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Echothiophate Iodide
Pronunciation
U.S. Brand Names
Generic Available
Synonyms
Pharmacological Index
Use
Pregnancy Risk Factor
Contraindications
Warnings/Precautions
Adverse Reactions
Overdosage/Toxicology
Drug Interactions
Stability
Mechanism of Action
Pharmacodynamics/Kinetics
Usual Dosage
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
(ek oh THYE oh fate EYE oh dide)

U.S. Brand Names
Phospholine Iodide® Ophthalmic

Generic Available

No


Synonyms
Ecostigmine Iodide

Pharmacological Index

Ophthalmic Agent, Antiglaucoma; Ophthalmic Agent, Miotic


Use

Reverse toxic CNS effects caused by anticholinergic drugs; used as miotic in treatment of open-angle glaucoma; may be useful in specific case of narrow-angle glaucoma; accommodative esotropia


Pregnancy Risk Factor

C


Contraindications

Hypersensitivity to echothiophate or any component; most cases of angle-closure glaucoma; active uveal inflammation or any inflammatory disease of the iris or ciliary body, glaucoma associated with iridocyclitis


Warnings/Precautions

Tolerance may develop after prolonged use; a rest period restores response to the drug


Adverse Reactions

1% to 10%: Ocular: Stinging, burning eyes, myopia, visual blurring

<1%: Bradycardia, hypotension, flushing, nausea, vomiting, diarrhea, muscle weakness, retinal detachment, diaphoresis, browache, miosis, twitching eyelids, watering eyes, dyspnea


Overdosage/Toxicology

Symptoms of overdose include excessive salivation, urinary incontinence, dyspnea, diarrhea, profuse sweating

If systemic effects occur, administer parenteral atropine; for severe muscle weakness, pralidoxime may be used in addition to atropine


Drug Interactions

Increased toxicity: Carbamate or organophosphate insecticides and pesticides; succinylcholine; systemic acetylcholinesterases may increase neuromuscular effects


Stability

Store undiluted vials at room temperature (15°C to 30°C/59°F to 86°F); reconstituted solutions remain stable for 30 days at room temperature or 6 months when refrigerated


Mechanism of Action

Produces miosis and changes in accommodation by inhibiting cholinesterase, thereby preventing the breakdown of acetylcholine; acetylcholine is, therefore, allowed to continuously stimulate the iris and ciliary muscles of the eye


Pharmacodynamics/Kinetics

Onset of action: Miosis: 10-30 minutes; Intraocular pressure decrease: 4-8 hours

Peak intraocular pressure decrease: 24 hours

Duration: Up to 1-4 weeks


Usual Dosage

Adults:

Accommodative esotropia:

Diagnosis: Instill 1 drop of 0.125% once daily into both eyes at bedtime for 2-3 weeks

Treatment: Use lowest concentration and frequency which gives satisfactory response, with a maximum dose of 0.125% once daily, although more intensive therapy may be used for short periods of time


Mental Health: Effects on Mental Status

None reported


Mental Health: Effects on Psychiatric Treatment

None reported


Dental Health: Local Anesthetic/Vasoconstrictor Precautions

No information available to require special precautions


Dental Health: Effects on Dental Treatment

No effects or complications reported


Patient Information

Be sure of solution expiration date; local irritation and headache may occur; notify physician if abdominal cramps, diarrhea, or salivation occurs; use caution if driving at night or performing hazardous tasks; do not touch dropper to eye; report any change in vision to physician


Nursing Implications

Keep refrigerated; do not touch dropper to eye


Dosage Forms

Powder for reconstitution, ophthalmic: 1.5 mg [0.03%] (5 mL); 3 mg [0.06%] (5 mL); 6.25 mg [0.125%] (5 mL); 12.5 mg [0.25%] (5 mL)


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