Midcles drugs. What is mydriatics and what are they used for? Atropine - how to dig in order to pass at the oculist

The mydriasis may be due to the increase in the action of the pupil dilator under the influence of sympathomamime-ticks, as well as the weakening of the effect of the pupil sphincter due to the blockade of cholinoreceptors, and at the same time the cylinder muscle paresis occurs. In this regard, m-cholinoblocators (indirect mydriatics) and sympathomimetics (direct midgorics) are used to expand the pupil.

M-cholinoblocators. As a result of the blockade of M-cholinoreceptors located in the sphincter of the pupil and the ciliary muscle, there is a passive expansion of the pupil due to the prevalence of the tone of the muscle, expanding the pupil, and relaxing the muscles, soring it. At the same time, as a result of the relaxation of the ciliary muscle, paresis accommodation occurs.

Intensively pigmented iris is more resistant to dilatation, to achieve effect, it is sometimes necessary to increase the concentration of the drug or the incidence of administration, so the overdose of mydriatics should be feared. The expansion of the pupil can provoke acute attack Glaucomas in patients with this pathology, persons over 60 years old and persons with hypermetropia, predisposed to glaucoma, due to the fact that they have a shallow front camera.

It is necessary to warn patients that the driving of the car for at least 2 hours after the study is prohibited.

According to the strength and duration of action, the M-cholinoblockers of the short (diagnostic) and long (therapeutic) action are distinguished.

Long-term midgorics are used to achieve cyclopellegia in order to study refractive in children. In addition, they are used for the treatment of spasms of accommodation of a semi-unpleasant and persistent nature in children with refraction anomalies and in complex therapy inflammatory diseases front department Eyes in order to prevent the development of the rear synechs.

Atropine (Atropm) has a maximally pronounced mydriatic and cyclopelgic effect. The expansion of the pupil and cyclopelgia reaches a maximum after 30-40 minutes after one-time injection of atropine and persist for 10-14 days.

In clinical practice, use 0.5% and 1% atropine solution. In adults and children over 7 years old with therapeutic goal, 1% an atropine solution is used, which bury 2-3 times a day, to achieve cyclopelgia - 2 times in time. In children under 7 years old, only 0.5% solution can be used.

The drug is not recommended to be prescribed to patients with closed-depth glaucoma, expressed urination disorders during prostate adenoma and in children up to 3 months. Atropine should be used with caution in patients with severe diseases of the cardiovascular system.

In the treatment of atropine, the development of systemic side effects is possible, to reduce the severity of which for 1 min after instillation, it is necessary to press the lacrimal tubules in the inner corner of the eye.

Local side effects - increase in intraocular pressure, hyperemia of the skin of the eyelids, hyperemia and edema of conjunctiva (especially when long use Atropine), Svetuboyazn.

Atropine is produced in the form of 1% eye drops and ointment; 0.5% eye dropscontaining atropine manufactures Ex Tempore.

Cyclopentolat (Cyclopentolate) is less pronounced compared to atropine mydritic effect. The maximum pharmacological effect occurs after 15-30 minutes after the instillation of cyclopentolate. Midships remains for 6-12 hours. The residual phenomena of cyclopelgia are preserved 12-24 hours.

The drug is used to achieve cycloplegia in order to study refraction in children for the treatment of spasms of accommodation of a semi-unpleasant and persistent nature and in the complex therapy of inflammatory diseases of the front eye, with preoperative preparation of patients with cataract extraction.

In order to study the Eye DNA, cyclopentolates burst 1-3 times 1 drop with an interval of 10 minutes, 2-3-fold instillation with an interval of 15-20 minutes is required to achieve cyclopelgia. It is used for medical purposes 3 times a day.

TropicsD. (Tropicamid) - short-range Midship. The expansion of the pupil after the injection of TRO-PIKID is observed after 5-10 minutes, the maximum mydriasis is noted after 20-45 minutes, the duration of the effect is 1-2 hours, the initial width of the pupils is restored after 6 hours. Maximum accommodation paresis occurs in 25 minutes and persisted for 30 min. Full cyclopelia stopping occurs after 3 hours.

The drug is used in the eye study study, rarely use to determine refractures in small children and with the medical goal for the prevention of the rear synechs inflammatory diseases eye. Tropicid is used in the form of 0.5% and 1% solutions.

