Myasthenia gravis (diagnosis and treatment) antidote for tubocurarine, postoperative urinary retention and distension

Acetylcholinesterase Inhibitor
Inhibits destruction of acetylcholine by acetylcholinesterase which facilitates transmission of impulses across myoneural junction; direct cholinomimetic effect on skeletal muscle and possible on autonomic ganglion cells and neurons of the CNS

1.Distribution: Vd: IV: 0.12 to 1.4 L/kg
2.Protein binding: 15% to 25% to albumin
3.Metabolism: Hepatic
4.Half-life elimination:
(1)IM: Adults: 51 to 90 minutes
(2)IV: Range: 24 to 113 minutes
5.Excretion: Urine (50% as unchanged drug; remainder as metabolites)

Hypersensitivity to neostigmine or any component of the formulation; peritonitis or mechanical obstruction of the intestinal or urinary tract.

Infant risk cannot be ruled out.

Nausea, vomiting, abdominal cramps and diarrhea, salivation, sweating, miosis, anorexia, increased bronchial secretion, bronchoconstriction, bradycardia, and hypotension

Myasthenia gravis diagnosis:1.5 mg IM, given as a single dose.
Non-depolarizing neuromuscular blockade reversal:0.5 to 2 mg slow IV injection. Administer an IV anticholinergic agent (e.g., atropine or glycopyrrolate) either prior to or concomitantly with (via separate syringes) neostigmine.