So Benjamin Y F, Lee Kit Ming, Tang Arthur H C, Yip Terence
Medicine, Queen Mary Hospital, Hong Kong, HKG.
Medicine/Nephrology, Tung Wah Hospital, Hong Kong, HKG.
Cureus. 2021 Sep 5;13(9):e17725. doi: 10.7759/cureus.17725. eCollection 2021 Sep.
Brimonidine eye drops are frequently prescribed for the treatment of glaucoma and ocular hypertension in adults. Systemic toxicities including neurological side effects have been reported with its use, especially in the paediatric population. In this report, we present a case of encephalopathy secondary to the use of brimonidine eye drops in a patient with underlying advanced chronic kidney disease, who recovered promptly after drug cessation. Herein, we also review the pharmacokinetics of eye drops leading to their systemic side effects, especially in the context of renal impairment. We also explore the possibility of extracorporeal treatment, such as by haemodialysis, for the treatment of these manifestations. This case demonstrates the need to clarify a patient's drug history and stop offending medications early on in a patient with delirium, while treatments such as antidotes or extracorporeal treatment are being considered.
溴莫尼定滴眼液常用于治疗成人青光眼和高眼压症。使用该药物已报告有包括神经副作用在内的全身毒性，尤其是在儿科人群中。在本报告中，我们介绍了一例在患有晚期慢性肾病的患者中使用溴莫尼定滴眼液继发脑病的病例，该患者停药后迅速康复。在此，我们还回顾了导致全身副作用的滴眼液的药代动力学，特别是在肾功能损害的情况下。我们还探讨了通过血液透析等体外治疗来治疗这些表现的可能性。该病例表明，在考虑使用解毒剂或体外治疗等治疗方法时，需要明确患者的用药史并尽早停用引起问题的药物，同时对于出现谵妄的患者也是如此。
