Pilocarpine 2. Therapeutic use

2. Therapeutic use in glaucoma: Pilocarpine is used to treat glaucoma and is the drug of choice in the emergency lowering of intraocular pressure of both narrow-angle (or closed-angle) and wide-angle (also called open-angle) glaucoma. Pilocarpine is extremely effective in opening the trabecular meshwork around Schlemm’s canal, causing an immediate drop in intraocular pressure as a result of the increased drainage of aqueous humor. This action occurs within a few minutes, lasts 4 to 8 hours, and can be repeated. The organophosphate echothiophate inhibits AChE and exerts the same effect for a longer duration. [Note: Carbonic anhydrase inhibitors, such as acetazolamide, as well as the β-adrenergic blocker timolol, are effective in treating chronic glaucoma but are not used for emergency lowering of intraocular pressure.] The miotic action of pilocarpine is also useful in reversing mydriasis due to atropine.Sjögren’s syndrome (increases salivation) • was used in glaucoma (causes miosis, cyclospasm