Generic Name

Carteolol Hydrochloride

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Classification

FDA Approved Indications

• Primary open-angle glaucoma
• Ocular hypertension

Mechanism of Action

Carteolol is a non-selective beta-adrenergic blocker that reduces intraocular pressure by decreasing aqueous humor production and possibly increasing outflow.

Dosage and Administration

Adult: Typically one drop in the affected eye once or twice daily.

Pediatric: Use not established; consult ophthalmologist.

Geriatric: Adjust as needed; greater sensitivity may increase risk of systemic side effects.

Renal Impairment: Use with caution; monitor closely, as drug clearance may be affected.

Hepatic Impairment: Use with caution; pharmacokinetics may be altered.

Pharmacokinetics

Absorption: Well absorbed following topical administration.

Distribution: Widely distributed; minimal CNS penetration.

Metabolism: Partially metabolized in the liver.

Excretion: Excreted primarily in urine.

Half Life: Approximately 3-4 hours.

Contraindications

• Bronchial asthma, bronchospastic lung disease
• Sinus bradycardia, greater than first-degree heart block, cardiogenic shock

Precautions

• Use with caution in patients with diabetes mellitus, thyrotoxicosis, or a history of severe allergies; may mask signs of hypoglycemia; systemic absorption can cause cardiovascular and respiratory effects.

Adverse Reactions - Common

• Local eye irritation (Common)
• Blepharitis (Less common)

Adverse Reactions - Serious

• Systemic beta-blocker effects such as bradycardia, hypotension, bronchospasm (Less common, especially with improper use or overuse)

Drug-Drug Interactions

• Other beta-blockers, calcium channel blockers, clonidine

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Patient/Family Teaching

• Use exactly as prescribed; do not touch dropper to eye or other surfaces.
• Report signs of systemic beta-blocker effects like unusual fatigue, dizziness, or slow heartbeat.
• Do not discontinue abruptly.

Special Considerations

Black Box Warnings:

• Systemic absorption can cause systemic beta-blockade effects especially in predisposed individuals.
• Potential to mask hypoglycemia symptoms in diabetics.

Genetic Factors: Not specifically documented.

Lab Test Interference: May interfere with blood glucose and thyroid function tests.

Overdose Management

Signs/Symptoms: Bradycardia, hypotension, bronchospasm, hypoglycemia.

Treatment: Supportive care; atropine for bradycardia; oxygen and vasopressors for hypotension; assist with ventilation if needed.

Storage and Handling

Storage: Store at room temperature, away from light and moisture.

Stability: Stable until expiration date on packaging.