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Unexpected outcome (positive or negative) including adverse drug reactions
CASE REPORT
Insidious-onset, non-wheezing carteolol-induced asthma in an atopic patient without asthma history
  1. Jo-Hsuan Wu1,
  2. Jih-Shuin Jerng2 and
  3. Chien-Chia Su3
  1. 1 National Taiwan University College of Medicine, Taipei, Taiwan
  2. 2 Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
  3. 3 Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
  1. Correspondence to Dr Jih-Shuin Jerng, jsjerng{at}ntu.edu.tw

Abstract

Carteolol, a non-selective beta-antagonist with a potential risk of severe bronchial constriction in patients with asthma, is one of the most commonly prescribed medication for managing ocular pressure in glaucoma. We present a case of a 24-year-old woman with a history of atopy but no known asthma who presented an insidious onset of clinical manifestations compatible with drug-induced asthma after the initiation of carteolol for ocular hypertension control. The patient developed progressive chest tightness and dyspnoea for 2 months before the pulmonary function test revealed a positive bronchoprovocation response. She reported significant improvement of respiratory symptoms within 2 weeks after the discontinuation of carteolol, and a negative provocation response was later confirmed by repeat pulmonary function test. In conclusion, eye drops with non-selective beta-antagonising effect can induce asthmatic symptoms in patients without a previous diagnosis of asthma and should be administered with caution in patients with associated risk factors.

  • glaucoma
  • unwanted effects/adverse reactions
  • asthma
  • drugs: respiratory system
  • contraindications and precautions

https://doi.org/10.1136/bcr-2019-229343

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    Footnotes

    • Contributors J-HW wrote the article and made substantial contributions to the conception and design of this article; C-CS and J-SJ made a critical assessment of the article. All authors have been involved in drafting the manuscript and revising it critically for important intellectual content. All authors read and approved the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Patient consent for publication Obtained.