What is an important consideration when prescribing alpha agonists for glaucoma?

When prescribing alpha agonists for glaucoma, systemic side effects are a significant consideration. Alpha agonists, such as brimonidine, can have central nervous system effects due to their ability to cross the blood-brain barrier, potentially causing sedation or fatigue. Additionally, they may lead to cardiovascular effects like bradycardia or hypotension. Patients with certain medical conditions, such as severe cardiovascular disease or those on medications affecting blood pressure, require careful monitoring.

While other factors such as reduced effectiveness over time, acute allergic reactions, and ocular irritation are also relevant, systemic side effects are particularly pertinent to the overall management of the patient's health. It is essential for practitioners to weigh these systemic risks against the benefits of lowering intraocular pressure when making treatment decisions for glaucoma.