Paper I
2015 February (2010 Scheme) · 40 marks · 120 min

Question

Explain briefly why physostigmine is preferred over neostigmine for the treatment of glaucoma.

Q91 marksShort Answers

Answer

Physostigmine is a tertiary amine (lipid-soluble) that penetrates the cornea well when applied topically, giving good miotic/intraocular pressure-lowering effect. Neostigmine is a quaternary ammonium compound (poorly lipid-soluble), so it penetrates the cornea poorly and is less effective topically. Additionally, physostigmine produces less local irritation than neostigmine, making it better tolerated for topical ocular use in glaucoma.

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