Prolonged central nervous system and respiratory depression in preterm neonates after exposure to brimonidine tartrate and timolol maleate ophthalmic drops

Corrina P Azarcon; Darby E Santiago

doi:10.3205/oc000152

Prolonged central nervous system and respiratory depression in preterm neonates after exposure to brimonidine tartrate and timolol maleate ophthalmic drops

GMS Ophthalmol Cases. 2020 May 4:10:Doc25. doi: 10.3205/oc000152. eCollection 2020.

Authors

Corrina P Azarcon¹, Darby E Santiago^{1

2}

Affiliations

¹ Department of Ophthalmology and Visual Sciences, Philippine General Hospital, Manila, Philippines.
² University of the Philippines College of Medicine, Manila, Philippines.

Abstract

Objective: We report three cases of preterm neonates who presented with central nervous system (CNS) and respiratory depression after inadvertent exposure to brimonidine tartrate 0.2% and timolol maleate 0.5% fixed-combination ophthalmic drops. Case descriptions: CNS and respiratory depression were observed in the three neonates within two hours of administration of brimonidine tartrate 0.2% and timolol maleate 0.5% eye drops. Respiratory support was initiated upon admission to the neonatal intensive care unit (NICU). The effects of the drug combination lasted for 24 to 48 hours. Conclusion: This case series suggests that the drug combination of brimonidine tartrate and timolol maleate causes a prolonged depression of the central nervous and respiratory systems in preterm neonates.

Keywords: apnea; brimonidine tartrate; central nervous system depression; preterm neonates; timolol maleate.

Publication types

Case Reports