2006 Miotics

activity, an enzyme likely to be involved in the metabolism of action similar to that of ecothiopate iodide (p. 2007.2). It Uses and Administration of cydopentolate. has been used as a 0.125 or 0.25% ophthalmic solution in Cyclopentolate hydrochloride is a tertiary amine antimusca­ l. Awan KJ. Adverse systemic reactions of topical cyclopentolate the treatment of open-angle glaucoma and in the diagnosis rinic with actions similar to those of atropine (p. 1310.3). It hydrochloride. Ann Ophthalmol l976; 8: 695-8. and management of accommodative convergent strabismus. is used to produce mydriasis and cycloplegia (p. 2000.2) for 2. Bauer CR. et al. Systemic cyclopentolate (Cyclogyl) toxicity in the Pediatr 92: ophthalmic diagnostic procedures and also in the treatment newborn infant. 1 1973; 501�5. 3. Fitzgerald DA, et al. Seizures associated with 1% cyclopentolate i of uveitis and iritis (p. 1615.1). It acts more quickly than eyedrops. J Paediatr Child Health 1990; 26: 106-7. Preparat ons atropine and has a shorter duration of action; the maximum 4. Demayo AP, Reidenberg MM. Grand mal seizure in a child 30 minutes mydriatic effect is produced 30 to 60 minutes after after Cyclogyl (cyclopentolate hydrochloride) and 10% Neo-Synephrine Pharmacopoeial Preparations (phenylephrine hydrochloride) eye drops were instilled. Abstract: USP 36: instillation, and may persist for up to 24 hours or longer in Demecarium Bromide Ophthalmic Solution. Pediatrics 2004; 113: 1390-1. Full version: http:f/pcdiatrics. some patients; the maximum cycloplegic effect is produced aappublications.org/cgi/reprim/ll3/5/e499 (accessed 24111/05) within 25 to 75 minutes and accommodation recovers within 6 to 24 hours. For diagnostic procedures, instillation of a 0.5% Interactions ophthalmic solution of cydopentolate hydrochloride, As for antimuscarinics in general (see Atropine Sulfate, repeated after about 5 to 15 minutes if necessary, is usually p. 1312.3). sufficient. Higher strengths have been used. In the treatment of uveitis and iritis, a 0.5% ophthalmic solution of cyclopentolate hydrochloride is instilled into the ProprietaryPreparations (details are given in Volume B) eye up to four times daily. Deeply pigmented eyes are more resistant to pupillary Single-ingredient Preparations, Arg. : Ciclopenal; Austral.: Cyclo­ dilatation and may require the use of a 1% solution. gyl; Belg.: Cyclogyl; Braz. : Ciclolato; Cicloplegico; Canad.: Ak­ Chile: China: For details of doses in children, see below. Pentolate; Cyclogyl; Diopentolate; Cyclogyl; Cyclogyl ('1\''i.it); Denm.: Cyclogyl; Fin.: Oftan Syklo; Fr.: Skiacol; Ger.: Zykolat-EDO; Gr.: Cyclogyl; Hong Kong: Cyclo­ Administration in children, For diagnostic procedures in gyl; Hung. : Humapent; India: Bell Pentolatet; Cyclate; Cyclo­ children, instillation of a I% ophthalmic solution of cyclo­ gik; Cyclogyl; Cyclopent; Dilate; Irl.: Mydrilate; Ital. : Ciclolux; pentolate hydrochloride, repeated after about 5 to 15 min­ Malaysia: Colircusi Cicloplejico; Cyclogyl; Mex. : Refractyl; Diclofenamide is an inhibitor of carbonic anhydrase with utes if necessary, is usually sufficient. Higher strengths Neth.: Cyclogyl; NZ: Cyclogyl; Port. : Cicloplegicedol; Midrioda­ properties similar to those of acetazolamide (p. 200 l.l). have been used. However, some recommend that vi; Rus.: Cyclomed (UHKJIOMM); Cycloptic (UHKJIOITTHK); S.Afr. : When given orally its effect begins within hour and lasts strengths greater than 0.5% should not be used in infants Cyclogyl; Singapore: Cyclogylt; Spain: Ciclopegic; Cicloplejico; I and that cyclopentolate should not be used at all during Swed. : Cyclogyl; Switz.: Cyclogyl; Thai.: Cyclogyl; Turk. : Siklo­ for 6 to 12 hours. Diclofenamide is used to reduce intra-ocular pressure in the first 3 months of life. mid; Sikloplejin; UK: Mydrilate; Ukr. : Cyclomed (l.