Pilokarpin

When ATH:
S01EB01

Characteristic.

Alkaloid plants Pinnatifolius Pilocarpus Jaborandi. Colourless crystals or a white crystalline powder, with a bitter taste; hygroscopic, very easily soluble in water, easily - in alcohol, insoluble in most non-polar solvent; aqueous solutions have a pH 5-5,5.

Pharmacological action.
Protivoglaukomnoe.

Application.

Glaucoma, incl. acute attack, trophicity eye disorders at central retinal vein thrombosis or acute obstruction of the arteries it, atrophy of the optic nerve, vitreous hemorrhage, elimination of atropine mydriatic action, homatropyna, scopolamine.

Contraindications.

Hypersensitivity, Irit, iridocyclitis and other conditions, where it is not recommended miosis (for example, after eye surgery, except, when it is necessary to narrow the pupil immediately after surgery, to prevent the formation of adhesions); anamnesis indicate retinal detachment, high myopia with the danger of retinal detachment.

Pregnancy and breast-feeding.

Category actions result in FDA - C. (The study of reproduction in animals has revealed adverse effects on the fetus, and adequate and well-controlled studies in pregnant women have not held, However, the potential benefits, associated with drugs in pregnant, may justify its use, in spite of the possible risk.)

During treatment is desirable not to breastfeed.

Side effects.

Headache (in the temporal or periorbital), sore eyes, myopia, cyclospasm, blurred vision, night blindness, lacrimation, rhinorrhea, superficial keratitis; in the long-term use-follicular conjunctivitis, contact dermatitis century.

Cooperation.

The effect is attenuated (stops) holinomimetikami of atropine. Timolol maleate and fenilэfrin (reduce the production of intraocular fluid) potentiate the reduction of intraocular pressure. Perhaps the increased side effects of beta-blockers (vыrazhennaya bradycardia, intracardiac conduction disorders). In conjunction with the mutual antagonism manifested adrenomimetikami (on pupil size). m-cholinomimetic activity decreases tricyclic antidepressants, phenothiazine derivatives, Chlorprothixene, klozapynom, enhanced anticholinesterases. Perhaps the development of bradycardia and hypotension during anesthesia in patients ftorotanovogo, using pilocarpine hydrochloride in eye drops.

Overdose.

Symptoms: nausea, bradycardia.

Treatment: symptomatic. Specific antidote is atropine.

Dosing and Administration.

In ophthalmic practice - 1% or 2% solution 2-3-4 times a day, rarely prescribed 5% and 6% solutions. Before going to bed, you can lay for eyelids 1% or 2% ointment. Systems with sustained release of pilocarpine (Eye Film) 20 mcg or 40 mcg administered in cases, when the normalization of intraocular pressure is not enough, a single instillation of 3-4 per day; lay film with the help of tweezers for ocular lower eyelid 1-2 times a day (immediately thereafter the eye should be kept stationary during 30-60, yet it happens wetting film and its transition into a soft state).

Precautions.

Requires regular monitoring of intraocular pressure. To reduce suction after instillation is recommended for 1-2 minutes pinch tear duct, pressing a finger at the inner corner of the eye. It should teach the patient use of systems with extended release of the drug and prevent, that long-term use may develop tolerance. Be wary appoint persons, busy driving and other potentially dangerous activities, requires a clear view, attention and a high reaction rate.

Cooperation