Pilocarpine is a cholinergic agent, stimulating m-cholinergic receptors. With instillation in pilocarpine eye causes cramps and spasm of accommodation, lowers intraocular pressure. Reduction of intraocular pressure reduction caused by the ciliary muscles and the muscles of the iris, which leads to the expansion of the anterior chamber angle and changes the physical structure of the trabecular tissue, thereby facilitating the outflow of aqueous humor. This effect lasts from 4 to 14 hours. Timolol is a beta-blocker, which prevents the binding of neurotransmitters sympathomimetic beta-1 and beta-2 adrenergic receptors. It lowers intraocular pressure by reducing aqueous humor production. Localization of action of timolol -. Beta-2 adrenergic receptors in the ciliary body winstrol side effects pilocarpine well penetrates into the cornea. The concentration in the aqueous humor reached its maximum after 30 minutes. Pilocarpine associated in many ocular tissues. This prolongs the half-life of the eye, which extends from 1.5 to 2.5 hours. However, the effect of decreasing intraocular pressure continued for several hours. Pilocarpine is not metabolized in the aqueous humor, and stands out with her. Concomitant administration of timolol, which reduces the formation of intraocular fluid -. Weakening of the elimination rate of pilocarpine Timolol maleate is rapidly penetrates the cornea of the eye tissue. The small amount reaches the systemic circulation by absorption through the conjunctiva, the mucous membranes of the nose and the lachrymal tract. Excretion of metabolites – the kidneys. In infants and young children the concentration of the active substance substantially exceeds the C max in adults plasma.
Primary open-angle glaucoma, secondary glaucoma (uveal, afakicheskaya, posttraumatic), angle-closure glaucoma (in combination with miotikami), increased intraocular pressure after ophthalmic interventions.
Bronchial asthma, sinus bradycardia (50 or less beats per minute), AV blockade II-III century., Decompensated heart failure, cardiogenic shock, severe corneal degeneration, iritis, iridocyclitis, rhinitis, hypersensitivity to one of the components of the drug, chronic obstructive lung disease, children’s age.
of retinal detachment, cerebrovascular disorders, diabetes, hyperthyroidism, before operations under general anesthesia, hypoglycaemia, oral beta-blockers.
Pregnancy and lactation:
In pregnancy, drug use, if the expected benefit to the mother outweighs the potential risk to the fetus. During the use of the drug should stop breastfeeding.
Dosing and Administration
The drug is instilled into the affected eye 1 drop – 2 times a day. Evaluation of therapy should include measurement of intraocular pressure after approximately 4 weeks after starting treatment.
Side effects: Local reactions: redness eyelid skin, burning and itching in the eyes, eye pain, spasm of the ciliary muscle, induced myopia, conjunctival hyperemia, tearing or decrease lacrimation, photophobia, decreased visual acuity in low light, swelling of the corneal epithelium, a short break severity view; blepharitis, conjunctivitis, long-term use may develop superficial punctate keratopathy (reduced corneal transparency) and decreased corneal sensitivity, possible ptosis, rarely – diplopia. With prolonged use – clouding of the lens, the syndrome of “dry eye”, increased sweating, fatigue, confusion. systemic reactions: the rigidity of the iris, the iris cyst, retinal detachment, paresthesia, rhinitis, nasal congestion, nasal bleeding, decreased blood pressure, bradycardia, bradyarrhythmia, AV block, heart failure, cardiac arrest; dizziness, headache, drowsiness, hallucinations, muscle weakness, sexual dysfunction, decreased potency, transient winstrol side effects ischemic attack, collapse, depression; dyspnea, bronchospasm, pulmonary insufficiency; nausea, vomiting, diarrhea, allergic reactions (including urticaria).
The most common symptoms caused by an overdose of beta drenoblokatorov -bradikardiya, lowering blood pressure, bronchospasm, and acute heart failure.
Treatment of overdose mainly symptomatic. Atropine may be used as an antidote to pilocarpine. Isoprenaline can be administered intravenously to correct bradycardia or bronchospasm; dobutamine – for the treatment of arterial hypotension.
Interaction with other medicinal products
In interaction with calcium channel blockers or cardiac glycosides -perhaps violation of AV conduction, acute left ventricular failure or hypotension.
Drugs that violate deposit catecholamines (reserpine) contributes to the development of arterial hypotension (including orthostatic), bradycardia, and dizziness.
Concomitant use of beta-blockers for systemic effects leads to a strengthening of their pharmacological effect.
Before starting treatment winstrol side effects eve cancel other antiglaucoma drugs. Measurement of intraocular pressure is carried out at different times of the day. With long-term appointment may develop resistance. Eye drops Pilotimol ® contain as preservative benzalkonium chloride and should not be used while wearing contact lenses. Before using the product, remove contact lenses and re-install them no earlier than after 15 minutes.
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