チモロール
WordNet
- a beta blocker (trade name Blocadren) administered after heart attacks (同)Blocadren
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア(Wikipedia)』「2014/08/09 03:26:35」(JST)
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Timolol
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Systematic (IUPAC) name |
(S)-1-(tert-butylamino)-3-[(4-morpholin-4-yl-1,2,5-thiadiazol-3-yl)oxy]propan-2-ol |
Clinical data |
Trade names |
Timoptic |
AHFS/Drugs.com |
monograph |
MedlinePlus |
a602022 |
Pregnancy cat. |
C (AU) C (US) |
Legal status |
℞ Prescription only |
Routes |
oral, Ophthalmic |
Pharmacokinetic data |
Bioavailability |
60% |
Metabolism |
Hepatic: 80% |
Half-life |
2.5-5 hours |
Excretion |
Renal |
Identifiers |
CAS number |
26839-75-8 Y |
ATC code |
C07AA06 S01ED01 |
PubChem |
CID 33624 |
IUPHAR ligand |
565 |
DrugBank |
DB00373 |
ChemSpider |
31013 Y |
UNII |
5JKY92S7BR Y |
KEGG |
D08600 Y |
ChEBI |
CHEBI:9599 Y |
ChEMBL |
CHEMBL499 Y |
Chemical data |
Formula |
C13H24N4O3S |
Mol. mass |
316.421 g/mol |
SMILES
- O[C@H](COc1nsnc1N2CCOCC2)CNC(C)(C)C
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InChI
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InChI=1S/C13H24N4O3S/c1-13(2,3)14-8-10(18)9-20-12-11(15-21-16-12)17-4-6-19-7-5-17/h10,14,18H,4-9H2,1-3H3/t10-/m0/s1 Y
Key:BLJRIMJGRPQVNF-JTQLQIEISA-N Y
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Y (what is this?) (verify) |
Timolol maleate is a non-selective beta-adrenergic receptor antagonist indicated for treating glaucoma, heart attacks and hypertension.
It is on the World Health Organization's List of Essential Medicines, a list of the most important medications needed in a basic health system.[1]
Contents
- 1 Medical uses
- 2 Side effects
- 3 Formulations
- 4 Brand names
- 5 Chemical synthesis
- 6 References
- 7 External links
Medical uses
In its oral form, it is used:
- to treat high blood pressure
- to prevent heart attacks
- to prevent migraine headaches[2]
In its ophthalmic form it is used to treat open-angle and occasionally secondary glaucoma by reducing aqueous humour production through blockage of the beta receptors on the ciliary epithelium. The pharmacological mechanism by which it actually does this is still unknown. First beta-blocker approved for topical use in treatment of glaucoma in the USA (1978). With monotherapy, depresses IOP 18-34% below baseline within first few treatments. However, there are short-term escape and long-term drift effects in some patients. That is, tolerance develops. May reduce extent of diurnal IOP curve up to 50%. IOP higher during sleep. 5-10x more potent beta-blocker than propranolol. Light sensitive; preserved with 0.01% benzalkonium Cl (and also comes BAC free). Can also be used in adjunctive therapy with pilocarpine or CAIs.
The 20 January 2014, issue of the Medical Journal of Australia (MJA) reported on topical timolol being successfully used to treat chronic leg ulcers in 92-year-old patient. <1>
A Cochrane Systematic Review compared the effect of timolol versus brimonidine in slowing the progression of open angle glaucoma in adult participants.[3]
Side effects
The most serious possible side effects include cardiac arrhythmias and severe bronchospasms. Timolol can also lead to fainting, congestive heart failure, depression, confusion, worsening of Raynaud's syndrome and impotence.
Formulations
- Gel-forming solution, ophthalmic, as maleate (Timoptic-XE): 0.25% (2.5 mL, 5 mL); 0.5% (2.5 mL, 5 mL)
- Solution, ophthalmic, as hemihydrate (Betimol): 0.25% (5 mL, 10 mL, 15 mL); 0.5% (5 mL, 10 mL, 15 mL) [contains benzalkonium chloride]
- Solution, ophthalmic, as maleate: 0.25% (5 mL, 10 mL, 15 mL); 0.5% (5 mL, 10 mL, 15 mL) [contains benzalkonium chloride]
- Timoptic: 0.25% (5 mL, 10 mL); 0.5% (5 mL, 10 mL) [contains benzalkonium chloride]
- Solution, ophthalmic, as maleate [preservative free] (Timoptic OcuDose): 0.25% (0.2 mL);0.5% (0.2 mL) [single use]
- Tablet, as maleate (Blocadren): 5 mg, 10 mg, 20 mg
For ophthalmic use, timolol is also available combined with other medications:
- Combigan - timolol and brimonidine
- IOTIM-B - timolol and brimonidine
- Cosopt - timolol maleate and dorzolamide hydrochloride
- DuoTrav - timolol and travoprost
- XOalacom (Pfizer) - timolol and latanoprost
Brand names
- In Canada: Apo-Timol, Apo-Timop, Gen-Timolol, Nu-Timolol, Phoxal-timolol, PMS-Timolol, Tim-AK, Timoptic, Timoptic-XE.