For the diagnostic expansion of the pupil, 1 drop of 1% solution or twice, 1 drop of a 1 drop of 0.5% solution with an interval of 5 minutes, is once installed. After 10 minutes, it is possible to carry out ophthalmoscopy. To determine refraction, the drug is buried 6 times with an interval of 6-12 minutes. After about 25-50 minutes, paresis accommodation occurs and the study can be conducted. With therapeutic goal, tropicid is used 3-4 times a day.

The drug should be used with caution in patients with closed-coal glaucoma.

When used, the development of photophobia, an increase in intraocular pressure, acute attack of the closed gloomy is possible.

Sympathomimetics. Sympathomimetics, being agonists of CC-adrenoreceptors, increase the muscle tone, expanding the pupil, resulting in the masses developing, however, there is no pan of the ciliary muscles and an increase in intraocular pressure. The mydriatic effect is pronounced, but short-term (4-6 h), potentiated by M-cholinoblockers.

For the diagnostic expansion of the pupil and enhance the effect of M-cholinoblocators before operational interventions On the eyeball and after them, the phenylephrine solution is used (Phenylephrin).

Like m-cholinoblocators, phenylephrine is not recommended to be used in patients with an indoor glaucoma. The use of a 10% solution of phenylephrine in children and elderly people should be avoided, during cardiovascular diseases it is impossible or a 2.5% solution should be applied. Phenylephrine should be used with caution during tachycardia, hypertiree dieselms, sugar diabetes. It is necessary to warn the patients that it is impossible to drive a car at least 2 hours after research.

For local application The appearance of pain and tingling in the eyes (it may be necessary to use local anesthetics in a few minutes), boldness of vision, photophobia. In sensitive patients, the development of side effects of a systemic nature is possible: arrhythmia, arterial hypertension, Coronarpasm. It is possible to strengthen the vasoconstrictor effect while simultaneously using mono-amino oxidase inhibitors.

To carefully draw diagnostics of organs of vision, special drops are applied - to expand pupils. These drugs are called mydriatics, and their use is a necessary condition for the diagnosis of most eye pathologies.

Besides diagnostic value With the help of droplets, you can eliminate some symptoms of diseases of the organs of vision. In the article, we will consider the features of the drops for the expansion of pupils, find out, in which cases it can be applied, we will find out whether drugs have side effects, we give a list of the most popular drugs of mydriatics.

Destination of droplets and exposure duration

So, in ophthalmology, drop-midritics usually apply to solve two problems:

• for diagnosis;
• for treatment.

As for the first point - diagnostics, then without a qualitative and sufficiently long expansion of pupils, it is almost unrealistic to conduct a more or less reliable and thorough examination of the eye day.

Midships are necessary in diagnostic studies of all patterns of retina, as well as to identify visual acuity.

In diagnostic medicine, drops of this category are mainly used:

• for the study of retinal pathologies;
• analysis of the condition of the lens, determining the degree of its transparency;
• studies of vision vessels;
• optic nerve;
• if it is necessary to detect detachment, dystrophy, other pathologies of visual organs.

Learn how the angiopathy of the retina's eyes in a child looks like.

Additionally, you can pass if the diagnosed is going to get driving. To determine the level of violation of vision, the degree of myopia or hyperopia, the drops are also necessary. With regard to small children, drops with the effect of the expansion of pupils are necessary to determine such an indicator as refraction. In order to correctly choose points with the desired number of diopters, the use of data drops is also useful too.

During the therapy, the drops that expand pupils are used in the case of the following diseases:

• irit;
• amblyopia;
• iridocyclitis;
• false myopia.

Read more, looks amblyopia high degree In children, you can see in.

As for the time of exposure, droplet-midities can expand pupils for several hours and for a week. It all depends on the purpose: for the examination sometimes enough and short time, but for treatment it is necessary for a long impact.

On video - drops for the expansion of pupils:

However, we note that long-term drops are usually more contraindications, side effects, and cause more strong discomfortthan "short-term" drugs. The most common intelligible signs include tears with bright sunny or artificial lighting. The average duration of the impact of the droplets is from three to four hours.

Any eye drops should be appointed only by a medical worker: self-esteem is unacceptable. An illiterate choice of funds and its improper use can lead to serious consequences, complications, up to intoxication of the body.

