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Pilocarpine
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
Pilocarpine is a natural alkaloid extracted from plants of the genus Pilocarpus with cholinergic agonist activity. As a cholinergic parasympathomimetic agent, it predominantly binds to muscarinic receptors, thereby inducing exocrine gland secretion and stimulating smooth muscle in the bronchi, urinary tract, biliary tract, and intestinal tract. When applied topically to the eye, this agent stimulates the sphincter pupillae to contract, resulting in miosis. It also stimulates the ciliary muscle to contract, resulting in spasm of accommodation and may cause a transitory rise in intraocular pressure followed by a more persistent fall due to opening of the trabecular meshwork and an increase in the outflow of aqueous humor. Pilocarpine is indicated for the treatment of radiation-induced dry mouth (xerostomia) and symptoms of dry mouth in patients with Sjögren’s syndrome. It is also used as a miotic in the treatment of glaucoma. In pharmaceutical products, pilocarpine is employed as pilocarpine hydrochloride (CAS number 54-71-7, EC number 200-212-5, molecular formula C11H17CIN2O2) (1).
Head and Neck Cancer
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Lorcan O’Toole, Nicholas D. Stafford
These symptoms can be ameliorated by the use of artificial saliva preparations and increased oral fluid intake. There is some evidence that pharmacological interventions such as pilocarpine may benefit a proportion of patients but at the risk of additional side effects.
Cholinergic Agonists
Published in Sahab Uddin, Rashid Mamunur, Advances in Neuropharmacology, 2020
Rupali Patil, Aman Upaganlawar
It shows some selectivity in stimulating secretion from various exocrine glands, such as sweat, salivary, lacrimal, and bronchial glands, and contracting iris smooth muscle. It has weak effects on GI smooth muscle and the heart (Rang et al., 2011). The sweat glands are sensitive to pilocarpine. After isolation of pilocarpine in 1875, shortly thereafter, Weber described its actions on the pupil and on the sweat and salivary glands (Brunton, 2011).
A review of dry eye disease therapies: exploring the qualities of varenicline solution nasal spray
Published in Expert Review of Ophthalmology, 2023
Siddharth Bhargava, Ranjani Panda, Asma M Azam, John D Sheppard
Approximately 34% of basal tear film production is thought to originate from the activation of efferent trigeminal parasympathetic nerves [68]. The trigeminal nerve endings scattered throughout the nasal cavity epithelium possess nicotinic acetylcholine receptors (nAChR’s) [69]. As such, molecular agonists that stimulate nAChR’s could function to activate the NLR, thereby increasing tear film production. Oral formulations of pilocarpine and cevimeline, muscarinic acetylcholine receptor agonists, are used in patients with Sjögren’s syndrome for the treatment of dry mouth. However, studies have reported symptomatic improvement in dry eye symptoms with such systemic administration [70–72]. Expectedly, systemic off-target parasympathetic side effects of the oral delivery route, such as nausea, diarrhea, flushing, and frequent urination, make this a sub-optimal modality for the treatment of dry eyes.
History of asthma in Canada
Published in Canadian Journal of Respiratory, Critical Care, and Sleep Medicine, 2022
Asthma treatments in the 19th century were rudimentary at best. Bronchodilator agents were available in herbal remedies including Ma Huang, an oral Chinese remedy containing ephedrine and used for more than 2,000 years, and an inhaled (cigarettes and burning powders) South Asian remedy, Datura Stramonium-containing belladonna (anticholinergic) alkaloids, brought from India to Britain around 1800. The former is not mentioned in Osler’s texts while the latter received passing mention.37,38 Atropine38 and pilocarpine,37 both anti-muscarinic, are mentioned. Other than that, treatments were symptomatic and include many agents that are currently considered absolutely or relatively contraindicated in the management of asthma. Drugs used acutely included morphine, cocaine, chloral hydrate, inhaled amyl nitrate, inhaled chloroform, inhaled ether, burning niter paper,37,38 tobacco smoking38 and strychnine.38 Chronic management included particular attention to diet and changing the environment (trial and error appears to have been the major method) along with potassium iodide and occasionally arsenic.38
Surgical Outcomes of Modified CO2 Laser-assisted Sclerectomy for Uveitic Glaucoma
Published in Ocular Immunology and Inflammation, 2022
Junyan Xiao, Chan Zhao, Yang Zhang, Anyi Liang, Yi Qu, Gangwei Cheng, Meifen Zhang
Postoperatively, the patients were treated with topical antibiotics and prednisolone eye drops, the doses of which were gradually adjusted and tapered to the preoperative maintenance dose by uveitis specialists. In addition, 2% pilocarpine was used each night for at least 4 weeks. Adjustable sutures were released transconjunctivally under a slit lamp at an early stage (<14 days) after the operation. The inner wall of the TM was assessed via gonioscopy at each visit. An experienced investigator performed ultrasound biomicroscopy (UBM) at 1 month, 3 months, and 12 months postoperatively. The probe frequency was 50 MHz, and the dB gain was adjusted to obtain the optimal image resolution and quality in the sclerectomy area. The size of the intrascleral lake at 1 month was compared with that at follow-up visits, and the morphological changes were divided into the following 4 types (Figure 1): stable (no change), mild reduction (≤30% change), moderate reduction (30% to 50% change), and severe reduction (>50% change, impending closure). If IOP exceeded 21 mm Hg and UBM revealed a severe reduction in the size of the intrascleral lake, then a needling procedure was performed, followed by a subconjunctival or subscleral injection of 5-FU (0.2 mL, 50 mg/mL). If the target IOP was not achieved, then laser goniopuncture (LGP) was performed with a Microruptor II neodymium: YAG (Nd:YAG) laser after severe PAS or iris incarceration was excluded postoperatively.