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SENSORY ORGANS › OPHTHALMOLOGICALS › ANTIGLAUCOMA PREPARATIONS AND MIOTICS › Parasympathomimetics
physostigmine
S01EB05
Forms & Strengths
- Ophthalmic ointment: 0.25%
Adult Dosing
- Ophthalmic: Apply a small amount to the conjunctival sac up to 3 times daily as directed for glaucoma or specific conditions.
Pediatric Dosing
- Safety and efficacy in pediatric patients have not been established.
Indications
- Reduction of intraocular pressure in open-angle glaucoma
- Miosis induction in specific ophthalmic conditions
Mechanism of Action
- Reversible acetylcholinesterase inhibitor that enhances cholinergic neurotransmission in the eye, causing pupillary constriction (miosis), ciliary muscle contraction, and decreased intraocular pressure via increased aqueous humor outflow.
Contraindications
- Hypersensitivity to physostigmine or carbamate derivatives
- Active iritis or uveitis
- Secondary glaucoma caused by inflammatory disease
- Conditions where constriction of the pupil is undesirable
Adverse Reactions
- Blurred vision
- Brow ache and headache
- Eyelid twitching
- Conjunctival hyperemia
- Ciliary spasm
- Rare systemic cholinergic effects if absorbed (salivation, diaphoresis, bradycardia)
Drug Interactions
- Succinylcholine (prolonged neuromuscular blockade due to cholinesterase inhibition)
- Beta-blockers or other antiglaucoma agents (additive effects on intraocular pressure)
- Anticholinergic agents (antagonism of therapeutic effects)
Curated Content: Needs Vetting Before Put to Clinical Use