Views

Drop mydriatics are divided into two categories:

• straight;
• indirect.

Direct Action Preparations Reducing the radial muscles of the eyes. This can be attributed to the means as phenylephrine and. Direction drops have a noticeable expanding effect on the pupil.

Drops indirect action Influence on the circular eye muscle, reduce the intensity of its abbreviations. These drugs are simultaneously expanding pupils and adjust the focus of view. This can be attributed to the means as, cycled, Miderum. When using "indirect" droplets, a short-term loss of the ability is usually arising: immediately after the instillation. After a few minutes, the vision is restored.

All drops differ in time of their impact, but those drugs that are used exclusively for diagnostic purposes have the same duration: less than usual. This is due to the fact that to carry out a high-quality survey and several hours.

Interesting: Drop-mydriatics have a greater duration of exposure, when the iridescent eye is bright.

Find out why the size of the pupils is different and the danger of such a manifestation of software.

Review of drugs - titles and description

Consider the most frequently used droplets in modern ophthalmology to expand pupils.

Atropine - how to dig in order to pass at the oculist

The drug has a substance that has been used by a few more centuries ago ladies trying to make attention to men. This component of the droplet makes the look of languid and expressive - which, in fact, the ladies and sought. Modern women Such a goal is not set, and atropine uses exclusively for therapeutic purposes.

Cost from 15 p.

The effect of the drug occurs due to the vegetable powerful alcoholoid - atropine sulfate. This substance leads to temporary paralysis. overall nerveDue to what, in fact, the expansion of the pupil occurs. The drug is useful in the study, it can be applied and under the therapy of Wenit.

Note that now this medicine is used less and less, since new, more safe preparations with similar action. The fact is that atropine has toxicity, leads to a temporary impairment of vision and discomfort.

The exposure time of the drug is very long - can expand pupils for a week, or even for 10 days. It is not recommended to apply this means for selflessly, without medical purposes.

The drug is mydriacil for the eyes (Midrium, TopikiD) - as it works, whether pupils expand

The tool begins to act quickly (literally 15 minutes after the instillation), and expands pupils for several hours. As a rule, there is enough impact for three hours, no more. Thanks to the short time of exposure to side effects in the drug at least. The medicine can be used for the diagnostic and therapeutic treatment of children.

Midryazil is used before researching the eye bottom with the aim of diagnostics, for the treatment of certain diseases, for evaluating refraction, with operations on the eye retina or lens. With caution, this preparation should be used if inflammatory processes organs of view, as well as high pressure intraocular fluid.

Price from 350 r.

How to book an ICRIRIN to increase pupils to verify vision

The tool has a short duration of exposure, it can be used both for diagnostics and for therapy (with elevated intraocular pressure).

It is impossible to use ICF, if the child has not yet been 12 years old, the drug is prohibited and for the treatment of older people with heart pathology, vessels.

Action Cycloed Medicine

Refers to one of the most popular mydriatics today. The tool has a long impact - 6-12 hours. It has a safe composition, and can even be used by women during the period of having a child, feeding. The drug may be useful both for diagnostic purposes and in the treatment of diseases (Ivita, Keratitis, sclerite). In addition, often used when carrying out operations in the eyes, in particular, when the cataract is removed.

As for children, the cyclomed can be used when a child is more than three years old. But for the treatment and diagnosis eye disease People of old age drug can not be applied. In addition, the use of cyclomad is prohibited if there are diseases such as intestinal pathways and prostate adenoma.

Interesting information on the topic! Find out how the facoemulsification of cataracts and how effective this procedure is.

Eye Means Meston, which is expanding the pupil on time

The remedy is dripping to increase eye pupils. It has a number of contraindications: pregnancy, pancreatitis, atherosclerosis, hepatitis, lactation period.

Cost from 90 p.

ATTENTION: With the available glaucoma, the use of any droplets-mydriatics under the ban.

How to drip appamide plus to expand pupils

As a rule, when diagnosing eye diseases in children, the amount of medication is reduced, and the drug is valid for only an hour. In adults - at least two hours. Due to the short-term impact of the means, it is used usually only for the purpose of diagnosis, not use for treatment.

Side effects

It should be noted that when instilcing mydriatics in the eyes, the components of the drugs fall into the bloodstream, after which they are distributed throughout the body. That is why after the use of funds, a whole "bouquet" of all sorts of side effects can be observed. Consider the most common from the "soups".

