A 64-year-old man with newly diagnosed primary open-angle glaucoma also suffers from severe bronchial asthma requiring regular inhalers. Which topical agent should be avoided as first-line therapy in him?
- A Latanoprost
- B Timolol maleate ✓
- C Dorzolamide
- D Brimonidine
Correct answer: B. Timolol maleate
Explanation
Topical timolol is absorbed systemically across the conjunctiva and nasal mucosa and can precipitate fatal bronchospasm in patients with reactive airway disease, so asthma and COPD are absolute contraindications. Latanoprost, dorzolamide and brimonidine have minimal bronchial effects, though brimonidine carries CNS depression risk in small children. Systemic beta-blockade from eye drops is a standard examination point because it is clinically silent unless specifically sought.
Reference: Katzung's Basic and Clinical Pharmacology, 16th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.