Neostigmine
Methylsulfate
Trade names: Neostigmine
Class: Anticholinesterase ' reversal of muscle relaxant
Pregnancy:
(Category C) Action:
reverse cholinesterase inhibitor. By
interfering with the breakdown of acetylcholine, Neostigmine indirectly
stimulates both nicotinic and muscarinic receptors
Uses:
The symptomatic
control of myasthenia gravis when oral therapy is impractical. The prevention
and treatment of postoperative distention and urinary retention after
mechanical obstruction has been excluded.
Reversal of effects of nondepolarizing
neuromuscular blocking agents (e.g., tubocuranne, metocurine, gallamine or
pancuronium) after surgery.
Dose:
reversal
of non-depolarising neuromuscular blockade, by intravenous injection over 1
minute, 50–70 micrograms/kg (max. 5 mg) after or with atropine sulfate 0.6–1.2
mg Contraindications:
Neostigmine Methylsulfate Injection is
contraindicated in patients with known hypersensitivity to the drug. It is also
contraindicated in patients with peritonitis or mechanical obstruction of the
intestinal or urinary tract.
Side effects:
• Dizziness, convulsions, loss of consciousness, drowsiness,
headache, dysarthria, miosis and visual changes.
• Cardiac arrhythmias .
• Rash and urticaria.
• Nausea, emesis, flatulence and increased peristalsis.
• Diaphoresis, flushing and weakness.
Nursing
considerations:
§ Neostigmine Methylsulfate Injection should be used with caution
in patients with epilepsy, bronchial asthma, bradycardia, recent coronary
occlusion, vagotonia, hyperthyroidism, cardiac arrhythmias or peptic ulcer.
§ When large doses of Neostigmine Methylsulfate Injection are
administered, theprior or simultaneous injection of atropine sulfate may be
advisable.
§ Separate syringes should be used for the neostigmine
methylsulfate and atropine.Because of the possibility of hypersensitivity in an
occasional patient, atropine and antishock medication should always be readily
available.