• defect visibility in the form of split items, things;
• blurred vision;
• increased pressure intraocular fluid;
• redness of the conjunctivities of the eye, eyelids, cornea;
• svetoboyazn I. painfulness, burning;
• thirst combined with difficult urination;
• irritability, nervous anxiety;
• heat.

If, after instillation of the drug, you felt one or more of the listed symptoms, you need to seek as soon as possible for medical help. Probably need symptomatic treatment, as well as reassign the drug.

If an overdose of mydriatics is allowed for instillation, the development of the following symptoms is likely:

• dry skin, mucous membranes;
• food disorders;
• defects of speech behavior;
• tachycardia;

In this case, conventional side effects are exacerbated.

If the dose of droplets was very serious, probably even coma In connection with the palsy of the respiratory center.

We learned that they represent drop-to-mydriatics, and for which they are used. As you can see, the use of these drugs is indispensable and in the diagnosis of eye diseases, and during treatment. Be sure to visit the doctor if any vision problems occur, and follow the instructions for applying the designated drops.

Drops for the expansion of pupils are referred to as Midship. These drops expand the pupil, or block one nerve, or annoy the other. Eye drops for the expansion of the pupil should be applied strictly by appointment of the doctor, since their active substance is poison and has a negative impact on human body generally.

Indications for the appointment of mydriatics

This type of drops are used in medicine with ophthalmologists with diagnostic purposes. Drops for the expansion of pupil allow the oculist to well consider the structure of the eye dna.

In the accommodation spa, such a kind of myopia, the purpose of the drops is of a dual character, both for diagnosis and treatment.

Eye drops, expanding pupils have an action on the eye muscle, relaxing it, they allow you to determine objective visual sharpness. Accommodation spasm occurs with strong overvoltage of muscles, the use of droplets allows you to eliminate this problem. At dawn of ophthalmology for expansion, only atropine was used, today there are quite a few other drugs, less toxic.

Packaging and form of drugs

The drops are the form of the drug, they are intended for injection into the conjunctival bag. Usually in packages there is a special dispenser or pipette, with which the solution can be entered into the eye.

This type of drug is appointed by a strictly physician if necessary for diagnostic procedures or treatment courses. Drops should be sterile, have a homogeneous color.

Action drops

Pupil expansion using medical preparations Comes in two ways:

• Immobilizing the ooo nerve;
• Excitation of a sympathetic nerve.

• Atropine;
• Hyoscyamine;
• Skopolamine;

These funds are expanding the pupil by relaxing and leading the muscles to the periphery. The side effect of these drugs is an increase in intraocular pressure. Their use is contraindicated to persons suffering glaucoma.

When applying these substances, the ability of the eye to adapt to the consideration of objects at different distances, in other words of accommodation. The crystal is stretched, is compass. The time of the action of mydriatics depends on the specific drug, it may vary from several hours to several days. Patients often complain about inaccurate, blurry picture.
When instillation, the solution is absorbed, in almost all structures eyeball. This active ingredient has the ability to penetrate well through the fabrics in blood system. Metabolized drugs in the liver, and are removed by the kidneys with urine.

Drops and pregnancy

Physiological pregnancy is not a contraindication to the survey from an ophthalmologist. Moreover, this procedure should pass each pregnant twice for the period of pregnancy. The purpose of the data, preventive inspections is the timely prevention of eye diseases. At the same time, if the doctor suffers from vision makes conclusions, about the upcoming trust and its technique.

Each pregnant woman must pass a preventive inspection at the oculist in the first trimester, in the second and directly a week before the upcoming birth. For the best visualization of the retina, the ophthalmologist resorts to the use of mydriatics. For inspection, these drops are not dangerous. With therapeutic purpose, they are prescribed and used pregnant women is strictly prohibited. Since they via the placental barrier penetrate the child, providing their toxic effect.

Contraindications for the use of mydriatics

Many contraindications, consider the most common:

• Allergies on the components of the solution;
• Increased intraocular pressure;
• Pregnancy, lactation period;
• Infants, old men are used with caution;

When taking these drugs, it is worth abandoning driving vehicles. Before using this drug, you will definitely consult a specialist.

