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| Beta-adrenergic blocking agents should be administered with caution in patients subject to spontaneous [[hypoglycemia]] or to diabetic patients (especially those with labile diabetes) who are receiving insulin or oral [[hypoglycemic]] agents. Beta-adrenergic receptor blocking agents may mask the signs and symptoms of acute hypoglycemia.
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| ====Thyrotoxicosis====
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| Beta-adrenergic blocking agents may mask certain clinical signs (e.g., [[tachycardia]]) of [[hyperthyroidism]]. Patients suspected of developing [[thyrotoxicosis]] should be managed carefully to avoid abrupt withdrawal of beta-adrenergic blocking agents which might precipitate a thyroid storm.
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| ===PRECAUTIONS===
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| ====General====
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| Ocupress Ophthalmic Solution should be used with caution in patients with known [[hypersensitivity]] to other [[beta-adrenoceptor]] blocking agents.
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| '''Use with caution in patients with known diminished pulmonary function'''.
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| In patients with [[angle-closure glaucoma]], the immediate objective of treatment is to reopen the angle. This requires constricting the [[pupil]] with a miotic. Ocupress has little or no effect on the [[pupil]]. When Ocupress is used to reduce elevated intraocular pressure in [[angle-closure glaucoma]], it should be used with a miotic and not alone.
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| ====Information to the Patient====
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| For topical use only. To prevent contaminating the dropper tip and solution, care should be taken not to touch the eyelids or surrounding areas with the dropper tip of the bottle. Keep bottle tightly closed when not in use. Protect from light.
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| ====Risk from Anaphylactic Reaction====
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| While taking beta-blockers, patients with a history of atopy or a history of severe [[anaphylactic reaction]] to a variety of [[allergens]] may be more reactive to repeated accidental, diagnostic, or therapeutic challenge with such [[allergen]]s. Such patients may be unresponsive to the usual doses of [[epinephrine]] used to treat anaphylactic reactions.
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| ====Muscle Weakness====
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| Beta-adrenergic blockade has been reported to potentiate muscle weakness consistent with certain myasthenic symptoms (e.g., [[diplopia]], [[ptosis]] and generalized weakness).<ref name="dailymed.nlm.nih.gov">{{Cite web | last = | first = | title = ZEBETA (BISOPROLOL FUMARATE) TABLET [DURAMED PHARMACEUTICALS, INC.] | url = http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=a11548a0-9c0f-4729-907c-75d8f99a6c85 | publisher = | date = | accessdate = 4 February 2014 }}</ref>
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| ==References==
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| {{Reflist|2}}
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| [[Category:Beta blockers]]
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| [[Category:Cardiovascular Drugs]]
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| [[Category:Drugs]]
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| {{WikiDoc Help Menu}}
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| {{WikiDoc Sources}}
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