Zimmerman T J, Wheeler T M
Ophthalmology. 1982 Jan;89(1):76-80. doi: 10.1016/s0161-6420(82)34866-6.
Pilocarpine, a parasympathomimetic drug used in the treatment of glaucoma, produces a variety of ocular and systemic adverse reactions. Ocular side effects include miosis, accommodative spasm, frontal headaches, twitching lids, conjunctival injection, cataractous changes, allergic reactions, iris cysts, retinal detachment, increased permeability of the blood-aqueous barrier, anterior chamber narrowing, and the potential for inducing an acute angle-closure attack. Systemic side effects include nausea, vomiting, tenesmus, abdominal spasm, salivation, lacrimation, sweating, pulmonary edema, and bronchial spasm. The systemic side effects can best be minimized initially through proper use of the medication and nasolacrimal occlusion. The Ocusert, a long-acting pilocarpine-incorporated ocular insert, is a recent advance in delivery technique that offers an adequate hypotensive action with fewer side effects. Pilopex is a promising new experimental pilocarpine polymer salt presently being studied in Israel. Photomydriasis, a process involving the use of a laser to enlarge miotic pupils also offers help for these patients. N-demethylated carbachol is a new parasympathomimetic drug currently under study for glaucoma therapy. Initial results show that it may have considerable ocular hypotensive action with fewer adverse effects.
毛果芸香碱是一种用于治疗青光眼的拟副交感神经药物，会产生多种眼部和全身不良反应。眼部副作用包括瞳孔缩小、调节痉挛、额头痛、眼睑抽搐、结膜充血、白内障改变、过敏反应、虹膜囊肿、视网膜脱离、血-房水屏障通透性增加、前房变窄以及诱发急性闭角型青光眼发作的可能性。全身副作用包括恶心、呕吐、里急后重、腹部痉挛、流涎、流泪、出汗、肺水肿和支气管痉挛。最初通过正确使用药物和鼻泪管阻塞可最大程度减少全身副作用。Ocusert是一种长效含毛果芸香碱的眼内植入物，是给药技术的一项最新进展，能提供足够的降压作用且副作用较少。Pilopex是一种有前景的新型实验性毛果芸香碱聚合物盐，目前正在以色列进行研究。光散瞳术，即一种使用激光扩大缩瞳的瞳孔的方法，也为这些患者提供了帮助。N-去甲基卡巴胆碱是一种目前正在研究用于青光眼治疗的新型拟副交感神经药物。初步结果表明，它可能具有相当大的降眼压作用且副作用较少。
