Neostigmine

Details About Generic Salt ::  Neostigmine 

Main Medicine Class:: Nervous System   Sub Medicine Class ::  Drugs for Neurodegenerative Disorders

10D. DRUGS ACTING ON BLADDER in 10. GENITO-URINARY SYSTEM
NEOSTIGMINE
ACETYLCHOLINESTERASE INHIBITOR | SKELETAL MUSCLE RELAXANT
also comes under 1F. Drugs for Neurodegenerative Disorders in 1. Nervous System,  
PK: A: Poor M: Hepatic E: Urine (50% as unchanged drug)

Indications & Dose: BLADDER ATONY IM/SC Adult Prevention: 0.25mg q4-6h 2-3 days; Treatment: 0.5-1mg q3h for 5 doses after bladder is emptied | MYASTHENIA GRAVIS PO Adult Treatment: 15mg/dose q3-4h, max 375mg/day Child 2mg/kg/day divided q3-4h | IV/IM/SC Adult Treatment: 0.5-2.5mg q1-3h, max 10mg/24h Child 0.01-0.04mg/kg q2-4h | IM Adult Diagnosis: 0.02mg/kg as single dose Child 0.04mg/kg as single dose | NEONATAL MYASTHENIA GRAVIS PO Child 1-5mg (as bromide) q4h | IM/SC Child 50-250µg (as metilsulfate) | POSTOPERATIVE URINARY RETENTION PO Adult 15-30mg (as bromide) | IM/SC Adult 500µg (as metilsulfate) | REVERSAL OF NON-DEPOLARISING MUSCLE BLOCK IV Adult 50-70µg/kg over 1min Child Neonate: 50µg/kg over 1min, a further dose of 25µg/kg may be required; 1 month-18 yr: 50µg/kg, max 2.5mg, a further dose of 25µg/kg may be requiredAdministered after/with glycopyrronium/atropine

Contra: Hypersensitivity, GI/GU obstruction

Precautions: Asthma, PUD, bradycardia, arrhythmias, recent coronary occlusion, vagotonia, hyperthyroidism, seizures

ADR: Serious: Anaphylaxis, AV block, cardiac arrest, tachycardia, bradycardia, bronchospasm, loss of consciousness, Others: dizziness, headache, drowsiness, asthenia, lacrimation, miosis, nausea, vomiting, diarrhea, abdominal cramps, increased peristalsis, urinary frequency, joint pain, dyspnea, flatulence

DDI: Serious Quinidine/Aspirin causes aggravation of myasthenic symptoms, Salbutamol decreases recovery of neuromuscular function of drug, GA impairs drug efficacy in reversing neuromuscular blockade, β-blockers results in bradycardia & hypotension

Diet: 1h before/2h after food

Monitor: Vital signs, respiratory & neurologic status

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