Aşırı Doz Siklopentolat Göz Damlasına Bağlı Gelişen Santral Antikolinerjik Sendrom

Abstract

Siklopentolat hidroklorür %1 damla göz kliniklerinde çok sık kullanılan topikal midriyatik ve sikloplejik bir ilaçtır. Bu olguda sekiz yaşındaki hastaya yanlışlıkla toplamda 16 damla siklopentolat hidroklorür %1 döküldükten sonra gelişen santral antikolinerjik sendrom sunulmuştur. Dizartri, ataksik yürüyüş, görsel halüsinasyon, ağız şapırdatma, dizoryantasyon ve yüzde kızarıklık gelişen hasta, tıbbi gözetim altında tutulmuş ve tüm bulgular 6 saat içinde spontan düzelmiştir. Özellikle uygun dozda kullanılmayan siklopentolat göz damlasına bağlı sistemik yan etkiler gelişebileceği için bu hastalar gözlem altında tutulmalıdır.

Keywords

• Siklopentolat hidroklorür %1,toksisite,,aşırı doz

Central Anticholinergic Syndrome Induced by Overdose Cyclopentolate Eye Drops

Abstract

Cyclopentolate hydrochloride %1 is a commonly used drug as a topical mydriatic and cycloplegic agent in ophthalmology clinics. In this report, an eight years old patient was presented who diagnosed as central anticholinergic syndrome after accidental instillation of a total dose of 16 drops cyclopentolate hydrochloride %1. Patient was strickly monitered as for the symptoms of dysarthria, gait ataxia, visual hallucination, mouth sneezing, disorientation and facial redness. All findings were resolved spontaneously within 6 hours. Cyclopentolate eye drops can cause systemic side effects especially if not used at appropriate dose, thus these patients should be observed.

Keywords

• Cyclopentolate hydrochloride %1,toxicity,overdose

References

1. 1. Lovasik JV. Pharmacokinetics of topically applied cyclopentolate HCl and tropicamide. Am J Optom Physiol Opt 1986; 63:787–803
2. 2. Awan KJ. Adverse systemic reactions of topical cyclopentolate hydrochloride. Ann Ophthalmol 1976; 8: 695-698.
3. 3. Huismans H. Intoxikationspsychose nach Cyclopentolat-HCl (Zyklolat). Klin Monatsbl Augenheilkd 1979; 175: 100-102.
4. 4. Haaga M, Kaila T, Salminen L, Ylitalo P. Systemic and ocular absorption and antagonist activity of topically applied cyclopentolate in man. Pharmacol Toxicol. 1998 ;82(1):19-22.
5. 5. Gilman AG, Rall TW, Nies AS, Taylor P,eds. Goodman and Gilman’s The Pharmacological Basis of Therapeutics, 8th ed. New York, NY, Pergamon Press, 1990
6. 6. Simcoe CW. Cyclopentolate (Cyclogyl) toxicity. Report of a case. Arch Ophthalmol. 1962; 67:406-408
7. 7. Baysal Z, Cengiz M, Oğuz H, Ganidağlı S. Central Anticholinergic Syndrome Induced by Cyclopentolate Eye Drops in A 4 Year Old Child. The Internet Journal of Emergency and Intensive Care Medicine 2006:9(1).
8. 8. Bhatia SS, Vidyashankar C, Sharma RK, Dubey AK. Systemic toxicity with cyclopentolate eye drops. Indian Pediatr 2000;37:329-331.

9. 9. Ağın H, Gerçek H, Kutlu A, Gülez N, Atlıhan F. Topikal siklopentolat kullanımına bağlı gelişen deliryum tablosu: Bir vaka takdimi. Çocuk Sağlığı ve Hastalıkları Dergisi 2008; 51: 39-42
10. 10. BinkhorstRD,WeinsteinGW,BaretzRM,ClahaneAC. Psychotic reaction induced by cyclopentolate (cyclogyl); results of a pilot study and a double-blind study. Am J Ophthalmol 1963; 55:1243–1245
11. 11. Khurana AK, Ahluwalia BK, Rajan C, Vohra AK. Acute psychosis associated with topical cyclopentolate hydrochloride. Am J Ophthalmol. 1988; 15:105(1):91
12. 12. Bagheri A, Givrad S, Yazdani S, Reza Mohebbi M.Optimal dosage of cyclopentolate 1% for complete cycloplegia: a randomized clinical trial. Eur J Ophthalmol. 2007 ;17(3):294-300.
13. 13. Mirshahi A, Kohnen T. Acute psychotic reaction caused by topical cyclopentolate use for cycloplegic refraction before refractive surgery: case report and review of the literature. J Cataract Refract Surg. 2003 ;29(5):1026-1030.