Echothiophate-anticholinesterase drug and its pharmacology

DESCRIPTIONS:

A potent, long-acting irreversible cholinesterase inhibitor used as an ocular hypertensive in the treatment of glaucoma. Occasionally used for accomodative esotropia.

PHARMACOKINETICS:

 Onset of action: 10-30 min (miosis); 4-8hr (IOP); 24 hr (peak effects IOP)

 Duration: 1-4 weeks (miosis).

 Administered in eye drops to patients with glaucoma.Forms an irreversible covalent bond with the   ACh binding site on cholinesterase.

PHARMACODYNAMICS:

Ecothiophate is a potent, long-acting cholinesterase inhibitor used as a miotic in the treatment of glaucoma. Echothiophate iodide will depress both plasma and erythrocyte cholinesterase levels in most patients after a few weeks of eyedrop therapy.

SIDE EFFECTS:

                  1. Retinal detachment has been reported in a few cases.

                  2.Stinging, burning, lacrimation.

                  3. Iris cysts may form.

                  4. Lens opacities.

                  5. Cardiac irregularities.

CONTRAINDICATIONS:

                  1. Narrow angle glucoma.

                  2. Hypersensitivity.

DRUG DRUG INTERACTIONS:

  1. Ecothiophate + succinycholine = The serum concentration of Succinylcholine can be increased .

  2. Ecothiophate +  carbamate or organophosphate = Increase the insecticidal effect of  carbamate or organophosphate.

THERAPEUTIC USES:

                  1. Glucoma.

                  2. Esotropia.

REFERENCE:-Tripathi K D"Essential of medical pharmacology",7th edition ,page no-105,108