By-effect

Midcles have a number of side effects:

• Violation of eye adaptation to see at different distances;
• Feeling of two;
• Increase pressure;
• The inability to look at the bright light source;
• Permanent thirst;
• Dryness mucous membranes;
• Urine delay.

Application, dosage

Consider the most common medicines:

• Atropine. You need a couple of drops per hour before inspecting the eye bottom. With therapeutic goal, you buried a couple of times a day, no more than a week.
• Skopolamine. It is used to explore the eye ophthalmologist. For treatment you need to drop a drop several times per day, the course determines the doctor.
• TropicsD. It is the most used drug today, as it has the smallest number of side effects. Used according to the designated instructions from the manufacturer.

Overdose

If you do not neglect the instruction, the overdose will not.

Overdose is manifested by dry mucous membranes, increasing pulse, urination delay.

Too big doses of medication can lead to death, by stopping breathing and cardiac activity.

Precautions

Drops must be stored at a temperature indicated by the manufacturer. In an inaccessible for children and animals. Freezing is not allowed, overheating solution.

This type of drug is prescribed only an ophthalmologist with testimony. It is impossible to apply drop data on their own, it can lead to severe consequences for the body.

Midcatics (Greek, MyDriasis Expansion of the pupil) - drugs causing the expansion of the pupil -midria. The expansion of the pupil occurs when the muscle circular fibers relaxes, a narrowing pupil, K-paradium contains M-cholinoreceptors and is innervated parasympathetic fibers, walking from Yakubovich's kernel as part of the eye nerve. A similar effect can be obtained as a result of a reduction in the radial fibers of the muscle, expanding the pupil receiving innervation from the sympathetic barrel and containing alpha-adrenoreceptors. The relaxation of the muscle, the narrowing pupil, causes substances with M-choline-blocking activity - amizyl (see), Atropine (see), homatropine (see), Platifillain (see), Skopolamine (see), etc., interacting With m-cholinoreceptors of this muscle. At the same time, intraocular pressure can increase due to the difficulty of liquid outflow from the eye chambers. The abbreviation of the muscle, expanding the pupil, cause adrenomimetic agents that stimulate alpha-adrenoreceptors - adrenaline (see), Mesoth (see), fetanol, ephedrine (see) and others. Along with the expansion of the pupil, M-cholinoblocators cause accommodation paralysis due to relaxation Cilic Muscle due to blocking its M-cholinoreceptors.

In general, in general, a similar effect on the function of the eye, preparations from the group of cholinoblocators differ from each other with different duration of action, as well as the degree of severity of the effect. So, the atropine causes the maximum expansion of the pupil in 30-40 minutes. After instillation; The effect of it is saved to 7-10 days. Accommodation paralysis arising after 1-3 hours disappears in 8-12 days.

Gomatropine has a less prolonged effect: the most pronounced mydriasis is observed after 40-60 minutes; Midship and accommodation paralysis are preserved within 1-2 days. The duration of the Midritic Effect of Platifillina is 5-10 hours., And the violation of accommodation is 5-6 hours.

M.S. Apply for diagnostic purposes in the study of the eye dna (see), as well as to determine the true refraction (see the refractometry of the eye). With leaps. The purpose of M. s. Apply with acute inflammatory diseases and eye injuries to create its functions, peace. In diagnostic manipulations, it is advisable to apply drugs acting shortly (eg, homatropine). For leaps. The goals are more suitable for long-term existing funds (eg, atropine).

Midship arising from the instillation of adrenomimetics is not accompanied by an increase in intraocular pressure, which allows them to use them in the study of the fundus in patients with glaucoma. Moreover, adrenomimetic agents are used to treat primary glaucoma in the presence of an open angle of the front eye chamber. Therapeutic effect These substances in this case, apparently, is due to a decrease in the secretion of intraocular fluid and the improvement of the hemodynamics of the eye. M. s. We are injected into the conjunctival bag of eyes in GIDE R-MOZ (Eye drops) or ointments.

Bibliography: Alexandrov 3. I. et al. Medicationsapplicable in ophthalmology, p. 4 et al., M., 1978; Mashkovsky M. D. Drugs, Part 1, p. 219, M., 1977; The Pharmacological Basis of Therapeutics, ED. By L. S. GOODMAN A. A. Gilman, N. Y., 1975.

