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carbachol; carbacholine; carbamylcholine (Isopto Carbachol, Miostat)
Tradenames: Isopto Carbachol, Miostat.
Indications:
1) treatment of glaucoma
2) miosis during surgery
Contraindications:
1) acute iritis
2) inflammation of the anterior chamber
Dosage:
1) ophthalmic: 1-2 drops QID PRN
2) intraocular: 0.5 mL instilled into anterior chamber before or after securing sutures
Intraocular (Miostat) 0.01% (1.5 mL)
Ophthalmic (Isopto Carbachol) 0.75%, 1.5%, 2.25%, 3% (15 mL)
Pharmacokinetics:
1) miosis occurs in 10-20 minutes
2) duration of action 4-8 hours
3) maximal reduction of intraocular pressure within 4 hours
Adverse effects:
1) not common (1-10%)
- blurred vision
- eye pain
2) uncommon (< 1%)
- headache, ciliary spasm with temporary loss of visual acuity, corneal clouding, persistent bullous keratopathy, postoperative keratitis, retinal detachment, transient ciliary & conjunctival injection, transient hypotension, asthma, increased peristalsis, stomach cramps, diarrhea
Mechanism of action:
1) acetylcholine analog with relatively more nicotinic receptor agonist activity & less muscarinic receptor agonist activity than acetylcholine [3]
2) direct-acting cholinergic agent that causes miosis
3) reduction of intraocular pressure
Interactions
drug interactions
Related
acetylcholine analog
General
ammonium compound
carbamate
miotic agent
parasympathomimetic (cholinergic agent)
Database Correlations
PUBCHEM correlations
References
- Drug Information & Medication Formulary, Veterans Affairs,
Central California Health Care System, 1st ed., Ravnan et al
eds, 1998
- Kaiser Permanente Northern California Regional Drug
Formulary, 1998
- The Pharmacological Basis of Therapeutics, 8th ed.
Gilman et al, eds. Permagon Press/McGraw Hill pg 143