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Timolol (Timololum) - the description, contraindications, application
The latin name: Timolol
Timolol Pharmacological groups: Beta - adrenoblockers
Timolol Working substance: Timolol
Timolol Application: Inside: an arterial hypertension, a hypertrophic cardiomyopathy, a prolapse of the mitral valve, a stenocardia, prophylaxis repeated a myocardial infarction, a migraine (the prevention of attacks), an essential tremor, alarm. Locally: the raised ophthalmotonus, a glaucoma (open-angle, the secondary, at an aphakia, etc.).
Timolol Contraindications: For purpose inside and locally: hypersensitivity, a bronchial asthma (including in an anamnesis), chronic obstructive diseases mild, a cardiogenic shock, an acute and chronic heart failure, AV blockade II-III of a degree, sinuatrial blockade, a sinus bradycardia (less than 45-50 impacts in one minute), a set of symptoms of delicacy of sinus unit; at local application: dystrophic diseases of a cornea, serious allergic inflammations of a mucosa of a nose, a feeding a breast, early children's age (premature and newborn children).
Timolol Restrictions to application: the Emphysema mild, not allergic chronic bronchitis, a vasculomotor rhinitis, a Raynaud's disease, infringement of function of a liver and-or kidneys, an acidosis, a diabetes, a hypoglycemia, a hyperthyroidism, a myasthenia, advanced age, pregnancy, for systemic purpose - children's age (safety and efficiency are not determined).
Timolol Application at pregnancy and a feeding a breast: it is Possible, if the expected effect of therapy exceeds potential risk for a fetus. For the period of treatment it is necessary to stop thoracal feeding.
Timolol Side effects: From the side of nervous system and sense organs: a giddiness, a headache, an asthenia, fatigability, infringement of dream, a sleeplessness, night nightmares, depression, exaltation, hallucinations, a short-term amnesia, disorientation in space, a paresthesia, intensifying of signs of a myasthenia; a sonitus; a boring of eyes, infringement of vision, a diplopia, a ptosis, dryness of a mucosa of eyes; at local application: transient misting of vision (from 30 with up to 5 mines - 6 %), a burning sensation and an itch in eyes, sensation of a foreign body in an eye, changes of a refraction and visual acuity, a lacrimation, a photophobia, decrease of sensitivity of a cornea, an edema of an epithelium of a cornea, an inflammation of edges of blepharons, a conjunctivitis, a blepharitis, a superficial dot keratopathy, a keratitis. From the side of respiratory system: an obstruction of a nose, a pain in a thoracal cell, tussis, a short wind, a dyspnea, a bronchospasm (the lethal outcome is possible), respiratory failure. From the side of cardiovascular system (a hemopoiesis, a hemostasis): palpitation, a symptomatic bradycardia, an arrhythmia, AV blockade, a cardiac standstill, a heart failure (the lethal outcome is possible), a hypotension, a collapse, a Raynaud's syndrome, a cold snap of extremities, an exacerbation of an alternating lameness, transient infringement of a cerebral circulation, an ischemia of a brain, a syncope, dropping of a haemoglobin, a hematocrit. From the side of bodies of the GASTROINTESTINAL TRACT: dryness in a mouth, an anorexia, the dyspeptic phenomena, a nausea, a vomiting, a diarrhea. From the side of integuments: an eruption, a urticaria, an exacerbation of a psoriasis, an itch, a prurigo, an alopecia. Other: a Quincke's disease, a withdrawal, change of mass of a body, a lupoid set of symptoms, weakening of a libido, an impotency, a Peyronie's disease, a hyperkalemia, a hyperuricemia, a hypertriglyceridemia.
Timolol Interaction: Enlarges it (is relative) probability of infringements of automatism, conduction and a contractility of heart on a background of Amiodaronum, a sympatholytics, a diltiazem, Verapamilum, quinidine drugs; risk of a hypotension and a decompensation of cardiac activity - on a background of dihydropyridine antagonists of calcium, inhalation Anesthetics Chloroformium. The NONSTEROIDAL ANTI-INFLAMMATORY DRUGS weaken hypotensive effect. At local application it is compatible with miotocs and inhibitors of a carbonic anhydrase. Simultaneous application of the eye drops containing Epinephrinum or Norepinephrinum, can cause a mydriasis. Epinephrinum and pilocarpine inclusive eye drops will potentiate downstroke of an ophthalmotonus. At simultaneous systemic and local application of beta - adrenoblockers probably relative intensifying of effects.
