Neostigmine (Neostigmine)
Overview of Neostigmine
Neostigmine (Methylsulphate) is a potent reversible inhibitor of acetylcholinesterase and its use is inthe treatment of mysthania gravis. Neostigmine bromide and neostigmine methylsulphate are quaternary ammonium compound. The pharmacologic properties of neostigmine mimic those of acetylcholine. Neostigmine (Methylsulphate) is more polar and does not enter in the CNS. its effects on skeletal muscle is greater than that of physostigmine.Neostigmine bromide and neostigmine methylsulphate are available for oral, opthalmic and parentral administration.
Indication of Neostigmine
Neostigmine is primarily indicated in conditions like Adynamic ileus, Myasthenia gravis, Myasthenia gravis diagnosis, Neuromuscular blockade reversal, Reversal of non-depolarizing neuromuscular blockade, and can also be given in adjunctive therapy as an alternative drug of choice in Paralytic ileus, Urinary retention, Urinary retention.
Contraindication of Neostigmine
Neostigmine is contraindicated in conditions like Intestinal obstruction,Urinary obstruction.
Side Effects of Neostigmine
The severe or irreversible adverse effects of Neostigmine, which give rise to further complications include Hallucinations, Hallucinations, Anxiety, Epilepsy, Disorientation, Loss of consciousness.,Neostigmine produces potentially life-threatening effects which include Cholinergic crises, Depolarizing block. which are responsible for the discontinuation of Neostigmine therapy.,The signs and symptoms that are produced after the acute overdosage of Neostigmine include Bradycardia, Hypotension, Nausea, Vomiting, Diarrhea, Convulsions, Increased bronchial secretion, Ataxia, Sweating, Miosis, Abdominal cramps, Increased peristalsis, Sweating, Fasciculation of skeletal muscles, General weakness, Increased bronchial secretion, Mucular cramps, Salivation.,The symptomatic adverse reactions produced by Neostigmine are more or less tolerable and if they become severe, they can be treated symptomatically, these include Nausea, Vomiting, Diarrhea, Abdominal pain, Sweating, Salivation.
Precautions of Neostigmine
Neostigmine should be used with caution in patients with asthma, seizure disorder, epilepsy, heart disease such as hypertension, bradycardia, recent myocardial infraction, thyroid disorders, intestinal disorders, ulcers, urinary problems or if have any allergy especially to bromides. Large dose by mouth should be avoided in condition where there may be increased absorption from the gastrointestinal tract. It is classified as pregnancy category C and should be used only if clearly needed during pregnancy.