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Pronunciation |
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(a
se teel KOE
leen) |
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U.S. Brand
Names |
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Miochol-E® |
|
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Generic
Available |
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No |
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Synonyms |
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Acetylcholine Chloride |
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Pharmacological Index |
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Cholinergic Agonist; Ophthalmic Agent, Miotic |
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|
Use |
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Produces complete miosis in cataract surgery, keratoplasty, iridectomy and
other anterior segment surgery where rapid miosis is
required |
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Pregnancy Risk
Factor |
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C |
|
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Pregnancy/Breast-Feeding
Implications |
|
Acetylcholine is used primarily in the eye and there are no reports of its
use in pregnancy; because it is ionized at physiologic pH, transplacental
passage would not be expected |
|
|
Contraindications |
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Hypersensitivity to acetylcholine chloride and any components; acute iritis
and acute inflammatory disease of the anterior chamber |
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|
Warnings/Precautions |
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Systemic effects rarely occur but can cause problems for patients with acute
cardiac failure, bronchial asthma, peptic ulcer, hyperthyroidism, GI spasm,
urinary tract obstruction, and Parkinson's disease; open under aseptic
conditions only |
|
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Adverse
Reactions |
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<1%: Bradycardia, hypotension, flushing, headache, altered distance
vision, decreased night vision, transient lenticular opacities, dyspnea,
diaphoresis |
|
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Overdosage/Toxicology |
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Treatment includes flushing eyes with water or normal saline and supportive
measures; if accidentally ingested, induce emesis or perform gastric
lavage |
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Drug
Interactions |
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Decreased effect possible with flurbiprofen and suprofen, ophthalmic
Increased effect may be prolonged or enhanced in patients receiving tacrine
|
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Stability |
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Prepare solution immediately before use and discard unused portion;
acetylcholine solutions are unstable |
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|
Mechanism of
Action |
|
Causes contraction of the sphincter muscles of the iris, resulting in miosis
and contraction of the ciliary muscle, leading to accommodation
spasm |
|
|
Pharmacodynamics/Kinetics |
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Onset of miosis: Occurs promptly
Duration: ~10 minutes |
|
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Usual Dosage |
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Adults: Intraocular: 0.5-2 mL of 1% injection (5-20 mg) instilled into
anterior chamber before or after securing one or more
sutures |
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|
Administration |
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Reconstitute immediately before use |
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Mental Health: Effects
on Mental Status |
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None reported |
|
|
Mental Health:
Effects on Psychiatric
Treatment |
|
Intraocular product; should not impact psychiatric drug
treatment |
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Dental Health: Local
Anesthetic/Vasoconstrictor
Precautions |
|
No information available to require special precautions |
|
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Dental Health:
Effects on Dental Treatment |
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Ophthalmic use of acetylcholine has no effect on dental
treatment |
|
|
Patient
Information |
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May sting on instillation; use caution while driving at night or performing
hazardous tasks; do not touch dropper to eye |
|
|
Nursing
Implications |
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Discard any solution that is not used; open under aseptic conditions
only |
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Dosage Forms |
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Powder, intraocular, as chloride: 1:100 [10 mg/mL] (2 mL, 15
mL) |
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