Acetylcholine


Concise Prescribing Info
Indications/Uses
Miosis during surgery.
Dosage/Direction for Use
Adult : Intraocular As 1% soln: Instill 0.5-2 mL directly into the anterior chamber of the eye. For prolonged miosis, a 2nd application may be used.
Dosage Details
Intraocular
Miosis during surgery
Adult: As 1% soln: Instill 0.5-2 mL (5-20 mg) directly into the anterior chamber of the eye before or after securing one or more sutures. For prolonged miosis, a 2nd application may be used.
Reconstitution
Reconstitute according to manufacturer’s instructions to produce a 2 mL soln containing acetylcholine 1% and mannitol 2.8%. Prepare the soln immediately before use.
Special Precautions
Patient w/ anterior/posterior synechiae, asthma, obstructive airway disease, CV disorder (e.g. bradycardia, heart block, recent MI), hypotension, vagotonia, epilepsy, parkinsonism, hyperthyroidism, peptic ulcer.
Adverse Reactions
Nausea, vomiting, abdominal pain, salivation, lachrymation, rhinorrhoea, eructation, diarrhoea, urinary frequency, headache, peripheral vasodilation; corneal oedema, clouding, and decompensation, persistent bullous keratopathy, retinal detachment, post-op iritis. Rarely, bradycardia, flushing, hypotension, sweating, dyspnoea, bronchoconstriction.
Overdosage
Symptoms: Bradycardia, hypotension, flushing, breathing difficulty, sweating. Management: Symptomatic and supportive treatment. Administer atropine sulfate 0.5-1 mg via IV/IM/SC inj. Epinephrine 0.1-1 mg may be beneficial for severe CV or bronchoconstrictor responses.
Drug Interactions
Enhanced and prolonged effect w/ cholinesterase inhibitors (e.g. neostigmine). May cause severe bronchospasm w/ subsequent pulmonary oedema and cardiac conduction abnormality w/ β-blockers (e.g. metoprolol). May become ineffective w/ ophth NSAIDs.
Action
Description: Acetylcholine, a quaternary ammonium parasympathomimetic, is an endogenous neurotransmitter released from postganglionic parasympathetic nerves to produce peripheral actions corresponding to muscarine. It stimulates the parasympathetic nervous system causing vasodilation, cardiac depression, miosis, and decrease in intraocular pressure. Additionally, it also has actions that corresponds to nicotine producing stimulant action on skeletal muscle, autonomic ganglia, and adrenal medulla.
Onset: Rapid.
Duration: Approx 20 min.
Chemical Structure

Chemical Structure Image
Acetylcholine

Source: National Center for Biotechnology Information. PubChem Database. Acetylcholine, CID=187, https://pubchem.ncbi.nlm.nih.gov/compound/Acetylcholine (accessed on Jan. 20, 2020)

Storage
Store between 4-25°C. Do not freeze or resterilise.
MIMS Class
ATC Classification
S01EB09 - acetylcholine ; Belongs to the class of parasympathomimetics. Used in the treatment of glaucoma and miosis.
References
Anon. Acetylcholine. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 08/08/2016.

Buckingham R (ed). Acetylcholine Chloride. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 08/08/2016.

Joint Formulary Committee. Acetylcholine Chloride. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 08/08/2016.

McEvoy GK, Snow EK, Miller J et al (eds). Acetylcholine Chloride (EENT). AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 08/08/2016.

Disclaimer: This information is independently developed by MIMS based on Acetylcholine from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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