Carbachol
Kelas obat: Agen Antineoplastik
Panganggone Carbachol
Open-Angle Glaukoma
Penurunan tekanan intraokular (IOP) ing pasien kanthi glaukoma primer, sudut terbuka (kronis prasaja, noncongestif).
Digunakake utamane ing pasien sing refrakter utawa hipersensitif marang pilocarpine.
Bisa digunakake bebarengan karo agen sympathomimetic, agen pamblokiran β-adrenergik, utawa inhibitor anhidrase karbonat.
Bedah Okular
Produksi miosis nalika operasi ing kamar anterior mripat (contone, ekstraksi katarak, keratoplasti, iridektomi perifer, cyclodialysis).
Ngurangi intensitas elevasi IOP sajrone 24 jam pisanan sawise operasi katarak.
Asetilkolin intraokular umume disenengi.
Angle-Closure Glaukoma
Pengurangan TIO ing perawatan darurat glaukoma sudut tertutup akut (kongestif)† [off-label] sadurunge operasi.
Pilocarpine umume disenengi .
Pemeriksaan Oftalmologis
Produksi miosis kanggo nglawan efek midriatik saka agen simpatomimetik (contone, hydroxyamphetamine, phenylephrine) sawise pemeriksaan ophthalmoscopic† [off-label] ing pasien glaukoma.
Pilocarpine umume disenengi.
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Carane nggunakake Carbachol
Administrasi
Administrasi Oftalmik
Atur solusi topikal ophthalmic menyang kantung konjungtiva; ora nyuntikake.
Injeksi intraokular kanthi injeksi menyang kamar ngarep.
Solusi TopikalCopot lensa kontak sadurunge nglebokake solusi.
Kanggo nyilikake efek sing ora becik, diwiwiti kanthi konsentrasi sing sithik lan tambah bertahap yen perlu. Kajaba iku, lebokake dosis saben dina utawa salah siji saka dosis saben dina sadurunge turu.
Sawise instilasi topikal, tekanan driji ing kantung lacrimal suwene 1-2 menit kanggo nyilikake saluran menyang irung lan tenggorokan lan nyuda resiko penyerapan lan reaksi sistemik. Copot solusi sing berlebihan ing mripat kanthi tisu lan mbilas obat apa wae ing tangan langsung.
Injeksi IntraokularLebokake menyang kamar ngarep mripat sadurunge utawa sawise jahitan jahitan, miturut pandhuane pabrikan. Vials mung kanggo nggunakake dosis siji; mbuwang bagean sing ora digunakake.
Dosis
Setel konsentrasi lan frekuensi instilasi solusi miturut syarat lan respon pasien, kaya sing ditemtokake dening maca tonometrik sadurunge lan sajrone terapi.
Ing pasien karo irides akeh pigmen, konsentrasi solusi sing luwih dhuwur bisa uga dibutuhake.
Dewasa
Open-Angle Glaukoma Ophthalmic Topikal1-2 tetes 1,5-3 % solusi topikal nganti kaping 3 saben dina.
Bedah Okular IntraokularNyuntikake ≤0,5 mL larutan 0,01%.
Batesan Resep
Dewasa
Bedah Okular IntraokularMaksimum: 0,5 mL saka injeksi 0,01%.
Populasi Khusus
Ora ana rekomendasi dosis populasi khusus ing wektu iki.
Pènget
Contraindications
Pènget/PanandhapPènget
Toksisitas Sistemik
Reaksi sistemik (contone, salivasi, sinkop, aritmia jantung, distress epigastrium, sirah, mutahke, asma, hipotensi, diare, urgensi urin, tambah kringet) jarang dilapurake sawise aplikasi topikal utawa injeksi intraocular; biasane kedadeyan mung kanthi administrasi sing kerep banget.
Gunakake kanthi ati-ati ing pasien kanthi gagal jantung akut, asma bronkial, ulkus peptik aktif, hipertiroidisme, spasme GI, obstruksi saluran kemih, penyakit Parkinson, MI anyar, utawa hipertensi sistemik utawa hipotensi.
Gunakake solusi topikal kanthi ati-ati yen ana abrasi kornea kanggo nyegah penetrasi sing berlebihan lan keracunan sistemik.
Yen ana gejala sistemik, mandhegake obat, paling sethithik sak wentoro.
Toksisitas OkularDetasemen retina jarang dilapurake; nggunakake kanthi ati-ati banget, yen kabeh, ing pasien kanthi riwayat utawa risiko detasemen retina, utamane yen isih enom utawa aphakic. Priksa periphery retina kanthi ati-ati paling sethithik saben taun kanggo ndeteksi ablasi sing bakal teka.
Injeksi intraokular: Kornea mendhung, keratopati bulosa sing terus-terusan, detasemen retina, lan iritis pasca operasi sing dilapurake sawise ekstraksi katarak ing sawetara pasien.
Reaksi Sensitivitas
HipersensitivitasKonjungtivitis alergi, dermatitis, utawa keratitis kacarita sok-sok karo miotik; biasane dikurangi kanthi ngganti menyang miotik liyane. Ing sawetara kasus, reaksi alergi bisa disebabake dening pengawet ing preparat.
Mateni obat kasebut yen sensitivitas berkembang utawa yen iritasi asli tetep utawa mundhak.
Pancegahan Umum
Efek Okular (Solusi Topikal)Kamungkinan spasme akomodasi lan penglihatan sing kurang ing cahya sing surem, utamane ing pasien geriatrik lan pasien sing duwe lensa opacities. (Deleng Saran kanggo Patients.)
Efek saru asring suda sawise sawetara dina pisanan terapi utawa yen obat dihentikan sementara. (Deleng Administrasi ing Dosis lan Administrasi.)
Kamungkinan kenaikan IOP sementara sanajan sudut mbukak. Ing sawetara pasien karo glaukoma sudut tertutup sing nampa miotik, bisa nambah IOP lan nyebabake serangan akut.
Kamungkinan opacities lensa lan katarak; opacities lensa bisa regress yen therapy mandheg ing awal pembangunan; Nanging, katarak asring progresif.
Pemeriksaan slit-lamp reguler dianjurake; mungkasi terapi, paling ora kanggo sementara, yen kista iris, iritis, syneChiae, utawa opacities lensa kedadeyan.
Populasi Spesifik
KandhutanKategori C.
LaktasiOra dingerteni manawa carbachol disebar ing susu. Gunakake kanthi ati-ati.
Panggunaan PediatrikKeslametan lan khasiat ora ditetepake.
Panggunaan GeriatrikKetajaman visual sing suda ing cahya sing surem umume ing pasien geriatrik. (Deleng Efek Okular [Solusi Topikal] ing Awas.)
Efek Umum sing Sabar
Solusi topikal: Iritasi okular (kobong utawa rasa ora nyaman), lacrimation, nyeri sirah temporal utawa periorbital, kram ciliary utawa akomodatif, penglihatan kabur utawa miopia, kongesti pembuluh darah konjungtiva, penglihatan sing kurang. ing cahya surem.
Apa obatan liyane bakal mengaruhi Carbachol
Obat Spesifik
Obat
Interaksi
Komentar
Miotik, antikolinesterase
Kemungkinan antagonisme
Penggunaan miotik bebarengan ora dianjurake; unresponsiveness kanggo loro obat bisa berkembang
Tambah risiko reaksi alergi lan keracunan
Agen hipotensi okular (contone, inhibitor anhidrase karbonik, epinefrin topikal, timolol topikal)
Efek ngedhunake IOP aditif
Digunakake kanggo kauntungan terapeutik
Disclaimer
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