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Adverse effects of brimonidine eye drop in children: A case series

Zahra Ghaffari1, Zakaria Zakariaei2, Monireh Ghazaeian3

  • 1Faculty of Medicine, Bu Ali Sina Hospital, Mazandaran University of Medical Sciences, Sari, Iran.

Journal of Clinical Pharmacy and Therapeutics
|February 24, 2021
PubMed

Insights

Brimonidine eye drops can be lethal for infants, causing serious symptoms like low consciousness and breathing problems. Even without typical signs, poisoning is possible and may not respond to naloxone.

Area of Science:

  • Ophthalmology
  • Pediatric Toxicology

Background:

  • Brimonidine is a common treatment for intraocular hypertension.
  • Its use is increasing in ophthalmic applications.

Observation:

  • A case series of five pediatric patients with brimonidine eye drop intoxication was analyzed.
  • Key symptoms included decreased consciousness, hypotonia, apnea, bradycardia, hypotension, and seizures.
  • One patient required cardiopulmonary resuscitation, and apnea was resistant to naloxone in one instance.

Findings:

  • Brimonidine eye drop intoxication presents significant risks in pediatric patients.
  • Central nervous system depression and cardiovascular instability are primary concerns.
  • Absence of miosis or lack of response to naloxone does not exclude brimonidine poisoning.

Implications:

  • Healthcare providers must be aware of the potential lethality of brimonidine in young children.
  • Prompt recognition and management are crucial for adverse events.
  • Diagnostic and treatment protocols should consider brimonidine poisoning even with atypical presentations.
Abstract

Keywords:
adrenergic alpha2-Agonistsadverse effectsbrimonidine tartratechildrencritical carepoisoning

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