V. V. Churyukanov.

25-01-2013, 23:36

Description

The mydriasis can be due to the increase in the action of the pupil dilator under the influence of sympathomimetics, as well as the weakening of the effect of the pupil sphincter, which is observed due to the blockade of cholinoreceptors, and at the same time the paresis of ciliary muscles occurs.

For expansion of pupils, m-cholinoblocators are used (cyclopelgic mydriatics) and sympathomimetics (non-cyclopellegic mydriatics).

M-Holoblocators

Pharmacodynamics: As a result of the blockade of m-cholinoreceptors located in the sphincter of the pupil and the ciliary muscle, there is a passive expansion of the pupil due to the predominance of the muscle tone, expanding the pupil, and relaxing the muscles, which is narrowing. At the same time, by relaxation of the ciliary muscles, paresis accommodation occurs.

Intensively pigmented iris more resistant to dilatation (dia. 9),

Chart 9. Changing the width of the pupil in people with different degrees of iris pigmentation after one-time instillation of various mydriatics.

to achieve a sufficient mydritic effect, it is necessary to increase the concentration or frequency of administration. As a result of an increase in the dose of the drug, the development of systemic side effects and symptoms of overdose in this group of patients is possible.

The expansion of the pupil can provoke a sharp attack of glaucoma in patients with closed-dealers and mixed glaucoma, persons over 60 years old and people with hypermetropine, predisposed to the closed gloomy due to the fact that they have a shallow front chamber.

Blocking M-cholinoreceptors in other organs and tissues, drugs of this group reduce the secretion of tear, salivary, bronchial, sweat and gastric glands. M-cholinoblocators reduce tone smooth muscles internal organs (bronchi, urethra, bladder and gastrointestinal tract). There is a moderate stimulating effect on the CNS (excitation, hallucinations, etc.) and a delayed long sedative action. Low tone wandering nerve, lead to an increase in heart rate and increase the conductivity, but the Gisa beam. In high doses cause vasodilation.

M-cholinoblocators are distinguished by strength and duration of action - short (diagnostic) [TropicsD) and long-term (therapeutic) action, cyclapenolat (Cydopentolate), scopolamine (scopolamin), homatopin (HOMATMPIN) [MNN]].

The dynamics of the cyclopelgic and mymatic effects of M-cholinoblocators is indicated in Table. 36

Table 36. Dynamics of pharmacological effects of cyclopelgic mydriatics

Indications for use - Midships use:

• to achieve cycliplegia in order to study refractures in children;
• in preoperative preparation of patients with cataract extraction.

It should be used with caution in small children and the elderly, patients with Down syndrome and expressed urination disorders during prostate adenoma, with severe diseases of the cardiovascular system.

It is necessary to warn patients that driving a car for at least 2 hours after the study is prohibited.

Side effects: Local nature is an increase in VGD, the transient reduction in vision, photophobia, swelling and hyperemia of the skin of the eyelids and conjunctiva.

Systemic nature - dry mouth, tachycardia, constipation, difficulty urination, hallucinations, excitation.

: With simultaneous use with nitrates, the risk of increasing IOP, with novocaina - it is possible to enhance anticholinergic effects.

Atropine (ATROPINUM) [MNN]

Pharmacodynamics: It has the maximum expressed mydritic and cyclopelgic effect. The expansion of the pupil after one-time injection of atropine reaches a maximum after 30-40 minutes and is preserved for 7-10 days. The cycloplegia after one-time injection of atropine reaches a maximum after 60-180 minutes and are stored for 6-12 days. The severity and dynamics of the mydritic and cyclopelic effect of atropine is indicated on the diabetes. 10.

Diagram 10.. Changing the volume of accommodation and the width of the stool after one-time instillation of atropine (according to Wolfe A. V., Honge N. C,).

Pharmacokinetics: Under the local application (drip or subconjunctive), atropine accumulates in almost all eye tissues (dia. 11).

Chart 11. Changes in an atropine concentration in eye tissues (according to Janes R. G., Stiles J. F.).

In the tissues, the eyes partially hydrolyzed under the influence of the enzyme - atropineserase. When local application is well adsorbed into systemic blood flow. About 40% is metabolized in the liver. The unchanged preparation and its metabolites are derived from the urine. The half-life is 2 h.