Timolol Overdosage: Signs: a giddiness, a headache, a nausea and a vomiting, a bradycardia, an arrhythmia, an acute heart failure, a bronchospasm. Treatment: at use of eye drops - an immediate lavage of eyes water or a normal saline solution. At intake - a gastric lavage, reception of absorbent coal, symptomatic therapy: Atropinum, beta - adrenoceptor agonists (an isoprenaline, Isadrinum), a glucagon a hydrochloride, systemic angiotonic agents (Norepinephrinum, Dobutaminum), 2-adrenoceptor agonists (at a bronchospasm); cardiac glycosides, diuretics, Aminophyllinum (at a heart failure); an oxygen therapy; carrying out of a pacing is possible. The haemodialysis is ineffective.
Timolol Way of application and dose: Inside: at an arterial hypertension of 10 mg 2 times day, if necessary a dose enlarge with week intervals up to maximal diurnal - 60 mg. Prophylaxis of a repeated myocardial infarction - through 1-4 weeks after the first infarct on 10 mg 2 times day. A maximal daily dose - 30 mg (10 mg in the morning and 20 mg in the evening). The prevention of attacks of a migraine - an initial dose on 10 mg 2 times day. Maximal diurnal - 30 mg (10 mg in the morning and 20 mg in the evening). Conjunctival, in the struck eye, to adults and children on 1 drop of 0,25%-0,5 % of a solution 1-2 times day during 6 weeks (no more). After stabilization of an ophthalmotonus - on 1 drop of 1 times in day.
Timolol Precautionary measures: Before the beginning of treatment it is necessary to compensate a heart failure. During therapy monitoring the HEART RATE, the HELL and earlier revealing of signs of a heart failure is necessary. Infringement of function of a liver and kidneys cause necessity of decrease of a dose. It is necessary to cancel for 48 h before an operative measure. Masks signs (tachycardia) of a hypoglycemia on a background of reception of peroral antidiabetic agents and an insulin and a thyrotoxicosis (the sudden cancellation can cause a thyrocardiac crisis). Intensifying an expressiveness of reactions of hypersensitivity and absence of effect from routine doses of Epinephrinum on a background of the burdened allergological anamnesis is possible. For decrease of an adsorption after an instillation in an eye it is necessary to press on 1-2 mines a finger on the plaintive canal at an internal angle of an eye. At an angle-closure glaucoma application is possible only together with miotocs. To instillate other. Drugs it is recommended not less than for 10 mines before application of Timololum. At local application it is necessary to supervise function of a watering, integrity of a cornea and a field of vision of 1 times in 6 month and an ophthalmotonus (through 4 weeks after the beginning of therapy). During treatment carrying only hard contact lenses (it is necessary to remove before an instillation and again to put on through 15 mines) is authorized. While translating the ophthalmologic patient from therapy by other beta - adrenoblockers stop reception of a previous medicinal agent and next day appoint Timololum. In case of a cancellation of other anti-glaucomatous drugs it is necessary to apply during 1 day both agents (under the control of an ophthalmotonus) and then to continue use of Timololum. With care to apply in an operating time to drivers of vehicles and people which trade is connected to the raised concentration of attention.
Timolol Special indicatings: Before an instillation a vial to turn and sharply to stir up (no more than 1 time). During treatment change of results of tests is possible at carrying out of laboratory researches.
Trading names of drugs with working substance Timolol:
(Arutimol) (Ocumol) Timololum (Timolol) (Glaumol) -? (Ocupres-E) Timololum - (Timolol-AKOS) (Glimol) Has fumigated (Ocuril) Timololum - (Timolol-DIA) 0,25 % (Glucomol 0,25 %) (Ocutim) Timololum - (Timolol-LANS) 0,5 % (Glucomol 0,5 %) (Optimol) Timololum - of a drop eye 0,25 % and 0,5 % (Timolol-MEZ, guttae ophthalmicae 0,25 % et 0,5 %) (Cusimolol) Timololum (Oftan Timolol) Timololum - (Timolol-POS) (Nyolol) (Oftensin) Timololum maleate (Timolol maleate) (Ocumed) (TimoHEXAL) Timopticum (Timoptic)
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