Brimonidine 0.2% should be avoided in infants under two years of age primarily because of which systemic risk?

• A Seizures
• B Irreversible bone marrow suppression
• C Apnoea and central nervous system depression ✓
• D Congestive cardiac failure

Explanation

Alpha-2 adrenergic agonists cross the blood-brain barrier readily in young children because of CNS immaturity and small body mass, producing somnolence, hypotonia, bradycardia, hypotension, and life-threatening apnoea. This makes brimonidine unsuitable below roughly two years of age. In this age group, beta blockers, carbonic anhydrase inhibitors, and prostaglandin analogues are used instead, with dorzolamide and timolol commonly chosen for infantile glaucoma adjunctive therapy.

Reference: Nelson Textbook of Pediatrics / American Academy of Ophthalmology BCSC Glaucoma, 21st / Latest ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.