Differences

This shows you the differences between two versions of the page.

Link to this comparison view

Both sides previous revision Previous revision
prostigmine [2015/06/20 23:35] adminprostigmine [2025/04/18 20:40] (current) – external edit 127.0.0.1
Line 1: Line 1:
 +====== 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://www.pharmacorama.com/en/Sections/Acetylcholine_2_2.php#7|Acetylcholine Effects]]
 +
 +=====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/cramps
 +  * loose stools/diarrhea
 +  * flatulence
 +  * dyspepsia
 +  * headache
 +  * dizziness
 +  * diaphoresis
 +  * lacrimation increase
 +  * rhinorrhea
 +  * pulmonary secretions increase
 +  * dyspnea
 +  * nausea/vomiting
 +  * urinary frequency/urgency
 +  * muscle weakness/cramps
 +  * 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>drugs}}