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PubMed · 8859074

Uveitis associated with topical beta-blockers.

R W Beck·P Moke·R C Blair·R Nissenbaum
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Abstract

OBJECTIVE: To assess the incidence of uveitis associated with topical beta-blockers. DESIGN: Retrospective cohort study. SETTING: A computerized database of a health maintenance organization was used to identify patients who were prescribed metipranolol or other beta-blockers. PATIENTS: Two groups: 1928 patients using 0.3% metipranolol and 3903 patients using other beta-blockers. MAIN OUTCOME MEASURE: Cases of uveitis were identified by noting a prescription of a topical corticosteroid and then conducting a chart review. RESULTS: No cases of uveitis were identified among the 5831 patients. The upper limits of the 95% confidence intervals for the incidence of uveitis in cohorts of this size are 1.87 cases per 1000 person-years of exposure for metipranolol and 1.38 for other beta-blockers. CONCLUSION: Drug-induced uveitis from metipranolol or other beta-blocker administration is a rare event, even if a causal relationship exists.

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Administration, TopicalAdrenergic beta-AntagonistsCohort StudiesFloridaHealth Maintenance OrganizationsHumansIncidenceMetipranololOphthalmic SolutionsRetrospective StudiesUveitisJournal Article

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R W Beck, P Moke, R C Blair, R Nissenbaum. 1996. Uveitis associated with topical beta-blockers.. https://doi.org/10.1001/archopht.1996.01100140381002

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Administration, Topical↗
PubMed2007

Topical use of antifibrinolytic agents reduces postoperative bleeding: a double-blind, prospective, randomized study.

OBJECTIVE: Postoperative bleeding is still one of the most common complications of cardiac surgery. Antifibrinolytic agents successfully reduce bleeding, but there are controversies concerning adverse effects after their systemic use. By topical application of antifibrinolytic agents in pericardial cavity, most of these effects are avoided. We compared the effects of topically applied aprotinin, tranexamic acid and placebo on postoperative bleeding and transfusion requirements. METHODS: In this single-center prospective, randomized, double-blind trial, 300 adult cardiac patients were randomized into three groups to receive one million IU of aprotinin (AP group), 2.5g of tranexamic acid (TA group) or placebo (PL group) topically before sternal closure. Groups were comparable with respect to all preoperative and intraoperative variables. Postoperative bleeding, transfusion requirements and hematologic parameters were evaluated. RESULTS: Postoperative bleeding within first 12-h period (AP group 433+/-294 [350; 360]ml, TA group 391+/-255 [350; 305]ml, PL group 613+/-505 [525; 348]ml), as well as cumulative blood loss within 24h (AP group 726+/-432 [640; 525]ml, TA group 633+/-343 [545; 335]ml, PL group 903+/-733 [800; 445]ml), showed statistically significant inter-group differences (both p<0.001). Bleeding rates values were significantly higher in placebo group compared to the groups treated with antifibrinolytic agents (AP and TA groups) concerning both variables. Although TA group showed the lowest values, no statistical differences between TA and AP groups were found. Inter-group difference of blood product requirements was not statistically significant. CONCLUSIONS: Topical use of either tranexamic acid or aprotinin efficiently reduces postoperative bleeding. TA seems to be at least as potent as aprotinin, but potentially safer and with better cost-effectiveness ratio.

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