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Acetylcholine
Pronunciation
U.S. Brand Names
Generic Available
Synonyms
Pharmacological Index
Use
Pregnancy Risk Factor
Pregnancy/Breast-Feeding Implications
Contraindications
Warnings/Precautions
Adverse Reactions
Overdosage/Toxicology
Drug Interactions
Stability
Mechanism of Action
Pharmacodynamics/Kinetics
Usual Dosage
Administration
Mental Health: Effects on Mental Status
Mental Health: Effects on Psychiatric Treatment
Dental Health: Local Anesthetic/Vasoconstrictor Precautions
Dental Health: Effects on Dental Treatment
Patient Information
Nursing Implications
Dosage Forms

Pronunciation
(a se teel KOE leen)

U.S. Brand Names
Miochol-E®

Generic Available

No


Synonyms
Acetylcholine Chloride

Pharmacological Index

Cholinergic Agonist; Ophthalmic Agent, Miotic


Use

Produces complete miosis in cataract surgery, keratoplasty, iridectomy and other anterior segment surgery where rapid miosis is required


Pregnancy Risk Factor

C


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

Hypersensitivity to acetylcholine chloride and any components; acute iritis and acute inflammatory disease of the anterior chamber


Warnings/Precautions

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


Adverse Reactions

<1%: Bradycardia, hypotension, flushing, headache, altered distance vision, decreased night vision, transient lenticular opacities, dyspnea, diaphoresis


Overdosage/Toxicology

Treatment includes flushing eyes with water or normal saline and supportive measures; if accidentally ingested, induce emesis or perform gastric lavage


Drug Interactions

Decreased effect possible with flurbiprofen and suprofen, ophthalmic

Increased effect may be prolonged or enhanced in patients receiving tacrine


Stability

Prepare solution immediately before use and discard unused portion; acetylcholine solutions are unstable


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

Onset of miosis: Occurs promptly

Duration: ~10 minutes


Usual Dosage

Adults: Intraocular: 0.5-2 mL of 1% injection (5-20 mg) instilled into anterior chamber before or after securing one or more sutures


Administration

Reconstitute immediately before use


Mental Health: Effects on Mental Status

None reported


Mental Health: Effects on Psychiatric Treatment

Intraocular product; should not impact psychiatric drug treatment


Dental Health: Local Anesthetic/Vasoconstrictor Precautions

No information available to require special precautions


Dental Health: Effects on Dental Treatment

Ophthalmic use of acetylcholine has no effect on dental treatment


Patient Information

May sting on instillation; use caution while driving at night or performing hazardous tasks; do not touch dropper to eye


Nursing Implications

Discard any solution that is not used; open under aseptic conditions only


Dosage Forms

Powder, intraocular, as chloride: 1:100 [10 mg/mL] (2 mL, 15 mL)


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