Pharmacological properties : תכונות פרמקולוגיות

Pharmacodynamic Properties

5.1   Pharmacodynamic properties
Pharmacotherapeutic group: Ophtalmologicals, antiglaucoma preparations and miotics, betablocking agents, ATC code: S01ED01.

Machanism of action
Timolol maleate is a non-selective beta-adrenergic receptor blocking agent that does not have significant intrinsic sympathomimetic, direct myocardial depressant, or local anaesthetic activity. Timolol maleate combines reversibly with the beta-adrenergic receptor, and this inhibits the usual biologic response that would occur with stimulation of that receptor. This specific competitive antagonism blocks stimulation of the beta-adrenergic stimulating (agonist) activity, whether these originate from an endogenous or exogenous source. Reversal of this blockade can be accomplished by increasing the concentration of the agonist which will restore the usual biological response.

Clinical Efficacy and Safety
Unlike miotics, ‘Tiloptic’ reduces IOP with little or no effect on accommodation or pupil size. In patients with cataracts, the inability to see around lenticular opacities 
when the pupil is constricted is avoided. When changing patients from miotics to ‘Tiloptic’ a refraction might be necessary when the effects of the miotic have passed.

Diminished response after prolonged therapy with ‘Tiloptic’ has been reported in some patients.

Pharmacokinetic Properties

5.2   Pharmacokinetic properties
The onset of reduction in intra-ocular pressure can be detected within one-half hour after a single dose. The maximum effect occurs in one or two hours; significant lowering of IOP can be maintained for as long as 24 hours with a single dose.