Cyclopentolate anticholinergic

Patients with Down syndrome are hypersensitive to topically applied anticholinergic agents. The pupils often dilate widely in response to tropicamide, reflecting an imbalance between cholinergic and adrenergic autonomic activity in the iris. Cyclopentolate, scopolamine, homatropine, and atropine should therefore be avoided in these patients if at all possible. 

The mydriatic and cycloplegic activities of anticholinergics in humans are listed in Table 3.18. Atropine is recommended in situations requiring complete and prolonged relaxation of the sphincter of iris and the ciliary muscle. Mydriatics, like cyclopentolate, eucatropine, and homatropine bromide, with a shorter duration of action, are usually preferred for measuring refractive errors because of the relative rapidity with which their cycloplegic effects are terminated. 

The central side effects have appeared among children even when cyclopentolate, tropicamide, and other anticholinergics are used as mydriatics. All anticholinergics increase intraocular pressure in most patients with simple glaucoma. 

Cyclopentolate, an anticholinergic agent with mydriatic and cycloplegic properties (2 drops of 0.5% solution), is used in diagnostic procedures requiring mydriasis and cyclople-gia (see also Figure 69). 

Persons exposed to nerve agents sometimes complain of blurred as well as dim vision. In one study,59 visual acuity was examined in six subjects before and after exposure to sarin vapor at a Ct of 15 mg min/m3. Near visual acuity was not changed in any of the six after exposure and was worsened after an anticholinergic drug (cyclopentolate) was instilled in the eyes. Far visual acuity was unchanged after sarin exposure in five of the six subjects and was improved in the sixth, who nonetheless complained that distant vision was blurred after sarin. 

Cyclopentolate is an anticholinergic drug used in eye drops as a mydriatic. It can cause both local [19 ] and systemic adverse reactions [20, 21 ]. 

Drug abuse Anticholinergic drugs are subject to abuse because of psychotropic, hallucinogenic, and euphoriant properties [46 ] and have been reported with cyclopentolate [47 ]. 

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