Cyclopentolate Hydrochloride

To compare the final cycloplegic refraction of tropicamide 1% and cyclopentolate 1% in children 3-16 years of age with brown irides.

Randomized, controlled, multicenter prospective clinical trial.

Included patients were randomized to either cyclopentolate 1% or tropicamide 1% in the first visit with autorefraction measurements. Each subject underwent a second cycloplegic refraction using the other agent on a separate visit with a minimum of 1-week interval and a maximum of 12 weeks. We measured the change in SE (ΔSE) for each eye by deducting the SE before cycloplegia from the SE after cycloplegia.

A total of 185 eyes from 94 children aged 3-16 years (average= 8.79 ±3.11 years) were included. The average SE of both eyes before cycloplegia was -0.082 ± 4.8 diopters. The SE after instillation of cyclopentolate and tropicamide in both eyes was 1.07±5.2 and 0.96±5.1, respectively (P value < .001). The average ΔSE after cycloplegia was 1.15±1.2 for cyclopentolate and 1.04±1.2 for tropicamide (P value < .001). The difference between ΔSE of cyclopentolate and tropicamide was found statistically significant at 0.11±1.2 (P < .001), although clinically insignificant. The ΔSE between the 2 drops before and after cycloplegia in both eyes for all refractive error groups was clinically insignificant. The greatest effect of cyclopentolate and tropicamide was in hyperopic eyes with ΔSE of 1.54±1.4 and 1.39±1.4, respectively.

Tropicamide might be an effective and safe replacement for cyclopentolate in the refracting nonstrabismic pediatric population 3-16 years of age regardless of their refractive error status.

New psychoactive substances are constantly emerging, among which ketamine analogs with the core structure of 2‐amino‐2‐phenylcyclohexanone have attracted global attention due to their continued involvement in acute intoxications. The monitoring of these substances largely relies on the acquisition of metabolic data. However, the lack of in vitro human metabolism information for these emerging structural analogs presents significant challenges to drug control efforts. To address this challenge, we investigated the first‐phase metabolism patterns of four novel ketamine structural analogs of 2‐FXE [2‐(ethylamino)‐2‐(2‐fluorophenyl) cyclohexan‐1‐one], 2‐MDCK [2‐(methylamino)‐2‐(o‐tolyl) cyclohexan‐1‐one], 3‐DMXE [2‐(ethylamino)‐2‐(m‐tolyl) cyclohexan‐1‐one], and 2‐DMXE [2‐(ethylamino)‐2‐(o‐tolyl) cyclohexan‐1‐one] utilizing human liver microsomes for the first time. Metabolites were identified using ultra‐performance liquid chromatography coupled with high‐resolution tandem mass spectrometry. Our findings reveal that N‐dealkylation and hydroxylation are the primary metabolic reactions, alongside other notable reactions, including oxidation, reduction, and dehydration. Based on our extensive research, we propose N‐dealkylation and hydroxylation metabolites as appropriate analytical markers for monitoring the consumption of these substances.