Echothiophate Iodide

Table of contents

  • Brand Names
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Genes that may be involved
  • Drug Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

North America

USA: Phospholine Iodide.

Drug combinations

Chemistry

Echothiophate Iodide: C~9~H~23~INO~3~PS. Mw: 383.23. (1) Ethanaminium, 2-[(diethoxyphosphinyl)thio]-N,N,N-trimethyl-, iodide; (2)(2-Mercaptoethyl)trimethylammonium iodide S-ester with O,O-diethyl phosphorothioate. CAS-513-10-0; CAS-6736-03-4 (echothiophate).

Pharmacologic Category

Antiglaucoma Agents; Miotics; Acetylcholinesterase Inhibitor. (ATC-Code: S01E).

Mechanism of action

Long-acting inhibition of cholinesterase enhances activity of endogenous acetylcholine. Reduced degradation of acetylcholine leads to continuous stimulation of the ciliary muscle producing miosis. Other effects include potentiation of accommodation and facilitation of aqueous humor outflow, with attendant reduction in intraocular pressure.

Therapeutic use

Used as miotic in treatment of chronic, open-angle glaucoma. Angle-closure glaucoma (postiridectomy or where surgery refused/contraindicated). Post-cataract surgery-related glaucoma. Accommodative esotropia.

Pregnancy and lactiation implications

Unlabeled use

Contraindications

Hypersensitivity to echothiophate or any component of the formulation. Angle-closure glaucoma. Active uveal inflammation.

Warnings and precautions

Caution if cardiac irregularities or cholinergic effects develop (overdosage may result in cholinergic crisis). May depress plasma and erythrocyte cholinesterase levels after a few weeks of therapy. Not generally recommended for use in the following cases: asthma, bradycardia, hypotension or recent MI, GI disease (including peptic ulcer disease), parkinsonism, history of seizure disorder, or vagotonia. Avoid use for tonometric glaucoma, or with active or history of uveitis, or retinal detachment. Use cautiously prior to ophthalmic surgery due to risk of blood in the anterior chamber. Use caution in patients on concomitant anticholinesterase agents (possible additive effects if chronically exposed to organophosphate/carbamate pesticides/insecticides). If general anesthesia required, use succinylcholine with great caution due to potential for respiratory or cardiovascular collapse. Tolerance may be developed (after prolonged use).

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