Müge GÜLEN, Mehmet Oğuzhan AY, Davut KAPLAN, Selen ACEHAN, Ferhat İÇME

Oftalmik Timolol Maleat Kullanımına Bağlı Semptomatik Bradikardi ve Senkop

Glokom tedavisinde kullanılan Timolol maleat bir non-selektif (Ã1 ve Ã2 reseptörlere etkili) topikal Ã bloker ilaçtır. Topikal etkisinin yanında istenmeyen sistemik yan etkiler de görülebilir. Bu yazıda topikal timolol maleat kullanımına bağlı semptomatik bradikardi ve presenkop gelişen nadir bir olgu sunuldu. Topikal Ã bloker ilaç başlanması düşünülen hastalar mutlaka kalp yetmezliği, nabız düşüklüğü, aritmiler, kalp blokları veya obstrüktif akciğer hastalığı varlığı açısından sorgulanmalıdır.

Anahtar Kelimeler:

Timolol maleat, bradikardi, senkop, yan etki

Symptomatic Bradycardia and Syncope due to Ophthalmic Timolol Maleate

Timolol maleate is a non-selective (effective to Ã1 and Ã2 receptors) is a topical beta blocker drug which is used in the treatment of glaucoma. Besides its topical impact, it may have some systemic side effects. In this paper, we presented a rare case with symptomatic bradycardia and syncope due to the usage of topical timolol maleate. The patients who were thought to be initiated topical beta blocker drugs should be questioned about the presence of heart failure, pulse impairment, arrhythmias, heart block and obstructive lung diseases.

Keywords:

Timolol maleate, bradycardia, syncope, side effect,

PDF

___

Atkins JM, Pugh BR Jr, Timewell RM. Cardiovascular effects of topical beta-blockers during exercise. Am J Ophthalmol. 1985;99:173-5.
Aslanides IM. Bilateral optic disc oedema associated with latanoprost. Br J Ophthalmol. 2000;84:673.
Goldberg I, Moloney G, McCluskey P. Topical ophthalmic medications: what potential for systemic side effects and interactions with other medications? Med J Aust. 2008;189:356-7.
Mohsen S, Koch JM, Steele RJ, Adler D, Pompili VJ, Sopko J. Third degree AV block due to ophthalmic timolol solution. International Journal of Cardiology. 2001;80:257-9.
Adam YS, Türker G. Primer açık açılı glokom ve tedavisi.http://www.istanbul.edu.tr/itf/goz/Primer_Acik _Acili_Glokom.pdf (accessed Feb 2014)
Minish T, Herd A. Symptomatic bradycardia secondary to interaction between topical timolol maleate, verapamil, and flecainide: a case report. J Emerg Med. 2002;22:247-9.
Gunaydin B, Cok OY. Hazards of topical ophthalmic drug administration. Trends in Anaesthesia and Critical Care. 2011;1:31-4.
Pringle SD, MacEwen CJ. Severe bradycardia due to interaction of timolol eye drops and verapamil. Br Med J (Clin Res Ed). 1987;294:155–6.
Morgan G, Mikhail M, Murray M, Larson CP. Clinical Anesthesiology, 3rd Ed. New York, Appleton & Lange, 2002.
Yazışma Adresi / Address for Correspondence: Dr.Müge Gülen Yunus Emre Devlet Hastanesi, Acil Tıp Kliniği, E SKİŞEHİR E-mail: muge-gulen@hotmail.com G eliş tarihi/Received on: 20.02.2014
Kabul tarihi/Accepted on:02.04.2014