Phospholine Iodide (echothiophate 0.125%)

Succinylcholine and general anesthesia: Possible respiratory or cardiovascular collapse, so succinylcholine should be given only with great caution, if at all, before or during general anesthesia in a patient on anticholinesterase medication.

Systemic anticholinesterase therapy: Caution when treating elevated IOP in a patient concurrently on systemic anticholinesterase medication, because of possible additive effects.

Organophosphate and carbamate exposure: Patients exposed to these insecticides and pesticides should be warned of additive systemic effects from respiratory tract or skin absorption; respiratory masks, frequent washing, and clothing changes may be advisable during exposure.

Cholinergic symptoms: Temporary discontinuance is necessary if salivation, urinary incontinence, diarrhea, profuse sweating, muscle weakness, or respiratory difficulty occurs.

Cardiac irregularities: Discontinue if they occur.

Vagotonic conditions: Caution, if used at all, in marked vagotonia, bronchial asthma, spastic gastrointestinal disturbance, peptic ulcer, pronounced bradycardia and hypotension, recent myocardial infarction, epilepsy, parkinsonism, and other disorders that may respond adversely to vagotonic effects.

Prior retinal detachment: Caution where there is a prior history.

Systemic absorption: Digital compression of the nasolacrimal ducts for a minute or two after instillation reduces drainage into the nasal chamber, and hands should be washed afterward to prevent skin absorption.

Examinations in accommodative esotropia: Regular examinations are advisable while the drug is prescribed for this indication.