A 58-year-old man with moderate persistent asthma has newly diagnosed primary open-angle glaucoma. His physician wants a topical beta-blocker with the least risk of bronchospasm. Which agent is most appropriate?
- A Timolol maleate 0.5%
- B Levobunolol 0.5%
- C Betaxolol 0.25% ✓
- D Carteolol 1%
Correct answer: C. Betaxolol 0.25%
Explanation
Betaxolol is a relatively cardioselective beta-1 antagonist, so it produces less blockade of pulmonary beta-2 receptors than non-selective agents such as timolol, levobunolol and carteolol. It therefore carries a lower, though not zero, risk of bronchospasm and remains the preferred beta-blocker when one must be used in a patient with reactive airway disease. Its IOP-lowering efficacy is slightly weaker than timolol.
Reference: Katzung, Basic and Clinical Pharmacology, 16th ed.
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Written and medically reviewed by the StethoPrep medical team.