Cikloplegici i midrijatici
Midrijatici uzrokuju širenje zjenice, slično cikloplegicima. Treba znati da smeđe šarenice zahtijevaju jači midrijatik od svijetlih.
Cikloplegici izazivaju paralizu cilijarnog mišića i midrijazu, potrebne u skijaskopiji i pregledu stražnjeg segmenta. Pacijenta treba upozoriti da ove kapi tokom nekoliko sati zamućuju vid na blizinu, te da će im zbog široke zjenice smetati jače svjetlo.
Djelovanje svih cikloplegika i midrijatika počinje za 15-60 minuta, no razlikuju se u trajanju djelovanja.
Tropikamid 1% se koristi najčešće. Ukapa se dva puta tokom pet minuta. Midrijaza nastaje za 20 minuta, a traje oko četiri sata.
Ciklopentolat 1% je jači i djeluje oko 24 sata.
Homatropin 1-2% djeluje oko dva dana.
Atropin 1% je najjači cikloplegik i djeluje do sedam dana.
Fenilefrin-hidroklorid 10% je midijatik bez cikloplegičke komponente.
Anticholinergics
Both dilation of the pupil (mydriasis) and paralysis of accommodation (cycloplegia) are produced by anticholinergic agents applied topically. They vary in their relative potencies and duration of action. See table .
Atropine is useful in the management of inflammatory conditions involving the iris and uveal tract, and for refraction in children up to about 6 years of age.
Tropicamide displays action similar to atropine but with more rapid onset and shorter duration. It is considered an inadequate cycloplegic in children
Sympathomimetics
Phenylephrine is mainly a direct-acting alpha- adrenoceptor stimulant.
Solutions of 2.5-10% produce mydriasis with insignificant effect on accommodation. 10% solutions may have profound effects on the cardiovascular system and should be used with caution. It is mainly indicated for dilatation of the pupil for fundoscopy, sometimes in combination with cyclopentolate or tropicamide.
Tablica s dužinama djelovanje svih cikloplegika
http://books.google.hr/books?id=Eybg7fb ... le&f=falsehttp://books.google.hr/books?id=ydim6J7 ... le&f=falseTropicamide (1%): An Effective Cycloplegic Agent for Myopic Children
http://www.iovs.org/content/42/8/1728.abstractThere is also an important role of tropicamid 1% for the prevention and/or treatment of posterior synechia..
http://books.google.hr/books?id=QhSmGd_ ... mide+(1%25)+synechiae+Children&source=bl&ots=lUl4aPotIl&sig=hqFMoptzyoFN8qzuM3As1DqkrW8&hl=hr&ei=2lrqTOTiNoXNhAfDwPgO&sa=X&oi=book_result&ct=result&resnum=3&ved=0CBwQ6AEwAjgK#v=onepage&q&f=false