Which of the following antiglaucoma medication is UNSAFE in infants –
**Core Concept**
Beta-blockers, particularly timolol, are commonly used in the treatment of glaucoma. However, their use is contraindicated in infants due to the risk of **bradycardia** and **hypotension**.
**Why the Correct Answer is Right**
Timolol works by reducing aqueous humor production through inhibition of the **beta-1 adrenergic receptors** in the ciliary body. However, in infants, the immature autonomic nervous system and the presence of beta-2 adrenergic receptors in the heart make beta-blockers like timolol particularly hazardous. The administration of timolol in infants can lead to severe **bradycardia**, **hypotension**, and even **cardiac arrest**.
**Why Each Wrong Option is Incorrect**
**Option A:** Pilocarpine is a cholinergic agonist used in the treatment of glaucoma, particularly in acute angle-closure glaucoma. It is not contraindicated in infants.
**Option B:** Latanoprost is a prostaglandin analog used to reduce intraocular pressure by increasing uveoscleral outflow. It is not contraindicated in infants.
**Option C:** Brimonidine is an alpha-2 adrenergic agonist used to reduce intraocular pressure. While it may have some systemic effects, it is not as hazardous in infants as beta-blockers.
**Clinical Pearl / High-Yield Fact**
Beta-blockers, including timolol, should be used with caution in children and infants due to the risk of systemic side effects. Always consider the age and underlying medical conditions of the patient before prescribing these medications.
**Correct Answer:** C. Brimonidine