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Direct-Acting Cholinergic Agonists: Therapeutic Uses01:11

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Direct-acting cholinergic agonists have many therapeutic uses in various medical fields. Choline esters, including acetylcholine, have limited clinical utility due to their non-selectivity and short duration of action. Still, acetylcholine and carbachol are applied topically during ophthalmologic surgery to induce miosis. Pilocarpine, a muscarinic and ganglionic stimulator, effectively treats open-angle glaucoma and alleviates xerostomia and dry mouth caused by radiotherapy or Sjögren...
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Direct-acting cholinergic agonists, such as synthetic choline esters and naturally occurring alkaloids, exert their effects by enhancing the actions of acetylcholine and stimulating the parasympathetic nervous system. Synthetic choline esters share structural similarities with acetylcholine. For example, they have a positively charged quaternary ammonium or onium group, contributing to their hydrophilic characteristics. As a result, they are poorly absorbed in the body through oral...
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SHORT-WAVELENGTH AUTOMATED PERIMETRY IN DIABETIC PATIENTS WITHOUT RETINOPATHY.

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[Pharmacological Tests for Horner Syndrome - Case Report].

K Skorkovská

    Ceska a Slovenska Oftalmologie : Casopis Ceske Oftalmologicke Spolecnosti a Slovenske Oftalmologicke Spolecnosti
    |June 25, 2016
    PubMed
    Summary

    This case report details a patient with long-standing anisocoria, diagnosed as left-sided Horner syndrome. It highlights challenges with current pharmacological tests for Horner syndrome and suggests alternatives.

    Keywords:
    Horner syndromeanisocoriacocaine testphenylephrine.

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    Area of Science:

    • Ophthalmology
    • Neurology

    Background:

    • Anisocoria, a difference in pupil size, can indicate various neurological or ocular conditions.
    • Horner syndrome is characterized by ptosis, miosis, and anhidrosis, resulting from disrupted sympathetic nerve pathways to the face and eye.

    Observation:

    • A patient presented with anisocoria (right pupil larger than left) for over a year, with a left-sided slight ptosis and left pupil dilation deficit.
    • Ophthalmological examination revealed normal anterior and posterior eye segments, but a slightly decolored iris on the left.

    Findings:

    • The clinical presentation strongly suggested left-sided Horner syndrome.
    • The underlying cause of the Horner syndrome remained unidentified.
    • Pharmacological pupillary tests, crucial for diagnosing Horner syndrome, present current challenges.

    Implications:

    • The case underscores the diagnostic difficulties in identifying the etiology of Horner syndrome.
    • It prompts a discussion on the limitations of standard diagnostic tests like the cocaine test.
    • The report proposes alternative pharmacological tests using substances available in the Czech Republic for Horner syndrome diagnosis.