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acetylcholine

S01EB09

Forms & Strengths

Intraocular solution: 1% (10 mg/mL) in 2 mL ampoules

Adult Dosing

Miosis induction during anterior segment surgery: 0.5 to 2 mL (5 to 20 mg) of 1% solution injected into the anterior chamber

Pediatric Dosing

Safety and efficacy in pediatric patients have not been established; dosing is extrapolated from adult usage based on anterior chamber volume

Indications

Rapid miosis during ophthalmic surgery (cataract, penetrating keratoplasty, iridectomy, and other anterior segment surgeries)

Mechanism of Action

Direct-acting cholinergic agonist that stimulates muscarinic receptors on the sphincter muscle of the iris, resulting in rapid miosis

Contraindications

Hypersensitivity to acetylcholine or any component of the formulation

Adverse Reactions

Corneal edema
Corneal clouding
Decompensation
Transient visual disturbances
Systemic effects are rare due to rapid hydrolysis by cholinesterase

Drug Interactions

Anticholinergic agents (e.g., atropine) may antagonize the miotic effect of acetylcholine
Topical cholinesterase inhibitors may potentiate systemic and ocular effects if co-administered

Curated Content: Needs Vetting Before Put to Clinical Use