Question

JJ, aged 68 years, visits the outpatient clinic for a check-up relating to his asthma condition. He has occasional bouts of acute asthma, which is adequately controlled using a salbutamol inhaler. JJ indicates that he has just been diagnosed with open-angle glaucoma, which is being treated with timolol 0.2 5% eye drops. He inserts one drop in each eye twice daily. The outpatient nurse ascertains that he has used the eye drops for two days. Is there a potential problem for JJ in using this combina­tion of salbutamol and timolol? Is there a potential problem associated with the use of timolol in this client?

Answer 1

JJ's use of both salbutamol and timolol poses potential problems due to their opposing actions. Timolol, a beta-blocker used for glaucoma, may reduce the effectiveness of salbutamol, a beta-agonist for asthma, and could exacerbate asthma symptoms.

Step-by-step explanation:

There is indeed a potential problem for JJ in using the combination of salbutamol and timolol. Salbutamol is a beta-agonist used in asthma to dilate the bronchi, making it easier to breathe. On the other hand, timolol is a beta-blocker often prescribed for open-angle glaucoma to reduce intraocular pressure. Although timolol is used topically as eye drops, it can still be absorbed systemically and potentially negate some of the effects of salbutamol. When combined, the two drugs can theoretically counteract each other, leading to reduced effectiveness of salbutamol in controlling asthma symptoms, presenting a problem for someone like JJ who suffers from acute asthma.

Furthermore, the use of timolol itself might pose a problem in some patients. Beta-blockers, even as eye drops, can adversely affect individuals with respiratory conditions like asthma. It can potentially cause bronchoconstriction, exacerbating JJ's asthma condition. Therefore, JJ's healthcare provider should be informed about the new prescription to reassess the suitability of using timolol considering his asthma condition, and alternative treatments for glaucoma may need to be considered.