Which of the following drugs should be avoided if possible with patients receiving Echothiophate treatment for glaucoma?

Echothiophate is an irreversible inhibitor of acetylcholinesterase and is used in the treatment of glaucoma. The primary concern when using Echothiophate is its potential to enhance the effects of neuromuscular blockers, particularly those that are also metabolized by cholinesterase.

Succinylcholine, a depolarizing neuromuscular blocker, is particularly affected by the presence of Echothiophate. Since Succinylcholine is typically broken down by plasma cholinesterase, the inhibition of this enzyme by Echothiophate can lead to prolonged neuromuscular blockade. This would result in an increased duration of action and potential respiratory complications, making it critical to avoid its use in patients undergoing treatment with Echothiophate.

In contrast, other neuromuscular blockers like Rocuronium, Neostigmine, and Vecuronium have different mechanisms of action and are not as adversely affected in terms of metabolism by Echothiophate. Neostigmine, for example, is an acetylcholinesterase inhibitor itself and is used to reverse neuromuscular block, while Rocuronium and Vecuronium are non-depolarizing neuromuscular