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To the Editor: The study by Dr Bell and colleagues¹ described the association between tamsulosin and adverse events following cataract surgery. The authors theorized that tamsulosin may demonstrate greater receptor affinity and selectivity compared with other antagonists studied, thereby resulting in the observed selective toxicity. However, a hypothesis that tamsulosin is bound to receptors in a manner resulting in protracted selective and specific ocular toxicity is problematic.

Descriptions of receptor affinity developed as a result of formal receptor-ligand assays should not be interpreted as indicating intrinsic (agonist or antagonistic) properties of drug action. Rather than receptor affinity alone, it is the pharmacodynamic consequence of drug exposure described in terms of dose-response relationships that more accurately predicts drug effect.² The ₁ antagonists examined in the study by Bell et al demonstrate competitive antagonism of ₁ receptor activity, with relative similarity in the agonist-concentration effect (E/[A]) curve shift with increasing agonist concentration.³ Although relative . . . [Full Text of this Article]

Bruce I. Gaynes, OD, PharmD
bgaynes@lumc.edu
Department of Ophthalmology
Loyola University Chicago
Maywood, Illinois

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RELATED ARTICLE

Association Between Tamsulosin and Serious Ophthalmic Adverse Events in Older Men Following Cataract Surgery
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Tamsulosin and Ophthalmic Adverse Events After Cataract Surgery
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Tamsulosin and Ophthalmic Adverse Events After Cataract Surgery—Reply
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