A patient of glaucoma with bronchial asthma presents to the emergency with status asthamaticus, causative agent might have. been
## **Core Concept**
The question involves a patient with glaucoma and bronchial asthma presenting with status asthmaticus. The key concept here is to identify a medication that could exacerbate asthma and is possibly used in glaucoma treatment. Glaucoma treatments often involve medications that can have systemic effects, including impacts on respiratory function.
## **Why the Correct Answer is Right**
The correct answer, **timolol**, is a non-selective beta-blocker used in the treatment of glaucoma to decrease intraocular pressure. Beta-blockers can cause bronchoconstriction by blocking beta-2 receptors in the lungs, which are responsible for dilating airways. In a patient with asthma, this can precipitate or worsen an asthma attack, potentially leading to status asthmaticus. Timolol's lack of selectivity for beta-1 over beta-2 receptors makes it particularly risky in asthma.
## **Why Each Wrong Option is Incorrect**
- **Option A:** Pilocarpine is a muscarinic receptor agonist used in glaucoma treatment to decrease intraocular pressure. It works by increasing the outflow of aqueous humor and is not typically associated with worsening asthma.
- **Option B:** Latanoprost is a prostaglandin F2α analogue used to treat glaucoma. It works by increasing the uveoscleral outflow of aqueous humor and does not have known effects on asthma.
- **Option D:** Acetazolamide is a carbonic anhydrase inhibitor used in glaucoma to decrease intraocular pressure. It works by reducing aqueous humor production and is not commonly associated with exacerbating asthma.
## **Clinical Pearl / High-Yield Fact**
A critical point to remember is that non-selective beta-blockers, like timolol, can exacerbate asthma. Patients with asthma who are prescribed beta-blockers should ideally be given selective beta-1 blockers (like metoprolol) if beta-blockade is necessary, though even then, caution is advised.
## **Correct Answer: C. Timolol.**