PILOCARPINE -CHOLINERGIC DRUG :SIDE EFFECT AND USES

                                                                       PILOCARPINE 

INTRODUCTION                                                  

Pilocarpine is a choline ester miotic and a positively charged quaternary ammonium compound. Pilocarpine, in appropriate dosage, can increase secretion by the exocrine glands. The sweat, salivary, lacrimal, gastric, pancreatic, and intestinal glands and the mucous cells of the respiratory tract may be stimulated. When applied topically to the eye as a single dose it causes miosis, spasm of accommodation, and may cause a transitory rise in intraocular pressure followed by a more persistent fall. Dose-related smooth muscle stimulation of the intestinal tract may cause increased tone, increased motility, spasm, and tenesmus. Bronchial smooth muscle tone may increase. The tone and motility of urinary tract, gallbladder, and biliary duct smooth muscle may be enhanced. Pilocarpine may have paradoxical effects on the cardiovascular system. The expected effect of a muscarinic agonist is vasodepression, but administration of pilocarpine may produce hypertension after a brief episode of hypotension. Bradycardia and tachycardia have both been reported with use of pilocarpine.

MECHANISM OF ACTION

Pilocarpine is a cholinergic parasympathomimetic agent. It increase secretion by the exocrine glands, and produces contraction of the iris sphincter muscle and ciliary muscle (when given topically to the eyes) by mainly stimulating muscarinic receptors.

USES

For the treatment of radiation-induced dry mouth (xerostomia) and symptoms of dry mouth in patients with Sjögrens syndrome.
used as a miotic and in the treatment of glaucoma

SIDE EFFECT

•shortness of breath;
•fast or slow heart rate;
•severe headache, pounding in your neck or ears;
•confusion, tremors; or
•a light-headed feeling, like you might pass out.
Common side effects may include:
•increased sweating, urinating more than usual;
•chills, or flushing (warmth, redness, or tingly feeling);
•headache, dizziness, weakness;
•nausea, vomiting, diarrhea;
•blurred vision, watery eyes; or
•runny nose.

DRUG DRUG INTERACTION

Cimetropium Bromide
Pilocarpine may decrease the anticholinergic activities of Cimetropium Bromide.
Nadolol
The risk or severity of adverse effects can be increased when Nadolol is combined with Pilocarpine.
Tacrine
The risk or severity of adverse effects can be increased when Tacrine is combined with Pilocarpine.
       REFERENCE-
 ESSENTIAL OF MEDICAL PHARMACOLOGY BY K.D TRIPATHI 7th edition pg.no.-102, 103