ISSN 2398-2942      

Neostigmine

icanis
Contributor(s):

Kyle Braund

Mark Lowrie


Introduction

Name

  • Neostigmine bromide.
  • Neostigmine methylsulfate.

Class of drug

  • Anticholinesterase.

Description

Chemical name

  • 3-[[(dimethylamino)carbonyl]oxy]-N,N,N-trimethylbenzenaminium.

Molecular formula

  • C12H19N2O2.

Physical properties

  • Tablets.
  • Solution.

Uses

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Indications

  • Inhibits acetylcholinesterase thereby prolonging the action of acetylcholine. Slower onset but longer duration of action than edrophonium Edrophonium.
  • Used to treat acute myasthenic crises Myasthenia gravis when difficulty in breathing and swallowing (megaesophagus) are seen.
  • Is also be used to reverse the action of non-depolarizing neuromuscular blocking agents Anesthesia: reversal of neuromuscular blocking agents. Most useful when long acting neuromuscular blocking agents such as pancuronium Pancuronium have been used.
  • In diagnosis of myasthenia gravis when edrophonium chloride is unavailable, neostigmine methylsulfate can be used at a dose of 40 µg/kg IM or 20 µg/kg IV. This challenge test is not useful in dogs with focal myasthenia gravis.

Administration

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Precautions

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Interactions

with other drugs

  • Aminoglycosides, clindamycin Clindamycin , lincomycin Lincomycin , polymyxins Polymyxin B and propranolol Propranolol may antagonize the effect of neostigmine.
  • Neostigmine enhances the effect of suxamethonium Suxamethonium but antagonises the effect of non-depolarizing muscle relaxants.

Adverse Reactions

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Further Reading

Publications

Refereed Papers

Other sources of information

  • Based on Small Animal Formulary. Tennant B (1999) 3rd edn. BSAVA, UK.
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