Which bronchodilator is considered safe for patients with glaucoma?

Salmeterol is a long-acting beta-2 adrenergic agonist (LABA) that is considered relatively safe for patients with glaucoma. This is primarily due to its selectivity for beta-2 receptors, which are primarily found in the lungs and have minimal effects on the beta-1 and alpha receptors that are implicated in the increase of intraocular pressure commonly associated with glaucoma.

When managing asthma or chronic obstructive pulmonary disease (COPD) in patients who also have glaucoma, it is important to choose a bronchodilator that will not exacerbate their ocular condition. The other listed bronchodilators, such as albuterol, levalbuterol, and terbutaline, while they do provide effective therapeutic effects as bronchodilators, have a higher propensity for causing systemic side effects, including potential increases in intraocular pressure, because they can stimulate beta-1 and alpha receptors at higher doses or through systemic absorption.

Therefore, the use of salmeterol stands out as a favorable option for patients with glaucoma, allowing for effective management of respiratory conditions without significantly risking increased intraocular pressure.