A 5-week-old infant with confirmed primary congenital glaucoma requires additional medical therapy while awaiting surgery. Which topical agent should be avoided because of a serious systemic adverse effect specific to this age group?
- A Timolol gel-forming solution
- B Dorzolamide
- C Brimonidine tartrate ✓
- D Latanoprost
Correct answer: C. Brimonidine tartrate
Explanation
Brimonidine crosses the immature blood-brain barrier of neonates and infants and depresses the central nervous system, producing apnoea, bradycardia, hypotension and somnolence. It is therefore contraindicated in children under about two years of age. Beta-blockers are used cautiously with low concentrations, carbonic anhydrase inhibitors require metabolic monitoring, and prostaglandin analogues have limited efficacy in infancy but no life-threatening toxicity. This age-specific hazard is a frequently tested point.
Reference: Nelson Textbook of Pediatrics, 22nd ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.