Miotic agent

The are mainly used for the treatment of glaucoma, especially when other miotic agents fail. 

Therapeutic uses Because of its high potency and relatively long duration of action, carbachol is rarely used therapeutically, except in the eye as a miotic agent to cause contraction of the pupil and a decrease in intraocular pressure. 

An insecticide. Ingestion can cause damage to eyes, nausea, vomiting, diarrhea, and central nervous system disturbances. An FDA proprietary drug. Used as a miotic agent. When heated to decomposition it emits toxic fumes of F and POx. See also PARATHION. 

Glaucoma therapy with strong miotic agents in myopic eyes... 

The use of strong miotics in myopic patients has been the cause of negligence claims when therapy has resulted in retinal detachment. Patients who are at risk for detachment should not be treated with miotic agents initially. To comply with the doctrine of informed consent, the use of miotics should be preceded by a discussion with patients of the risks and benefits of the drug chosen. When miotics are used for treatment, patients should be examined carefully to rule out the presence of risk factors (e.g., lattice degeneration) that may increase the likelihood of a retinal detachment. 

Demadex torasemide. demecarium bromide [ban, inn, jan] (bc 48 Humorsol ) is a bisquaternary ammonium compound, a reversible ANTICHOLINESTERASE used topically as a MIOTIC AGENT in ANTIGLAUCOMA TREATMENT. 

Carbachol is a potent direct-acting miotic agent its duration of action is longer than that of pilocarpine (8 to 10 hours) because of resistance to hydrolysis by cholinesterases. This drug also may act as a weak inhibitor of cholinesterase. Patients with an inadequate response to or intolerance of pilocarpine as a result of ocular hritation or allergy frequently do well on carbachol. The ocular and systemic adverse effects of carbachol are similar to butmore frequent, constant, and severe than those of pilocarpine. " ... 

The strong insecticidal and acaricidal effect of this compound is linked with a high toxicity to warm-blooded animals (ld q for rats is 3 mg/kg), so that it has not been used in agriculture. In ophthalmology it is used as a miotic agent under the name Mintacol . 

Topical miotic agents are historically important glaucoma medications but are less commonly used today. Miotics lower lOP by causing muscarinic-induced contraction of the ciliary muscle, which facilitates aqueous outflow. They do not affect aqueous production. Multiple miotic agents have been developed. Pilocarpine and carbachol are cholinomimetics that stimulate muscarinic receptors. Ecbotbiopbate (Phospholine iodide) is an organophosphate inhibitor of acetylcholinesterase it is relatively stable in aqueous solution and, by virtue of its quaternary ammonium structure, is positively charged and poorly absorbed. The usefulness of these medicines is lessened by their numerous side effects and the need to use them three to four times a day. 

Pilocarpine is used as a miotic agent in the therapy of glaucoma, and is also used in the therapy of xerostomia caused by drugs with a high degree of antimuscarinic effects. 

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