Description
Pilocarpine Pharmacodynamics
M-cholinomimetic, has myotic and anti-glaucoma effects.
It causes contraction of the circular (miosis) and ciliary muscles (accommodation spasm), increases anterior chamber angle (iris root is retracted), increases permeability of the trabecular zone (trabecula tightens and blocked areas of Schlemm’s canal open), improves outflow of aqueous humor from eye and finally reduces intraocular pressure.
In primary open-angle glaucoma instillation of 1% solution causes decrease of intraocular pressure by 25-26%. The effect starts after 30-40 min, reaches a maximum after 1.5-2 h and lasts for 4-14 h.
Systems with prolonged release of pilocarpine provide control of intraocular pressure for 1 day, and induced myopia developing during the first hours quickly decreases and usually does not exceed 0.5 diopters.
Indications
– Acute onset of closed angle glaucoma; secondary glaucoma (vascular, post-traumatic (burn-in)), primary open-angle glaucoma (in combination with beta-adrenoblockers or other pressure-reducing medications); necessity for pupil constriction after mydriatic instillation.
Contraindications
Hypersensitivity to the drug components, iritis, cyclitis, iridocyclitis, keratitis, conditions after ophthalmologic surgeries and other eye diseases in which pupil constriction is undesirable. Children under 18 years of age. Pregnancy, breast feeding period.
With caution:
In patients with a history of retinal detachment and in young patients with high degree myopia.
Directions for use and dosages.
- It is applied into conjunctival sac in 1-2 drops 1-3 times a day. Number of instillations may vary depending on indications and individual sensitivity of a patient.
- For treatment of an acute attack of closed-angle glaucoma during the first hour 1 drop of pilocarpine solution is instilled every 15 min, during 2-3 hours every 30 min, during 4-6 hours every 60 min and further 3-6 times a day until the attack is stopped.
- If pupil constriction is necessary after mydriatic instillation, 1-2 drops are injected into the conjunctival sac 2-6 times a day.
