Demecarium bromide is an example of which class of glaucoma medications?

Demecarium bromide is an example of which class of glaucoma medications?

• A. Pilocarpine 2%
• B. Demecarium bromide
• C. Dorzolamide 2%
• D. Timolol

Answer: (B)

Demecarium bromide belongs to the indirect-acting cholinergic (acetylcholinesterase inhibitor) class. By inhibiting acetylcholinesterase, it raises acetylcholine levels at the ocular muscarinic receptors, leading to prolonged stimulation of the iris sphincter and ciliary muscle. This causes miosis and improved trabecular outflow of aqueous humor, lowering intraocular pressure. It’s distinct from direct-acting muscarinic agents like pilocarpine, which stimulate receptors directly, and from carbonic anhydrase inhibitors or beta-blockers, which reduce aqueous production rather than enhance outflow. Demecarium’s indirect mechanism gives it a longer duration but also more systemic side effects, which is why its use has declined in favor of other agents.

Demecarium bromide belongs to the indirect-acting cholinergic (acetylcholinesterase inhibitor) class. By inhibiting acetylcholinesterase, it raises acetylcholine levels at the ocular muscarinic receptors, leading to prolonged stimulation of the iris sphincter and ciliary muscle. This causes miosis and improved trabecular outflow of aqueous humor, lowering intraocular pressure. It’s distinct from direct-acting muscarinic agents like pilocarpine, which stimulate receptors directly, and from carbonic anhydrase inhibitors or beta-blockers, which reduce aqueous production rather than enhance outflow. Demecarium’s indirect mechanism gives it a longer duration but also more systemic side effects, which is why its use has declined in favor of other agents.