Pyridostigmine: Difference between revisions
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*Dosage Forms: oral immediate or extended release, IV | *Dosage Forms: oral immediate or extended release, IV | ||
*Routes of Administration: IV, PO | *Routes of Administration: IV, PO | ||
*Common Trade Names: | *Common Trade Names: | ||
*As opposed to [[physostigmine]], pyridostigmine does not cross the blood brain barrier, and is thus a poor agent for agitation and CNS complications | |||
==Adult Dosing== | ==Adult Dosing== | ||
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===Serious=== | ===Serious=== | ||
*Cholinergic crisis | *Cholinergic crisis | ||
*Bradyarrythmia | *[[Bradyarrythmia]] | ||
===Common=== | ===Common=== | ||
*Nausea/vomiting, abdominal cramps, diarrhea | *[[Nausea/vomiting]], abdominal cramps, [[diarrhea]] | ||
*Muscle cramps, fasciculation, asthenia | *Muscle cramps, fasciculation, asthenia | ||
*Increased bronchial and salivary secretions | *Increased bronchial and salivary secretions | ||
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==Mechanism of Action== | ==Mechanism of Action== | ||
*Neostigmine analogue; competitive cholinesterase | *Neostigmine analogue; competitive cholinesterase inhibitor→ less acetylcholine breakdown→ more available acetylcholine in synapses | ||
==Comments== | ==Comments== | ||
Latest revision as of 20:03, 13 October 2018
Administration
- Type: Neostimine analogue, cholinesterase inhibitor
- Dosage Forms: oral immediate or extended release, IV
- Routes of Administration: IV, PO
- Common Trade Names:
- As opposed to physostigmine, pyridostigmine does not cross the blood brain barrier, and is thus a poor agent for agitation and CNS complications
Adult Dosing
- Myasthenia gravis: 60-1500 mg PO daily (immediate release) or 180-540mg PO daily (slow-release)
- Reversal of neuromuscular blocking agents: 0.1-0.25 mg/kg IV
- Organophosphate poisoning prophylaxis: 30mg PO q8h
Pediatric Dosing
Special Populations
- Pregnancy Rating: C
- Lactation risk: Infant risk minimal
- Renal dosing: lower dose may be required, titrate to effect
Contraindications
- Allergy to class/drug
- Mechanical bowel or urinary obstruction
Adverse Reactions
Serious
- Cholinergic crisis
- Bradyarrythmia
Common
- Nausea/vomiting, abdominal cramps, diarrhea
- Muscle cramps, fasciculation, asthenia
- Increased bronchial and salivary secretions
Pharmacology
- Half-life: 3 minutes (IV), 200 minutes (oral)
- Metabolism:
- Excretion: Renal
Mechanism of Action
- Neostigmine analogue; competitive cholinesterase inhibitor→ less acetylcholine breakdown→ more available acetylcholine in synapses