II. Indication
- Open Angle Glaucoma second line agent (adjunctive)
- Presbyopia (Pilocarpine or Vuity)
III. Contraindications
- Ocular inflammation
IV. Mechanism
- Reduces resistance to aqueous outflow (decreases IOP 20 to 30%)
V. Medications (Green Cap)
-
Cholinergic Agonists
- Pilocarpine (Isoptocarpine, Pilopine gel, Ocusert, Pilocar)
- Dosing: 1 drop three to four times daily
- Most common Cholinergic Agent used in Open Angle Glaucoma
- Carbachol (Isopto Carbachol)
- Pilocarpine (Isoptocarpine, Pilopine gel, Ocusert, Pilocar)
-
Anticholinesterases
- Echothiophate (Phospholine Iodide)
- Demacarium (Humorsol)
VI. Adverse Effects
- Generally well tolerated
- Burning or stinging
- Cataract formation
- Pupil Constriction or Miosis (primary expected effect)
- Headache
- Systemic effects (if absorbed)
VII. Drug Interactions
- Dicylomine
VIII. References
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Definition (NCI) | A synthetic choline ester and a positively charged quaternary ammonium compound. Carbachol is a parasympathomimetic that mimics the effect of acetylcholine on both the muscarinic and nicotinic receptors. This drug is administered ocularly to induce miosis to reduce intraocular pressure in the treatment of glaucoma. Carbachol is also used to stimulate micturition by contraction of detrusor muscle. This drug may cause hypotension, bradycardia, nausea, vomiting, bronchospasm, and abdominal cramps. |
Definition (MSH) | A slowly hydrolyzed cholinergic agonist that acts at both muscarinic and nicotinic receptors. |
Definition (CSP) | slowly hydrolyzed cholinergic agonist that acts at both muscarinic and nicotinic receptors. |
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | D002217 |
SnomedCT | 326500009, 33675006, 387183001 |
English | Carbachol, Carbacholine, Carbocholine, Ethanaminium, 2-((aminocarbonyl)oxy)-N,N,N-trimethyl-, chloride, Carbachol [urine retention], 2-((Aminocarbonyl)oxy)-N,N,N-trimethylethanaminium Chloride, carbachol (medication), Carbachol [Chemical/Ingredient], carbacholine, CARBACHOL, carbachol, Carbachol [urine retention] (product), Carbamoylcholine chloride, Carbamylcholine chloride, Carbachol (product), Carbachol (substance), Carbachol [urine retention] (substance), Bioniche Brand of Carbachol, NutraMax Brand of Carbachol |
Swedish | Karbakol |
Czech | karbachol |
Finnish | Karbakoliini |
Italian | Carbacolina, Carbacolo |
Russian | KARBAKHOLIN, KARBAMILKHOLIN, КАРБАМИЛХОЛИН, КАРБАХОЛИН |
Japanese | カルバミルコリン, カルバコール |
Croatian | KARBAHOL |
Polish | Karbachol, Karbamylocholina |
Spanish | carbacol [retención urinaria] (producto), carbacol [retención urinaria], carbacol (producto), carbacol (sustancia), carbacolina, carbacol, cloruro de carbamilcolina, Carbacol |
French | Carbachol, Carbacholine, Carbaminoylcholine |
German | Carbachol |
Portuguese | Carbacol |
Ontology: Miotics (C0026207)
Definition (MSH) | Agents causing contraction of the pupil of the eye. Some sources use the term miotics only for the parasympathomimetics but any drug used to induce miosis is included here. |
Definition (CSP) | agent that causes the pupil of the eye to contract. |
Concepts | Pharmacologic Substance (T121) |
MSH | D008916 |
SnomedCT | 372822009, 69242008 |
English | Miotics, pupillary constrictor, miotic, miotics, Miotic, Miotic (product), Miotic (substance), Miotic, NOS, Miotics, Ophthalmic |
French | Agents myotiques, Médicaments myotiques, Miotiques, Myotiques |
Swedish | Pupillsammandragande medel |
Czech | miotika |
Finnish | Miootit |
Russian | ANTIKHOLINESTERAZNYE SREDSTVA, M-KHOLINOMIMETICHESKIE SREDSTVA, MIOTIKI, MIOTICHESKIE SREDSTVA, M-ХОЛИНОМИМЕТИЧЕСКИЕ СРЕДСТВА, АНТИХОЛИНЭСТЕРАЗНЫЕ СРЕДСТВА, МИОТИКИ, МИОТИЧЕСКИЕ СРЕДСТВА |
Croatian | MIOTICI |
Polish | Miotica, Leki zwężające źrenice |
Spanish | Efecto Miótico, miótico (producto), miótico (sustancia), miótico, Mióticos |
Portuguese | Efeito Miótico, Mióticos |
German | Miotika |
Italian | Preparati miotici |
Ontology: Parasympathomimetic Agents (C0030512)
Definition (MSH) | Drugs that mimic the effects of parasympathetic nervous system activity. Included here are drugs that directly stimulate muscarinic receptors and drugs that potentiate cholinergic activity, usually by slowing the breakdown of acetylcholine (CHOLINESTERASE INHIBITORS). Drugs that stimulate both sympathetic and parasympathetic postganglionic neurons (GANGLIONIC STIMULANTS) are not included here. |
Concepts | Pharmacologic Substance (T121) |
MSH | D010277 |
SnomedCT | 19581007, 372668005 |
English | Parasympathomimetics, Agents, Parasympathomimetic, Drugs, Parasympathomimetic, Parasympathomimetic Agents, Parasympathomimetic Drugs, parasympathomimetic agent, parasympathomimetics, parasympathomimetics (medication), parasympathomimetic drugs, parasympathomimetic drug, parasympathomimetic agents, parasympathomimetic, PARASYMPATHOMIMETICS, Parasympathomimetic agents, Parasympathomimetic, Parasympathomimetic agent (product), Parasympathomimetic agent (substance), Parasympathomimetic agent, Parasympathomimetic agent, NOS |
Swedish | Parasympatomimetika |
Czech | parasympatomimetika, cholinomimetika |
Finnish | Parasympatomimeetit |
French | Médicaments parasympathomimétiques, Agents parasympathomimétiques, Parasympathomimétiques |
Russian | PARASIMPATOMIMETIKI, ПАРАСИМПАТОМИМЕТИКИ |
Croatian | PARASIMPATOMIMETICI |
Polish | Leki parasympatykomimetyczne |
Japanese | 副交感神経興奮薬, 副交感神経作動剤, 副交感神経作動薬, 副交感神経様作動物質, 副交感神経様作動薬, 副交感神経様作用薬物 |
Spanish | Efecto Parasimpaticomimético, agente parasimpaticomimético (producto), agente parasimpaticomimético (sustancia), agente parasimpaticomimético, Parasimpaticomiméticos |
Portuguese | Efeito Parassimpatomimético, Parassimpatomiméticos |
German | Parasympathikomimetika |
Italian | Parasimpatomimetici |
Ontology: Echothiophate (C0301366)
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
SnomedCT | 387339003, 60682004 |
English | echothiophate, ecothiopate, ECHOTHIOPHATE, Echothiophate, Ecothiopate, Echothiophate (product), Echothiophate (substance) |
Spanish | ecotiofato (producto), ecotiofato (sustancia), ecotiofato |