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| + | ====== Prostigmine (Neostigmine) ====== | ||
| + | =====Effects===== | ||
| + | |||
| + | **Anticholinesterase drug** | ||
| + | * Reduces breakdown of Acetylcholine in the neuromuscular junction by inhibiting acetylcholinesterase | ||
| + | * Reversibly binds to and inactivates acetylcholinesterase | ||
| + | * Has less effect on the eye, heart and brain than physostigmine but has more effect on GI tract and bladder | ||
| + | * [[http:// | ||
| + | |||
| + | =====Dosing===== | ||
| + | |||
| + | **To diagnose Myasthenia Gravis** | ||
| + | * 1mg for 70kg Adult (or 0.02 mg/kg) IM, Give with 0.4 mg Atropine IM | ||
| + | **To treat Myasthenia Gravis** | ||
| + | * Start with 15 mg PO Q8h, Max 375 mg/day | ||
| + | * 15 mg PO = 0.5 mg SC/IM/IV | ||
| + | ====Renal dosing==== | ||
| + | * Creatinine Clearance 10-50 decrease dose by 50% | ||
| + | * Creatinine Clearance <10 decrease dose by 75% | ||
| + | =====Excretion===== | ||
| + | * Urine (50% unchanged) | ||
| + | * Recommended Creatinine level at baseline | ||
| + | =====Side Effects===== | ||
| + | |||
| + | **Common Reactions** | ||
| + | * hypersalivation | ||
| + | * fasciculation | ||
| + | * abdominal bloating/ | ||
| + | * loose stools/ | ||
| + | * flatulence | ||
| + | * dyspepsia | ||
| + | * headache | ||
| + | * dizziness | ||
| + | * diaphoresis | ||
| + | * lacrimation increase | ||
| + | * rhinorrhea | ||
| + | * pulmonary secretions increase | ||
| + | * dyspnea | ||
| + | * nausea/ | ||
| + | * urinary frequency/ | ||
| + | * muscle weakness/ | ||
| + | * miosis | ||
| + | * visual changes | ||
| + | * rash | ||
| + | * drowsiness | ||
| + | **Serious Reactions** | ||
| + | * Cholinergic crisis: | ||
| + | * overstimulation at the neuromuscular junction leading to | ||
| + | * flaccid paralysis | ||
| + | * respiratory failure | ||
| + | * increased sweating | ||
| + | * salivation | ||
| + | * bronchial secretions | ||
| + | * mitosis | ||
| + | * treated with Atropine | ||
| + | * bradycardia | ||
| + | * AV block | ||
| + | * arrhythmias | ||
| + | * hypotension | ||
| + | * severe syncope | ||
| + | * cardiac arrest | ||
| + | * bronchospasm | ||
| + | * respiratory depression | ||
| + | * respiratory arrest | ||
| + | * respiratory paralysis | ||
| + | * paralysis | ||
| + | * anaphylaxis | ||
| + | * hypersensitivity reaction | ||
| + | * seizures | ||
| + | |||
| + | {{tag> | ||