Cyclopentolate hydrochloride

Pharmacological properties

Cyclopentolate, blocking m-cholinergic receptors, prevents the action of the mediator of cholinergic synapses - acetylquinoline. as a result of blocking cholinergic synapses located in the sphincter of the pupil and in the ciliary muscle, the pupil dilates due to the predominance of muscle tone, expanding the pupil, and relaxation of the muscle, narrowing the pupil. at the same time, due to relaxation of the ciliary (accommodation) muscle, paralysis of accommodation (cycloplegia) develops. pupil expansion occurs within 15-30 minutes after a single instillation. mydriasis persists for 6–12 hours; in particularly sensitive patients, mydriasis can persist much longer. residual cycloplegia persist for 12-24 hours. The drug has a mild antispasmodic effect, reduces the secretion of salivary, gastric, bronchial, sweat glands and pancreas; increases intraocular pressure; reduces the tone of the vagus nerve, which leads to an increase in heart rate with a slight increase in hell.

Penetrates through the BBB; in medium therapeutic doses, has a moderately pronounced stimulating effect on the central nervous system, stimulates respiration.

It is well absorbed through the conjunctiva. A significant level in the central nervous system is achieved in 0.5–1 hours. Connection with blood plasma proteins is moderately expressed. The half-life is 2 hours.

Indications

For diagnostic purposes with ophthalmoscopy; determination of refraction; in preoperative preparation - to dilate the pupil during cataract extraction; in inflammatory diseases of the anterior eye (episiscleritis, scleritis, keratitis, iridocyclitis, uveitis) as part of complex therapy.

Application

Locally, instill 1-2 drops in the conjunctival sac of the eye.

For fundus examination: 1 drop at an interval of 10 minutes 1-3 times a day.

In the study of refraction in children and adolescents - 1-2 drops with an interval of 15-20 minutes 2-3 times a day.

In inflammatory diseases - 1 drop 3 times a day, in severe cases, it is allowed to use 1 drop every 3-4 hours.

Contraindications

Glaucoma, hypersensitivity to the components of the drug.

Side effects

Conjunctival hyperemia and discomfort after instillation, a temporary decrease in visual acuity, increased intraocular pressure in patients with primary glaucoma, weakness, nausea, dizziness, tachycardia. in children sensitive to cyclopentolate, general weakness, nausea, dizziness, drowsiness, dry mouth, headache, and occasionally tachycardia can develop.

special instructions

Cyclomed is less effective in patients with dark pigmented irises. in this category of persons, when using the drug, residual accommodation can reach 2–4 diopters.

In children with a steady spasm of accommodation for cycloplegia, it is better to conduct a course of instillation of atropine sulfate.

When using Cyclomed in elderly patients, it is necessary to control intraocular pressure.

Patients with hypersensitivity to atropine do not have a cross allergy to Cyclomed, which allows it to be used in this category of patients. During the period of use of the drug should refrain from driving and other potentially dangerous activities.

Since the effect of the drug during pregnancy and lactation has not been studied enough, the use in this category of patients is possible only if the expected therapeutic effect exceeds the risk of developing possible side effects in the fetus or infant.

Use the drug with caution in children under the age of 3 years, in patients over the age of 60 years, with intestinal obstruction, prostatic hyperplasia.

Interactions

Sympathomimetics (phenylephrine) can enhance the effect of cyclomed, and m-cholinomimetics (pilocarpine) can weaken it.m-cholinomimetics with simultaneous use with cyclomed can increase the severity of its side effects.

Overdose

With strict observance of the recommendations, an overdose was not observed. however, in case of exceeding the recommended doses of the drug, as well as when taking the drug inside, the following symptoms may be observed: dry skin and mucous membranes, tachycardia, agitation and neuropsychic abnormalities (speech impairment, increased fatigue, disorientation in space, emotional disturbances); when taken in very high doses - respiratory paralysis and coma.

Treatment: iv administration of a specific antidote - physostigmine. Children are prescribed a dose of 0.5 mg; in the absence of effect, administration is repeated for 5 minutes in the same dose (maximum dose should not exceed 2 mg). For adults, the antidote is administered in a dose of 2 mg; in the absence of effect for 20 minutes of administration, repeat at a dose of 1-2 mg.

Storage conditions

At room temperature (up to 25 ° C) in a dark place and out of the reach of children. do not freeze! the shelf life of the drug after opening the bottle is 1 month.