Cyclopentolate, blocking m-cholinergic receptors, prevents the action of the mediator of cholinergic synapses - acetylquinoline. as a result of blocking cholinergic synapses located in the sphincter of the pupil and in the ciliary muscle, the pupil dilates due to the predominance of the tone of the muscle that dilates the pupil, and the muscle that narrows the pupil relaxes. at the same time, due to the relaxation of the ciliary (accommodative) muscle, accommodation paralysis (cycloplegia) develops. pupil dilation occurs within 15–30 minutes after a single instillation. mydriasis persists for 6-12 hours, in particularly sensitive patients, mydriasis can persist much longer. residual effects of cycloplegia persist for 12-24 hours. The preparation has a weakly pronounced antispasmodic effect, reduces the secretion of salivary, gastric, bronchial, sweat glands and pancreas; increases intraocular pressure; reduces the tone of the vagus nerve, which leads to an increase in heart rate with a slight increase in blood pressure.
Penetrates the BBB; in average therapeutic doses has a moderately pronounced stimulating effect on the central nervous system, stimulates respiration.
It is well absorbed through the conjunctiva. A significant level in the central nervous system is reached after 0.5-1 hours. The connection with blood plasma proteins is moderately expressed. The half-life is 2 hours.
For diagnostic purposes with ophthalmoscopy; determination of refraction; in preoperative preparation - to dilate the pupil during cataract extraction; in inflammatory diseases of the anterior part of the eye (episcleritis, scleritis, keratitis, iridocyclitis, uveitis) as part of complex therapy.
Locally, instill 1-2 drops into the conjunctival sac of the eye.
To study the fundus: 1 drop with an interval of 10 minutes 1-3 times a day.
When examining refraction in children and adolescents - 1-2 drops with an interval of 15-20 minutes 2-3 times a day.
In inflammatory diseases - 1 drop 3 times a day, in severe cases, it is allowed to use 1 drop every 3-4 hours.
Glaucoma, hypersensitivity to preparation components.
Conjunctival hyperemia and discomfort after instillation, temporary decrease in visual acuity, increased intraocular pressure in patients with primary glaucoma, weakness, nausea, dizziness, tachycardia. children sensitive to cyclopentolate may develop general weakness, nausea, dizziness, drowsiness, dry mouth, headache, and occasionally tachycardia.
Cyclomed is less effective in patients with dark-pigmented irises. in this category of persons, when using the preparation, residual accommodation can reach 2–4 diopters.
In children, in the presence of a stable accommodation spasm for cycloplegia, it is better to carry out a course of instillations of atropine sulfate.
When using Cyclomed in elderly patients, it is necessary to control intraocular pressure.
Patients with hypersensitivity to atropine do not have cross-allergy to Cyclomed, which makes it possible to use it in this category of patients. During the period of using the preparation, you should refrain from driving and other potentially hazardous activities.
Since the effect of the preparation during pregnancy and lactation has not been studied enough, the use in this category of patients is possible only if the expected therapeutic effect outweighs the risk of possible side effects in the fetus or infant.
The preparation is used with caution in children under the age of 3 years, in patients over the age of 60 years, with intestinal obstruction, prostatic hyperplasia.
The effect of cyclomed can be enhanced by sympathomimetics (phenylephrine), and weakened by m-cholinomimetics (pilocarpine). m-cholinomimetics, when used simultaneously with cyclomed, can increase the severity of its side effects.
With strict adherence to the recommendations, overdose was not observed. however, if the recommended doses of the preparation are exceeded, as well as when the preparation is taken orally, the following symptoms may be observed: dry skin and mucous membranes, tachycardia, agitation and neuropsychiatric abnormalities (speech impairment, increased fatigue, disorientation in space, emotional disturbances); when taken in very high doses - respiratory paralysis and coma.
Treatment: intravenous administration of a specific antidote - physostigmine. Children are prescribed in a dose of 0.5 mg; if there is no effect for 5 minutes, repeat the introduction in the same dose (the maximum dose should not exceed 2 mg). For adults, the antidote is administered at a dose of 2 mg; in the absence of effect for 20 minutes, the administration is repeated at a dose of 1–2 mg.
At room temperature (up to 25 ° C), protected from light and out of reach of children. do not freeze! the shelf life of the preparation after opening the bottle is 1 month.
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