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Parasympathomimetic, carbamate inhibitor
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Demecarium bromide is a potent, long acting cholinesterase- inhibitor used topically to treat acute glaucoma. Parasympathomimetic drugs cause contraction of the muscles associated with the ciliary body and of the iris sphincter. This allows increased outflow of aqueous humor by mechanically opening the iridocorneal angle. Parasympathomimetic drugs also increase aqueous humor protein and may cause vasodilation of the conjunctiva. In dogs, demecarium bromide has been shown to decrease intraocular pressure for up to 48 hours.
The most commonly used parasympathomimetic to treat primary glaucoma is 2% pilocarpine. Demecarium bromide is an alternative drug.
Acute primary glaucoma generally is a breed-related hereditary condition. It is a true medical emergency. Topical prostaglandins are the first-line drugs of choice in the affected eye. Demecarium bromide often is used in the medical management of the non-affected eye. Almost all cases of primary glaucoma will become bilateral if the contralateral eye is not monitored and appropriately medicated. One of the advantages to demecarium bromide is that it may be administered once or twice a day.
As with other parasympathomimetic drugs, overdose may cause GI distress, hypotension, bradycardia, and dyspnea.
Dr. Barbara Forney is a veterinary practitioner in Chester County, Pennsylvania. She has a master's degree in animal science from the University of Delaware and graduated from the University of Pennsylvania School of Veterinary Medicine in 1982.
She began to develop her interest in client education and medical writing in 1997. Recent publications include portions of The Pill Book Guide to Medication for Your Dog and Cat, and most recently Understanding Equine Medications published by the Bloodhorse.
Dr. Forney is an FEI veterinarian and an active member of the AAEP, AVMA, and AMWA.
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