What are the main systemic side effects associated with beta-blocker eye drops?

• A. Bronchiolar constriction; reduced HR (low pulse, low BP, heart block); depression; arrhythmias; sexual dysfunction
• B. Increased tear production; mydriasis; nasal congestion
• C. Elevated blood pressure; tachycardia
• D. Headache only

Answer: (C)

Topical beta-blockers can enter the bloodstream and block beta receptors outside the eye. This systemic blockade often slows the heart and can lower blood pressure, and it can also constrict the airways. So the main systemic side effects you’d expect are bronchiolar constriction (bronchospasm), a slower heart rate, and lower blood pressure, with possible related effects like rhythm disturbances or heart block. Sexual dysfunction and fatigue or mood changes can also occur because of broader beta-blockade.

The other options don’t fit this pattern: increased tear production, mydriasis, and nasal congestion are not typical systemic effects of these drops and more likely reflect local or different drug actions. Elevated blood pressure and tachycardia would be opposite to the usual beta-blocker effect. Headache alone is too narrow a symptom to capture the systemic impact.

So the best match is the description that includes bronchiolar constriction with reduced heart rate and low blood pressure, reflecting systemic beta-blockade from the eye drops.