Indications for the use of atropine:

• to expand the pupil when conducting ophthalmoscopy;
• to achieve cyclopalegia in order to study refractures in children (especially in children under 4);
• for the treatment of spasms of accommodation of a semi-unpleasant and persistent nature in children with refractive anomalies;
• in the complex therapy of inflammatory diseases of the forefront of the eye in order to prevent the development of the rear synechs;
• for the treatment of embolism and spasm of the central artery of the retina.

  Contraindications: Atropine should not be used in children up to 3 months, in patients with a closed-nailed glaucoma or an anatomically narrow angle of the front chamber, with increased sensitivity To the components of the drug.

It should be used with caution in small children (only 0.5% solution is used in children under 7 years) and the elderly, patients with Down syndrome and expressed urination disorders in the prostate adenoma, with severe diseases of the cardiovascular system.

Side effects: Atropine causes the same side effects (both local and systemic nature) as other M-cholinoblocators.

In large doses in young children and old people, agropin can lead to a paralysis of breathing, it causes mental and motor anxiety, dizziness, cramps, hallucinations. To reduce the side effects of a systemic nature, a few minutes after the instillation, it is necessary to press the lacrimal tubules in the inner corner of the eye.

Method of application and dose: To carry out ophthalmoscopy 0.5-g, the solution is used once. The study can be carried out after 30 minutes.

To study the refraction 0.5-1%, the solution is buried 2 times a day for 1-3 days before the study.

In an integrated therapy of uveitis, 0.5-1% solution is buried 2-3 times a day. Also, for this purpose, the subconjunctive injections of 0.1% of the atropine solution or 0.1-0.5% solution is introduced by electrophoresis using the electrophoresis or the eye body from the anode.

For the treatment of discirculatory disorders in the central artery of the retina 0.2-0.5 ml of 0.1% of the atropine solution, parabulbarnically or retrobulbarno is injected.

Interaction with others drugs : When applying atropine with monoaminoxidase inhibitors, heart arrhythmias arise; With quinine, novocainamide is possible to increase the cholinolitical effect. When taking inside, with the drugs of the valley, Tanin is observed by physico-chemical interaction, leading to a mutual weakening of effects.

Preparations

Agropine is produced in the form of 1% eye drops, ointments and 0.1% injection solution, 0.5% eye drops containing atropine are manufactured by EX Temporae.

• Atropine sulfate (Russia) - 1% eye drops in bottles of 5 ml;
• Atropin ointment (Russia) - 1% eye ointment;
• Eye films with atropine sulfate (Russia);
• Atromed (ATROMED) (Promed Exports Pvt Ltd, India) - 1% solution (eye drops) in 5 ml bottles.

Cyclopentolate (Cyclopentolate) [MNN]

Pharmacodynamics: It has less pronounced, compared with atropine, mydriatic action. After instillation of cyclopentolate, the maximum mydriasis develops in 30-60 minutes, and the expansion of the pupil is preserved for 24 hours. Cycliplegia is observed in 25-75 minutes after instillation, residual phenomena Cyclopelles persist 12-24 hours. The severity and dynamics of cyclopentolate effects are presented on the diagram. 12 and 13.

Diagram 12. Changing the width of the pupil after the instillation of cyclopentolate (according to Prriestley V. S., MEDINC M. M.).

Chart 13. Changes in accommodation after a single instillation of a 1% tropiac form solution, 1% solution of cyclopentolate, 4% homatropine solution (according to Gettes in .. Belmont O.).

Pharmacokinetics: No data.

Indications for use: Used to achieve cyclopalegia in order to study refraction in children (it is better to use in children over 4 years old). In addition, it is used to treat spasms of accommodation of a semi-free and persistent nature in children with refractive anomalies and in the complex therapy of inflammatory diseases of the forefront of the eye in order to prevent the development of the rear synechs, in the preoperative preparation of patients with cataract extraction.

Correspond to the previously listed for atropine and the entire group of cholinolithics as a whole.

Method of application and dose: Day study of the Eye DNA Cyclopentolate is buried 1-3 times 1 drop with an interval of 10 minutes.

To achieve cycloplegia, 2-3-fold instillations with an interval of 15-20 minutes are required.

It is used for medical purposes 3 times a day.

A drug

• Cyclomed (Cyclomed) (Promed Exports Pvt Ltd, India) - 1% eye drops in 5 ml bottles.

