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Brimonidine Eye Drops Causing Encephalopathy in a Patient With Advanced Chronic Kidney Disease

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 secon...

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Autores principales: So, Benjamin Y.F., Lee, Kit Ming, Tang, Arthur H.C., Yip, Terence
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8491792/
https://www.ncbi.nlm.nih.gov/pubmed/34659939
http://dx.doi.org/10.7759/cureus.17725
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author So, Benjamin Y.F.
Lee, Kit Ming
Tang, Arthur H.C.
Yip, Terence
author_facet So, Benjamin Y.F.
Lee, Kit Ming
Tang, Arthur H.C.
Yip, Terence
author_sort So, Benjamin Y.F.
collection PubMed
description 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.
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spelling pubmed-84917922021-10-14 Brimonidine Eye Drops Causing Encephalopathy in a Patient With Advanced Chronic Kidney Disease So, Benjamin Y.F. Lee, Kit Ming Tang, Arthur H.C. Yip, Terence Cureus Internal Medicine 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. Cureus 2021-09-05 /pmc/articles/PMC8491792/ /pubmed/34659939 http://dx.doi.org/10.7759/cureus.17725 Text en Copyright © 2021, So et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Internal Medicine
So, Benjamin Y.F.
Lee, Kit Ming
Tang, Arthur H.C.
Yip, Terence
Brimonidine Eye Drops Causing Encephalopathy in a Patient With Advanced Chronic Kidney Disease
title Brimonidine Eye Drops Causing Encephalopathy in a Patient With Advanced Chronic Kidney Disease
title_full Brimonidine Eye Drops Causing Encephalopathy in a Patient With Advanced Chronic Kidney Disease
title_fullStr Brimonidine Eye Drops Causing Encephalopathy in a Patient With Advanced Chronic Kidney Disease
title_full_unstemmed Brimonidine Eye Drops Causing Encephalopathy in a Patient With Advanced Chronic Kidney Disease
title_short Brimonidine Eye Drops Causing Encephalopathy in a Patient With Advanced Chronic Kidney Disease
title_sort brimonidine eye drops causing encephalopathy in a patient with advanced chronic kidney disease
topic Internal Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8491792/
https://www.ncbi.nlm.nih.gov/pubmed/34659939
http://dx.doi.org/10.7759/cureus.17725
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