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ACUTE EXPOSURE INFORMATION
- CHOLINERGIC SYNDROME -
- Carbachol chloride is a direct-acting cholinergic compound.
- Carbachol chloride is used as a miotic in human medicine and a parasympathomimetic in large animal veterinary medicine (ie, for colic in horses). It is used as a miotic agent in intraocular surgery, where it has been shown to be less toxic to the endothelium than acetylcholine. It had no substantial toxic effects on the corneal endothelium when injected intracamerally in cats.
- Carbachol chloride is used as eye drops to lower intraocular pressure in glaucoma, by instillation into the anterior chamber of the eye to produce miosis in cataract surgery, in the treatment of intestinal atony and urinary retention, and to halt paroxysmal supraventricular tachycardia.
- Carbachol chloride can be used to lower intraocular pressure in glaucomatous dogs. It has been used experimentally to increase blood pressure and produce cardiovascular stimulant effects in experimental animals when infused directly into the cerebral ventricles. It causes seizures and brain damage when injected directly into the amygdala or hippocampus of rats.
- Carbachol chloride can be absorbed following ingestion or dermal contact. At the time of this review, no data were found on whether or not it can be systemically absorbed by inhalation, although it did increase airway resistance in sheep and human volunteers following inhalation exposure by direct stimulation of airway smooth muscle. In normal and asthmatic human subjects, bronchoconstriction induced by inhaled carbachol chloride could be prevented by prior inhalation of cromolyn sodium.
- Carbachol directly stimulates muscarinic sites, but also stimulates acetylcholine release and has pronounced nicotinic effects on the neuromuscular skeletal muscle junction, postganglionic autonomic nervous system, and adrenal medulla.
- Typical CHOLINERGIC symptoms include MUSCARINIC EFFECTS (miosis, flushing, bradycardia, bronchospasm, increased bronchial secretions, involuntary urination and/or defecation, nausea, vomiting, sweating, lacrimation, salivation, hypotension, hypothermia, and seizures). CARBACHOL also produces NICOTINIC EFFECTS (muscle cramps, fasciculations, weakness, paralysis, tachycardia, and hypertension).
- Carbachol chloride releases toxic and irritating fumes of chloride, ammonia, and oxides of nitrogen when heated to decomposition. Inhalation exposure to such fumes would be predicted to result in respiratory tract irritation with bronchospasm, chemical pneumonitis, or noncardiogenic pulmonary edema.
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