Pharm

Muscarinic Agonist

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Muscarinic Agonist, Pilocarpine, Salagen, Cevimeline, Evoxac

  • Mechanism
  1. Cholinergic agonist acting at muscarinic receptors
  • Indications
  1. Sjogren's Syndrome Dry Eyes (and possibly Dry Mouth) refractory to general measures
  • Contraindications
  1. Angle closure Glaucoma
  2. Uncontrolled Asthma
  • Adverse effects
  1. Diaphoresis
  2. Decreased night Vision
  3. Nonselective agents (Pilocarpine) may have cardiopulmonary effects
  • Preparation
  • Pilocarpine (Salagen)
  1. Nonselective (may have cardiac or lung effects)
  2. Dose: 5 mg orally twice daily
  • Preparation
  • Cevimeline (Evoxac)
  1. Selective for exocrine glands
  2. Dose: 30 mg orally three times daily
  • References
  1. Fife (2002) Arch Intern Med 162(11): 1293-300 [PubMed]
  2. Ono (2004) Am J Ophthalmol 138(1): 6-17 [PubMed]
  3. Tsifetaki (2003) Ann Rheum Dis 62(12): 1204-7 [PubMed]
  4. Wu (2006) J Formos Med Assoc 105(10): 796-803 [PubMed]