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Miochol-E
Miochol-E (generic name: acetylcholine chloride) is a miotic agent used in ophthalmic surgeries. It is primarily administered during cataract surgery or other eye surgeries to cause the pupil to constrict rapidly (miosis). By inducing miosis, Miochol-E helps surgeons perform procedures more effectively by stabilizing the pupil. It belongs to the cholinergic agonists drug class, specifically working as an analog of the neurotransmitter acetylcholine.
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Frequently Asked Questions
What is the purpose of Miochol-E in eye surgery?
Miochol-E is used to cause rapid pupil constriction (miosis) during surgeries like cataract extraction to help the surgeon manage the pupil size and improve surgical outcomes.
Can Miochol-E cause any long-term vision changes?
No, Miochol-E causes temporary pupil constriction, and normal vision typically returns after the surgery and recovery period.
How is Miochol-E administered?
Miochol-E is injected directly into the eye's anterior chamber during surgery, and it must be prepared right before the procedure to ensure sterility and effectiveness.
How quickly does Miochol-E take effect?
Miochol-E works almost immediately upon administration, causing rapid miosis (pupil constriction) within minutes.
Is Miochol-E safe for use in all eye surgeries?
Miochol-E is commonly used in surgeries like cataract extraction, but it may not be appropriate for all patients, especially those with inflammatory eye conditions like uveitis. Consult your ophthalmologist to determine if it's right for your specific situation.
Comprehensive Drug Guide
How Does Miochol-E Work?
Miochol-E works by mimicking the action of acetylcholine, a neurotransmitter responsible for muscle contraction. When applied intraocularly, it stimulates the cholinergic receptors in the eye, leading to rapid constriction of the pupil (miosis). This helps control pupil size during eye surgery, which is essential for precise surgical procedures.
Common Dosages
- Single-dose intraocular solution: 20 mg acetylcholine chloride for injection with a 1 mL diluent for reconstitution.
Typical Dosing
- The usual dose for Miochol-E is 1 to 2 drops (0.5 to 1 mL) of the reconstituted solution instilled into the anterior chamber of the eye during surgery. The dosage may vary based on the specific surgical procedure and patient needs.
Typical Dosing
FDA Approved Indications
- Rapid pupil constriction (miosis) during ophthalmic surgery, such as cataract extraction.
- Restoration of miosis following intraocular lens implantation.
Who Shouldn't Take Miochol-E?
- Hypersensitivity to acetylcholine chloride or any of the components of the formulation.
- Patients with iritis, an inflammation of the iris, or uveitis due to the potential for worsening inflammation.
Advice From The Pharmacist
- Miochol-E is strictly for intraocular use during surgery and must be prepared immediately before administration.
- The solution should be used within 24 hours of reconstitution to maintain sterility and effectiveness.
- After surgery, patients should follow up with their ophthalmologist to monitor eye recovery and ensure there are no complications.
- Since Miochol-E causes rapid pupil constriction, patients may experience temporary blurred vision or difficulty seeing in low-light environments after surgery.
Side Effects of Miochol-E
Common Side Effects
- Temporary eye irritation or discomfort
- Blurred vision or difficulty seeing in dim lighting
- Increased tear production
Uncommon/Severe Side Effects
- Hypersensitivity reactions such as rash, itching, or swelling around the eyes
- Intraocular inflammation
Risks and Warnings of Miochol-E
- Infection Risk: Using unsterilized instruments or contaminated solution can increase the risk of eye infections. Ensure the solution is sterile and prepared according to instructions.
- Inflammation Risk: In patients with pre-existing uveitis or iritis, Miochol-E may worsen inflammation in the eye. Use with caution in such cases.
Interactions with Miochol-E
Common Drug Interactions
- Miochol-E is generally used during surgery and is not known to have significant drug interactions when used properly.
- However, patients on systemic cholinergic medications or acetylcholinesterase inhibitors may experience enhanced cholinergic effects, though this is rare in intraocular administration.
Alternatives to Miochol-E
- Pilocarpine: Another miotic agent used to constrict the pupil during ophthalmic surgery.
- Carbachol: Another cholinergic agonist, also used for inducing miosis in eye surgeries.
- Phenylephrine: Used for the opposite effect, to dilate the pupil during certain surgical procedures.
