NEOSTIGMINE

Neostigmine is an anticholinesterase which is also used as a parasympathomimetic. It is used for neuromuscular disorders and inhibits acetylcholine hydrolysis by binding to acetylcholinesterase. It then facilitates transmission of signals across neuromuscular junctions and has a direct effect on skeletal muscle and nerves.

Uses

Neostigmine is used to treatmyasthenia gravis, paralytic ileus, urinary retention after surgery or for reversal of neuromuscular blockade.

Warnings

Peritonitis
Mechanical GI or urinary obstruction

Side Effects

Neostigmine may have the following side effects:

Nausea
Vomiting
Increased salivation
Diarrhea
Abdominal cramps
Hypersensitivity reactions
Urticaria
Respiratoryfailure

Precautions

Take extra caution in patients with the following medical conditions:

Bronchial asthma
Cardiovascular disorders
Bradycardia
Peptic ulcer disease
Epilepsy
Parkinsonism
Patient who underwent recent intestinal or bladder surgery
Renal impairment
Children
Pregnancy
Lactation

Interactions

Neostigmine may interact with the following medicines:

Depolarising muscle relaxants like suxamethonium
Drugs with neuromuscular blocking activity like aminoglycosides, clindamycin, colistin, cyclopropane, halogenated inhalational anaesthesia
Quinine, chloroquine, hydroxychloroquine, quinidine, procainamide, propafenone, lithium
Beta-blockers

Overdose & Brands

Symptoms of overdose include the following:

Abdominal cramps
Increased peristalsis
Diarrhea
Nausea and vomiting
Increased bronchial secretions
Bradycardia
Hypotension

Seek medical help immediately.

Available Brands

Prostigmin
Neotalis
Prostig