{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T12:22:27Z","timestamp":1756902147527,"version":"3.44.0"},"reference-count":9,"publisher":"The Pediatric Pharmacy Association","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016]]},"abstract":"<jats:p>Carbonic anhydrase inhibitors are a common cause of normal anion gap metabolic acidosis; however, development is less commonly associated with ophthalmic administration of these agents. We report a case of a premature neonate who was being treated at our institution with betaxolol, dorzolamide, and latanoprost ophthalmic products for suspected bilateral congenital glaucoma. In addition, the patient was also receiving caffeine, ursodiol, and acidified liquid human milk fortifier. The patient developed a normal anion gap metabolic acidosis, and both dorzolamide ophthalmic solution and the acidified human milk fortifier were considered potential causes. Upon discontinuation of the dorzolamide ophthalmic solution and the switching of liquid human milk fortifiers, the normal anion gap metabolic acidosis gradually resolved. As a result of the pH and acidity, the acidified liquid human milk fortifier is thought to be associated with an anion gap acidosis; therefore, dorzolamide is suspected to be the primary cause of a normal gap acidosis. This case demonstrates that systemic effects can occur with ophthalmic administration of dorzolamide in a premature neonate. Ophthalmic agents should not be overlooked as a potential cause of systemic toxicity.<\/jats:p>","DOI":"10.5863\/1551-6776-21.3.256","type":"journal-article","created":{"date-parts":[[2016,7,20]],"date-time":"2016-07-20T18:47:56Z","timestamp":1469040476000},"page":"256-259","source":"Crossref","is-referenced-by-count":2,"title":["Metabolic Acidosis with Ophthalmic Dorzolamide in a Neonate"],"prefix":"10.5863","volume":"21","author":[{"given":"Amanda C.","family":"Capino","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Clinical and Administrative Sciences, University of Oklahoma College of Pharmacy, Oklahoma City, Oklahoma"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas C.","family":"Dannaway","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Oklahoma College of Medicine, Oklahoma City, Oklahoma"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamie L.","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Clinical and Administrative Sciences, University of Oklahoma College of Pharmacy, Oklahoma City, Oklahoma"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3883","reference":[{"issue":"4","key":"i1551-6776-21-3-256-b1","series-title":"Clin J Am Soc Nephrol","first-page":"671","article-title":"Differential diagnosis of nongap metabolic acidosis: value of a systematic approach","volume":"7","year":"2012","unstructured":"Kraut\n              JA, \n            \n              Madias\n              NE.\n            \n          \n          Differential diagnosis of nongap metabolic acidosis: value of a systematic approach. Clin J Am Soc Nephrol. 2012;7(4):671\u2013679."},{"issue":"9","key":"i1551-6776-21-3-256-b2","series-title":"Ann Pharmacother","first-page":"1130","article-title":"Acetazolamide in critically ill neonates and children with metabolic alkalosis","volume":"47","year":"2013","unstructured":"Andrews\n              MG, \n            \n              Johnson\n              PN, \n            \n              Lammers\n              EM, \n          \n          et al. Acetazolamide in critically ill neonates and children with metabolic alkalosis. Ann Pharmacother. 2013;47(9):1130\u20131135."},{"issue":"2","key":"i1551-6776-21-3-256-b3","series-title":"Br J Ophthalmol","first-page":"247","article-title":"Topical brinzolamide and metabolic acidosis","volume":"90","year":"2006","unstructured":"Menon\n              GJ, \n            \n              Vernon\n              SA.\n            \n          \n          Topical brinzolamide and metabolic acidosis. Br J Ophthalmol. 2006;90(2):247\u2013248."},{"issue":"8","key":"i1551-6776-21-3-256-b4","series-title":"Br J Ophthalmol","first-page":"1052","article-title":"Topical dorzolamide and metabolic acidosis in a neonate","volume":"87","year":"2003","unstructured":"Morris\n              S, \n            \n              Geh\n              V, \n            \n              Nischal\n              KK, \n          \n          et al. Topical dorzolamide and metabolic acidosis in a neonate. Br J Ophthalmol. 2003;87(8):1052\u20131053."},{"year":"2014","series-title":"Ophthalmic Diagnosis and Treatment","key":"i1551-6776-21-3-256-b5","unstructured":"Yarnoff\n              M.\n            \n          \n          Ophthalmic Diagnosis and Treatment. 3rd ed. New Delhi, India: Jaypee Brothers Medical Publishers Ltd, 2014."},{"year":"2015","series-title":"Lexi-Comp Online","key":"i1551-6776-21-3-256-b6","unstructured":"Dorzolamide monograph. Lexi-Comp Online, Hudson, OH: Lexi-Comp Inc; 2015. Accessed July 12, 2015."},{"issue":"2","key":"i1551-6776-21-3-256-b7","series-title":"J Perinatol","first-page":"115","article-title":"Association of metabolic acidosis with bovine milk-based human milk fortifiers","volume":"35","year":"2015","unstructured":"Cibulskis\n              CC, \n            \n              Armbrecht\n              ES.\n            \n          \n          Association of metabolic acidosis with bovine milk-based human milk fortifiers. J Perinatol. 2015;35(2):115\u2013119."},{"issue":"2","key":"i1551-6776-21-3-256-b8","series-title":"Compr Ophthalmol Update","first-page":"85","article-title":"Ophthalmic medications in pediatric patients","volume":"6","year":"2005","unstructured":"Myers\n              TM, \n            \n              Wallace\n              DK, \n            \n              Johnson\n              SM.\n            \n          \n          Ophthalmic medications in pediatric patients. Compr Ophthalmol Update. 2005;6(2):85\u2013101."},{"issue":"2","key":"i1551-6776-21-3-256-b9","series-title":"Clin Pharmacol Ther","first-page":"239","article-title":"A method for estimating the probability of adverse drug reactions","volume":"30","year":"1981","unstructured":"Naranjo\n              CA, \n            \n              Busto\n              U, \n            \n              Sellers\n              EM, \n          \n          et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther. 1981;30(2):239\u2013245."}],"container-title":["The Journal of Pediatric Pharmacology and Therapeutics"],"original-title":[],"link":[{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/21\/3\/article-p256.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/meridian.allenpress.com\/jppt\/article-pdf\/21\/3\/256\/1782196\/1551-6776-21_3_256.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/21\/3\/article-p256.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/21\/3\/article-p256.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:41:31Z","timestamp":1747356091000},"score":1,"resource":{"primary":{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/21\/3\/article-p256.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016]]},"references-count":9,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.5863\/1551-6776-21.3.256","relation":{},"ISSN":["1551-6776"],"issn-type":[{"type":"print","value":"1551-6776"}],"subject":[],"published":{"date-parts":[[2016]]}}}