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Pronunciation |
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(KAR
ba
kole) |
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U.S. Brand
Names |
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Carbastat® Ophthalmic; Carboptic®
Ophthalmic; Isopto® Carbachol Ophthalmic; Miostat®
Intraocular |
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Generic
Available |
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No |
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Synonyms |
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Carbacholine; Carbamylcholine Chloride |
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Pharmacological Index |
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Cholinergic Agonist; Ophthalmic Agent, Antiglaucoma; Ophthalmic Agent,
Miotic |
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Use |
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Lowers intraocular pressure in the treatment of glaucoma; cause miosis during
surgery |
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Pregnancy Risk
Factor |
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C |
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Contraindications |
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Acute iritis, acute inflammatory disease of the anterior chamber,
hypersensitivity to carbachol or any component |
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Warnings/Precautions |
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Use with caution in patients undergoing general anesthesia and in presence of
corneal abrasion |
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Adverse
Reactions |
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1% to 10%: Ocular: Blurred vision, eye pain
<1%: Transient fall in blood pressure, headache, stomach cramps, diarrhea,
ciliary spasm with temporary decrease of visual acuity, corneal clouding,
persistent bullous keratopathy, postoperative keratitis, retinal detachment,
transient ciliary and conjunctival injection, asthma, increased peristalsis
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Overdosage/Toxicology |
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Symptoms of overdose include miosis, flushing, vomiting, bradycardia,
bronchospasm, involuntary urination
Atropine is the treatment of choice for intoxications manifesting with
significant muscarinic symptoms. Atropine I.V. 2-4 mg every 3-60 minutes (or
0.04-0.08 mg I.V. every 5-60 minutes if needed for children) should be repeated
to control symptoms and then continued as needed for 1-2 days following the
acute ingestion. Epinephrine 0.1-1 mg S.C. may be useful in reversing severe
cardiovascular or pulmonary sequelae. |
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Drug
Interactions |
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Decreased effect of carbachol possible with topical
NSAIDs |
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Stability |
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Intraocular: Store at room temperature of 15°C to
30°C/59°F to
86°F
Topical: Store at 8°C to
27°C/46°F to
80°F |
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Mechanism of
Action |
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Synthetic direct-acting cholinergic agent that causes miosis by stimulating
muscarinic receptors in the eye |
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Pharmacodynamics/Kinetics |
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Ophthalmic instillation:
Onset of miosis: 10-20 minutes
Duration of reduction in intraocular pressure: 4-8 hours
Intraocular administration:
Onset of miosis: Within 2-5 minutes
Duration: 24 hours |
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Usual Dosage |
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Adults:
Intraocular: 0.5 mL instilled into anterior chamber before or after securing
sutures |
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Mental Health: Effects
on Mental Status |
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None reported |
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Mental Health:
Effects on Psychiatric
Treatment |
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None reported |
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Dental Health: Local
Anesthetic/Vasoconstrictor
Precautions |
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No information available to require special precautions |
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Dental Health:
Effects on Dental Treatment |
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Ophthalmic use of carbachol has no effect on dental
treatment |
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Patient
Information |
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May sting on instillation; may cause headache, altered distance vision, and
decreased night vision |
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Nursing
Implications |
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Finger pressure should be applied on the lacrimal sac for 1-2 minutes
following topical instillation; remove excess around the eye with a tissue.
Instillation for miosis prior to eye surgery should be gentle and parallel to
the iris face and tangential to the pupil border; discard unused
portion. |
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Dosage Forms |
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Solution:
Topical, ophthalmic:
Carboptic®: 3% (15 mL)
Isopto® Carbachol: 0.75% (15 mL, 30 mL); 1.5% (15 mL,
30 mL); 2.25% (15 mL); 3% (15 mL, 30 mL)
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