- In the United States: Betimol, Blocadren, Istalol, Timoptic, Timoptic-XE, Timoptic OcuDose.
- In Jordan:Apimol ( By API )[4]
- IOTIM is No. 1 prescribed brand in INDIA from FDC LIMITED .
Chemical synthesis
References
- ^ "WHO Model List of EssentialMedicines". World Health Organization. October 2013. Retrieved 22 April 2014.
- ^ Dawn A. Marcus; Philip A. Bain (27 February 2009). Effective Migraine Treatment in Pregnant and Lactating Women: A Practical Guide. シュプリンガー・ジャパン株式会社. pp. 141–. ISBN 978-1-60327-438-8. Retrieved 14 November 2010.
- ^ Sena DF, Lindsley K (2013). "Neuroprotection for treatment of glaucoma in adults". Cochrane Database Syst Rev 2: CD006539. doi:10.1002/14651858.CD006539.pub3. PMID 20166085.
- ^ http://www.jfda.jo/
- ^ . doi:10.1021/jo00881a011. edit
External links
- http://dx.doi.org/10.1021/jo00881a011
Beta blockers (C07)
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Beta, nonselective |
- Alprenolol
- Bopindolol
- Bupranolol
- Carteolol
- Cloranolol
- Mepindolol
- Nadolol
- Oxprenolol
- Penbutolol
- Pindolol
- Propranolol
- Sotalol
- Tertatolol
- Timolol
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Beta1 selective |
- Acebutolol
- Atenolol
- Betaxolol
- Bevantolol
- Bisoprolol
- Celiprolol
- Epanolol
- Esmolol
- Metoprolol
- Nebivolol
- Practolol
- S-atenolol
- Talinolol
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Alpha + beta |
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Other/ungrouped |
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anat (a:h/u/t/a/l,v:h/u/t/a/l)/phys/devp/cell/prot
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noco/syva/cong/lyvd/tumr, sysi/epon, injr
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proc, drug (C2s+n/3/4/5/7/8/9)
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Ophthalmologicals: antiglaucoma preparations and miotics (S01E)
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Sympathomimetics |
- Apraclonidine
- Brimonidine (+timolol)
- Clonidine
- Dipivefrine
- Epinephrine
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Parasympathomimetics |
muscarinic
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muscarinic/nicotinic
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Acetylcholinesterase inhibitors
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- Demecarium
- Ecothiopate
- Stigmine (Fluostigmine
- Neostigmine
- Physostigmine)
- Paraoxon
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Carbonic anhydrase inhibitors/
(sulfonamides) |
- Acetazolamide
- Brinzolamide (+timolol)
- Diclofenamide
- Dorzolamide (+timolol)
- Methazolamide
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Beta blocking agents |
- Befunolol
- Betaxolol
- Carteolol
- Levobunolol
- Metipranolol
- Timolol
- Mepindolol
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Prostaglandin analogues (F2α) |
- Bimatoprost (+timolol)
- Latanoprost (+timolol)
- Tafluprost
- Travoprost (+timolol)
- Unoprostone
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Other agents |
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anat (g/a/p)/phys/devp/prot
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proc, drug (S1A/1E/1F/1L)
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UpToDate Contents
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English Journal
- Suspected granulomatous anterior uveitis associated with brimonidine tartrate 0.2 % and timolol maleate 0.5 % ophthalmic solution.
- Casado A, Cabarga C, de la Fuente MA, Muñoz-Negrete FJ.SourceDepartment of Ophthalmology, Hospital Universitario Ramón y Cajal, Carretera de Colmenar Km 9,1, 28034, Madrid, Spain, casadorojo@hotmail.es.
- Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv für klinische und experimentelle Ophthalmologie.Graefes Arch Clin Exp Ophthalmol.2013 Nov;251(11):2659-60. doi: 10.1007/s00417-013-2415-3. Epub 2013 Jul 9.
- PMID 23835755
- The Safety and Efficacy of Brinzolamide 1%/Timolol 0.5% Fixed Combination Versus Dorzolamide 2%/Timolol 0.5% in Patients with Open-Angle Glaucoma or Ocular Hypertension.
- Akçay BI, Güney E, Bozkurt TK, Unlü C, Akçali G.SourceUmraniye Research and Training Hospital , Ophthalmology Clinic, İstanbul, Turkey .
