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Neostigmine
From WikEM
Contents
Administration
- Type: Cholinesterase inhibitor
- Dosage Forms:
- Routes of Administration: IV, oral (not FDA-approved)
- Common Trade Names:
Adult Dosing
- Reversal of non-depolarizing neuromuscular blocking agents:
- Initial: 0.03-0.07 mg/kg IV, if no efffect, repeat q1 min up to max total dose of 0.07mg/kg or 5mg
- Myasthenia gravis: 15-375mg PO daily (Not FDA-approved)
Pediatric Dosing
- Safety/efficacy not well-established in peds, but generally same weight-based dosing as adults
Special Populations
- Pregnancy Rating: Fetal risk cannot be ruled out
- Lactation risk: Avoid breastfeeding
- Renal dosing: no adjustment
- Hepatic dosing: no adjustment
Contraindications
- Allergy to class/drug
- Mechanical bowel or urinary tract obstruction
- Peritonitis
Adverse Reactions
Serious
- Bradyarrythmia, Atrioventricular block
- Seizure, loss of conciousness
Common
- Hypotension
- Nausea, vomiting
Pharmacology
- Half-life: 40-75 min
- Metabolism: Hepatic (extensive)
- Excretion: Renal
Mechanism of Action
- Competitive cholinesterase inhibitor→ less breakdown of acetylcholine→ more acetylcholine in synapses
