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Miostat
Miostat (generic name: carbachol) is a miotic agent used during intraocular surgery to induce miosis (pupil constriction). It is commonly used in cataract surgery and other ophthalmic procedures to control the size of the pupil and reduce intraocular pressure. Miostat works by stimulating the muscarinic receptors in the eye, leading to the contraction of the iris sphincter muscle, which causes the pupil to constrict. This action helps maintain pupil constriction during surgery, aiding the surgeon’s ability to perform delicate intraocular procedures.
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Frequently Asked Questions
How quickly does Miostat take effect?
Miostat induces miosis within minutes of being instilled into the eye, making it useful for immediate pupil constriction during surgery.
Can Miostat affect my vision after surgery?
Yes, Miostat may cause temporary blurred vision immediately after surgery. This typically resolves as the eye heals. Follow your doctor’s advice for post-operative care.
Is Miostat safe for long-term use?
No, Miostat is not intended for long-term use. It is administered during surgery to induce temporary miosis and is generally used only during surgical procedures.
Can Miostat cause eye irritation?
Yes, some patients may experience mild eye irritation or discomfort after Miostat is administered during surgery. These symptoms are usually temporary and resolve as the eye heals.
How is Miostat different from other miotic agents?
Miostat (carbachol) is similar to other miotic agents like pilocarpine and acetylcholine, but it may have a longer duration of action, making it useful for maintaining miosis during longer surgeries.
Comprehensive Drug Guide
How Does Miostat Work?
Miostat (carbachol) is a cholinergic agonist that mimics the action of acetylcholine at muscarinic receptors in the eye. By stimulating these receptors, Miostat causes the contraction of the iris sphincter muscle, resulting in pupil constriction (miosis). It also increases the outflow of aqueous humor, which can help lower intraocular pressure during or after surgery. These effects make it useful for maintaining a small pupil size during ophthalmic procedures.
Common Dosages
- A few drops instilled into the anterior chamber of the eye (intracameral administration) during surgery to induce miosis.
Typical Dosing
- During surgery, Miostat is typically administered by the surgeon directly into the anterior chamber of the eye. The amount used depends on the specific needs of the surgical procedure.
- It is used once during the procedure to achieve and maintain miosis.
Typical Dosing
FDA Approved Indications
- Intraocular use during cataract surgery or other surgical procedures where miosis is required.
Who Shouldn't Take Miostat?
- Known hypersensitivity to carbachol or any component of the formulation.
- Acute iritis or any condition where miosis (pupil constriction) would be undesirable.
Advice From The Pharmacist
- Miostat is used by healthcare professionals during surgery and is not intended for at-home use. If you are undergoing eye surgery, discuss any concerns or medication allergies with your surgeon.
- Miostat is typically not used long-term, as it is intended for short-term surgical use to control pupil size during intraocular procedures.
- After surgery, follow your doctor’s instructions for post-operative eye care, including the use of prescribed eye drops to manage inflammation, infection, or discomfort.
Side Effects of Miostat
Common Side Effects
- Temporary eye discomfort or irritation after surgery
- Blurred vision
- Increased tearing
- Eye redness
Uncommon/Severe Side Effects
- Intraocular inflammation
- Increased intraocular pressure (IOP)
- Retinal detachment (very rare)
Risks and Warnings of Miostat
- Intraocular Inflammation: Miostat may cause mild to moderate inflammation in the eye following surgery. Anti-inflammatory eye drops may be prescribed post-operatively to manage this.
- Caution in Patients with Asthma: As carbachol is a cholinergic agonist, caution should be exercised in patients with a history of asthma or other respiratory issues, as systemic absorption (though rare) can lead to bronchoconstriction.
- Retinal Detachment: Although extremely rare, Miostat may be associated with a slight increased risk of retinal detachment. Patients should notify their surgeon if they experience flashes of light, floaters, or a sudden decrease in vision after surgery.
Interactions with Miostat
Common Drug Interactions
- Topical steroids: The use of corticosteroids may counteract the effects of Miostat by promoting mydriasis (pupil dilation) and reducing its ability to constrict the pupil.
Alternatives to Miostat
- Miochol-E (acetylcholine chloride): Another intraocular solution used to induce rapid miosis during cataract surgery and other ophthalmic procedures.
- Pilocarpine: Another cholinergic agent used for similar purposes, including inducing miosis and reducing intraocular pressure.
