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Pronunciation |
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(ek
oh THYE oh fate EYE oh
dide) |
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U.S. Brand
Names |
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Phospholine Iodide®
Ophthalmic |
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Generic
Available |
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No |
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Synonyms |
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Ecostigmine Iodide |
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Pharmacological Index |
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Ophthalmic Agent, Antiglaucoma; Ophthalmic Agent, Miotic |
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Use |
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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 |
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Pregnancy Risk
Factor |
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C |
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Contraindications |
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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 |
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Warnings/Precautions |
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Tolerance may develop after prolonged use; a rest period restores response to
the drug |
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Adverse
Reactions |
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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 |
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Overdosage/Toxicology |
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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 |
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Drug
Interactions |
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Increased toxicity: Carbamate or organophosphate insecticides and pesticides;
succinylcholine; systemic acetylcholinesterases may increase neuromuscular
effects |
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Stability |
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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 |
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Mechanism of
Action |
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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 |
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Pharmacodynamics/Kinetics |
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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 |
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Usual Dosage |
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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 |
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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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No effects or complications reported |
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Patient
Information |
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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 |
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Nursing
Implications |
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Keep refrigerated; do not touch dropper to eye |
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Dosage Forms |
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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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