(HKJIOMe.IJ;); In the treatment of uveitis, the BNFC suggests that a USA: Ak-Pentolate; Cyclogyl; Ocu-Pentolate; Pentolairt; glaucoma (p. 1999.1). The usual initial oral dose is I 00 mg every 6 to 12 hours until the desired response is obtained, 0.5% ophthalmic solution of cyclopentolate hydrochloride Venez. : Cyclogyl. followed by a maintenance dose of 50 mg every 8 hours. may be instilled into the eye 2 to 4 times daily; a 1% India: Cycdex; Cyclogyl-D; Cyclo­ Multi·ingredient Preparations. Didofenamide sodium has been given by injection. solution should be used for deeply pigmented eyes. pent Plus; Cyclopent-DM; Malaysia: Cyclomydril; S.Afr. : Cyclo­ mydril; Singapore: Cyclomydrilt; USA: Cyclomydril. Diclofenamide may be of benefit in hyper- and hypokalaemic periodic paralysis. Adverse Effects, Treatment, and Precautions Pharmacopoeial Preparations BP 2014: Cyclopentolate Eye Drops; As for Atropine Sulfate, p. 1312.1. USP 36: Cyclopentolate Hydrochloride Ophthalmic Solution. Preparations Eye drops of cyclopentolate hydrochloride may cause ...... (details are given in Volume B) temporary irritation. ProprietaryPreparations Dapipra:z:ole Hydrochloride (USAN, r/NNM) Single-ingredient Preparations. Gr.: Oratrol; Ital.: Antidrasit; Abuse, Cyclopentolate eye drops have been abused. 1 One Spain: de, Da iprazole,. Chlorhy, Fenamide; Glauconidet. of 2 patients who did so had been instilling 200 to 400 AF-2139; Dapiprazol. hidrodoruro p drale d<:\ Dapiprazoli Hydrochlof!dum; Hidroc!oruro de drops of cyclopentolate into both eyes daily for about 4 . Pharmacopoeial Preparations months, presumably for its CNS effects, and had intense daplprazol; ,[lan\<1npa3olla f'14AP0><11opMA. USP 36: Dichlorphenamide Tablets. nausea, vomiting, weakness, and tremors on withdrawal. S,q,7,8·Tetril hydro-3-[2 -14·0'lolxh1-piper azinyilethyJJ··Hria­ l. Sato EH, et al. Abuse of cydopentolate hydrochloride (Cydogyl)· drops. N zolo[4,�-a]pyridine monohydrochioride 326: Engl 1 Med 1992; 1363---4. C:lfpN:,!-lCI:'361.9 . Dorzolamide Hydrochloride C45· ;_ . T}lf22 -!:PJ (di:rpiptazole;; 72822- 13.-0 (dapipraz;ole Hypersensitivity. Two children developed hypersensitivity hyctr��hJoride), (BANM, USAN, r/NNM) @ reactions shortly after the instillation of I% cyclopentolate ATC� S01EX02. Dorzolamid Hidrokloror: Dorzolamida, . tlidrodon.;ro de; hydrochloride eye drops into each eye.1 Both children . ATCVet -::-- QSQ iEX02, Dorzolamide, Chforhyd rate Dorzolamidhydro hlori�; initially had a facial rash but in one of them the rash later d�; · � iJJ\fil -· DS9U)Nl !(JX. Dorzolamidi hydrochloridu ; Hidroclorura de .dormlarr>ida; spread to include the arms and legs and was accompanied !11 (dorzolamide); by mild breathlessness. L-671152 MK-0507; i'vll<-'507; .Qop3onaMMAa I. Jones LWJ, Hodes DT. Possible allergic reactions to cydopentolate f11APQXf10PI11l. (45,65}-4,(Ethyiam!no)'5,6,dihydro-6-rrethyi-4H. thien (2,3'" hydrochloride: case reports with literature review of uses and adverse Dapiprazole hydrochloride is an alpha blocker given as eye ? reactions. Ophthalmic Physiol Opt 1991; II: 16-21. .blthiopyranc 2-Sbeta blocker. A 4-year-old boy with cerebral palsy and paraplegia Dorzolamide is given as eye drops containing dorzola­ suffered tonic-clonic seizures, facial flushing, and tachy­ mide hydrochloride equivalent to 2% of the base. For cardia 70 minutes after one drop of a 1% cyclopento1ate USP 36: (Demecarium Bromide). A white or slightly yellow, monotherapy it is usually given three times daily; a twice­ solution was instilled into each eye to dilate his pupils.1 The slightly hygroscopic, crystalline powder. Freely soluble in daily regimen is recommended when used with a beta child had no history of convulsions and had received 1% water and in alcohol; sparingly soluble in acetone; soluble in blocker. cyclopentolate eye drops on 2 previous occasions without ether. pH of a l% solution in water is between 5.0 and 7.0. incident. In a more recent case,4 a 23-month-old boy had a Store in airtight containers. Protect from light. References. tonic-clonic seizure lasting 30 minutes after the use of 1. Lesk MR, et al. Effectiveness and safety of dorzolamide-timolol alone or cyclopentolate I% and phenylephrine 10% eye drops. One combined with latanoprost in open-angle glaucoma or ocular 42: drop of each was instilled into both eyes every 5 minutes for Profile hypertension. Ann Pharmacother 2008; 498-504. 2. Katz U, et a!. Efficacy and of brimonidine and dorzolamidc for 3 doses; the seizure occurred 45 minutes after the last dose. Demecarium is a quaternary ammoniuni compound that is intraocular lowering glaucoma and ocular hypertension. The child was found to have low pseudocholinesterase a reversible inhibitor of cholinesterase with a long duration Curr Med Res 2007; 23: 2971-83.

All cross-references refer to entries in Volume A