- Journal of ocular pharmacology and therapeutics : the official journal of the Association for Ocular Pharmacology and Therapeutics.J Ocul Pharmacol Ther.2013 Nov 1. [Epub ahead of print]
- Abstract Purpose: The aim of this study was to compare the intraocular pressure (IOP) lowering efficacy and to determine patient preference based on ocular discomfort with fixed combination brinzolamide/timolol and fixed combination dorzolamide/timolol in patients with open-angle glaucoma or ocular
- PMID 24180628
- Can ophthalmic drops cause central nervous system depression and cardiogenic shock in infants?
- Kiryazov K, Stefova M, Iotova V.SourceFrom the Department of Pediatrics, University Multiprofile Hospital for Active Treatment "Sveta Marina," Varna, Bulgaria.
- Pediatric emergency care.Pediatr Emerg Care.2013 Nov;29(11):1207-9. doi: 10.1097/PEC.0b013e3182aa1384.
- Topical ocular medications have been widely prescribed and successfully used in children for the management of different ophthalmic disorders. We present 2 infants admitted to our pediatric intensive care unit who developed altered state of consciousness, hypotonia, hypothermia, bradycardia, and apn
- PMID 24196091
Japanese Journal
- Highlighted Paper selected by Editor-in-Chief : Neuroprotective Effect of Ocular Hypotensive Drugs : Latanoprost/Timolol in Combination Are More Effective than Each as Monotherapy in RGC-5
- CLINICAL INVESTIGATION : Comparison of the intraocular pressure-lowering effect and safety of brimonidine/timolol fixed combination and 0.5% timolol in normal-tension glaucoma patients
- Japanese journal of ophthalmology : the official international journal of the Japanese Ophthalmological Society 60(1), 20-26, 2016-01
- NAID 40020704916
- Neuroprotective Effect of Ocular Hypotensive Drugs: Latanoprost/Timolol in Combination Are More Effective than Each as Monotherapy in RGC-5
Related Links
- Timolol eye drops or gel-forming solution may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: eye irritation double vision headache depression dizziness nausea Some side ...
- Timolol official prescribing information for healthcare professionals. Includes: indications, dosage, adverse reactions, pharmacology and more. ... Exacerbation of Ischemic Heart Disease Following Abrupt Withdrawal Hypersensitivity ...
Related Pictures
★リンクテーブル★
[★]
- 英
- timolol
- 化
- マレイン酸チモロール timolol maleate
- 商
- ブロカドレン BLOCARDEN、チマバック、Timoptic、Betimol
- コソプト、ザラカム、チアブート、チモプトール、チモレート、デュオトラバ、ファルチモ、リズモン
- 関
- 眼科用剤
薬効薬理
- チマバック点眼液0.5%
- 眼圧下降作用:チマバック点眼液0.5%は,家兎の正常眼圧を用いた試験系において,眼圧下降効果が認められた1).また,家兎の実験的高眼圧モデルに対しても,眼圧上昇抑制及び下降効果が認められた1).
- チモプトールXE 点眼液 0.25%/チモプトールXE 点眼液 0.5%
- ウサギにおけるα-キモトリプシン惹起高眼圧及び水負荷による眼圧上昇試験において、チモロールマレイン酸塩の点眼は有意に眼圧上昇を抑制することが認められている。9)
- ラット、イヌ、ネコにチモロールマレイン酸塩を全身投与した場合、イソプレナリンにより惹起された心拍数、心筋収縮力及び心拍出量の増加は著明に抑制され、本剤のβ-受容体遮断作用はピンドロールと同程度、プロプラノロールより数倍強力である。10)、11) また、チモロールマレイン酸塩は有意の内因性交感神経刺激作用、直接心筋抑制作用、局所麻酔作用を示さない。10)、11)
作用機序
- チモプトールXE 点眼液 0.25%/チモプトールXE 点眼液 0.5%
- 眼圧下降作用機序の詳細は明らかでないが、サル12)、健康成人13) でのフルオロフォトメトリー試験及び緑内障患者でのトノグラフィー試験6)、14) において、チモロールマレイン酸塩の眼圧下降作用は主に房水産生の抑制によることが示唆されている。しかし房水流出率の増加が関与するとの報告もある。15)、16)
添付文書
- http://www.info.pmda.go.jp/go/pack/1319702Q2090_1_06/1319702Q2090_1_06?view=body
- チモプトールXE 点眼液 0.25%/チモプトールXE 点眼液 0.5%
- http://www.info.pmda.go.jp/go/pack/1319702Q3037_4_01/1319702Q3037_4_01?view=body
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マレイン酸チモロール