Pyridostigmine: Difference between revisions
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==Administration== | ==Administration== | ||
*Type: | *Type: Neostimine analogue, cholinesterase inhibitor | ||
*Dosage Forms: | *Dosage Forms: oral immediate or extended release, IV | ||
*Routes of Administration: | *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== | ||
*[[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== | ==Pediatric Dosing== | ||
==Special Populations== | ==Special Populations== | ||
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: | *[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C | ||
*[[Lactation risk categories|Lactation risk]]: | *[[Lactation risk categories|Lactation risk]]: Infant risk minimal | ||
*Renal dosing: lower dose may be required, titrate to effect | |||
==Contraindications== | ==Contraindications== | ||
*Allergy to class/drug | *Allergy to class/drug | ||
*Mechanical bowel or urinary obstruction | |||
==Adverse Reactions== | ==Adverse Reactions== | ||
===Serious=== | ===Serious=== | ||
*Cholinergic crisis | |||
*[[Bradyarrythmia]] | |||
===Common=== | ===Common=== | ||
*[[Nausea/vomiting]], abdominal cramps, [[diarrhea]] | |||
*Muscle cramps, fasciculation, asthenia | |||
*Increased bronchial and salivary secretions | |||
==Pharmacology== | ==Pharmacology== | ||
*Half-life: | *Half-life: 3 minutes (IV), 200 minutes (oral) | ||
*Metabolism: | *Metabolism: | ||
*Excretion: | *Excretion: Renal | ||
==Mechanism of Action== | ==Mechanism of Action== | ||
*Neostigmine analogue; competitive cholinesterase inhibitor→ less acetylcholine breakdown→ more available acetylcholine in synapses | |||
==Comments== | ==Comments== | ||
==See Also== | ==See Also== | ||
*[[Neostigmine]] | |||
*[[Neuromuscular blocking agents]] | |||
*[[Myasthenia gravis]] | |||
==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:Pharmacology]] | [[Category:Pharmacology]] | ||
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