Gomatropine (HOMATROPINE) [MNN]

Pharmacodynamics: has a less pronounced Midritic action compared to atropine. After a single instillation of homatropine, the maximum mydriasis and cyclopelgia develop after 40-60 minutes and are stored for 1-3 days. The severity and dynamics of effects are presented on the diabetes. 13 and 14.

Chart 14. Changing the width of the pupil after one-time instillation of homatropine, tropiacal, phenylephrine (according to Gainbill H. D .. Oleg K. N.).

Pharmacokinetics: No data.

Indications for use: Used to achieve cyclopalegia in order to study refraction in children (it is better to use in children over 4 years old). In addition, it is used to treat the spasms of the accommodation of a semi-unpleasant and persistent nature in children with refraction anomalies and in the complex therapy of inflammatory diseases of the forefront of the eye in order to prevent the development of the rear synechs.

Contraindications and side effects

Method of application and dose: To explore the Eye Dna, the homatropine is instilled once. To achieve the cycpposlegia, 2-3 multiple bundles with an interval of 5-10 minutes are required. It is used for medical purposes 3 times a day.

A drug

• 0.25% homatropine solution (eye drops) is manufactured by Ex Temro. In world practice, 2 and 5% homatropine hydrobromide solutions are used.

Skopolamine (Scopolamine) [mnn]

Pharmacodynamics: It has less pronounced, compared with atropine, mydriatic action. After a single instillation of the Skopolamine, the maximum mydriasis develops after 20-30 minutes, the cycliplegia - 30-60 minutes and persisted within 3-7 days. The severity and dynamics of effects are presented on the diabetes. fifteen.

Chart 15. Changing the volume of accommodation and the width of the pupil after one-time set of scopolamine (according to Morron J.).

Pharmacokinetics: No data.

Indications for use: Used to achieve cyclopalegia in order to study refraction in children (it is better to use in children over 4 years old). In addition, it is used to treat the spasmodization of the accommodation of a semi-unpleasant and persistent nature in children with refractive anomalies and in the complex therapy of inflammatory diseases of the front eye in order to prevent the development of the rear sines.

Contraindications and side effects Complies previously listed for the entire group of cholinolithics as a whole.

Method of application and dose: For the study of the eye dame of 0.25%, the scopolamine solution is instilled once. To achieve cycloplegia, 1-2-fold instillation with an interval of 5-10 minutes per 1 hour before the study is required. With therapeutic purpose, it is used 3-4 times a day.

A drug

• 0.25% Skoplamine solution (eye drops) manufactures Ex Tempor.

Tropicamid (Tropicamid)

Pharmacodynamics: Short-effect Midship. The expansion of the pupil after injection tropiacs is observed after 5-10 minutes, the maximum mydriasis is noted after 20-40 minutes with a duration of the effect of 1-2 hours, the initial width of the pupils is restored after 6 hours. Maximum accommodation paresis occurs in 25 minutes and persisted for 15-30 min. Full binding of the cyclopelgia occurs after 3 hours. The dynamics and severity of effects are presented on the diagram. 13 and 14.

Pharmacokinetics: No data.

Indications for use: Used when studying the eye eye. It is rarely used to determine refractive in small children and with the medical goal for the prevention of the rear synechs in inflammatory eye diseases.

Contraindications and side effects Complies previously listed for the entire group of cholinolithics as a whole. However, side effects are less pronounced than other drugs. Tropicid can be used in children under the age of 3 months.

Method of application and dose: for diagnostic expansion (the lap 1 drop of 1% solution or twice 1 drop of 0.5% solution with an interval of 5 minutes. After 10 minutes, an ophthalmoscopy can be carried out. To determine the refraction, the drug is buried 6 times with an interval of 6-12 minutes. In approximately 25-50 minutes, paresis accommodation occurs and research can be carried out. With therapeutic purposes are used 3-4 times a day.

Preparations

• Midryacil (MyDriacyl) (Alcon-Couvreur, Belgium) 0.5% and 1% eye drops in dropper bottles of 15 ml;
• Midrum (Mydrum) (Laboratories Chauvin SA, Germany) 0.5% and 1% eye drops in dropper bottles of 15 ml;
• Tropicamid (Tropicamid) (Biogal, Hungary) - 0.5% and 1% eye drops in 15 ml flocks.

Article from the book: