NEOSTIGMINE METHYLSULFATE

Electrolyte / Mineral

Brand names: Neostigmine Methylsulfate

Intravenous

Mechanism of Action

12.1 Mechanism of Action- Neostigmine methylsulfate is a competitive cholinesterase inhibitor. By reducing the breakdown of acetylcholine, neostigmine methylsulfate induces an increase in acetylcholine in the synaptic cleft which competes for the same binding site as nondepolarizing neuromuscular blocking agents, and reverses the neuromuscular blockade.

Indications

1 INDICATIONS AND USAGE Neostigmine Methylsulfate Injection

a cholinesterase inhibitor

is indicated for reversal of the effects of nondepolarizing neuromuscular blocking agents (NMBA) after surgery. Neostigmine Methylsulfate

a cholinesterase inhibitor

is indicated for reversal of the effects of nondepolarizing neuromuscular blocking agents (NMBA) after surgery ( 1 ).

Contraindications

• 4 CONTRAINDICATIONS Neostigmine is contraindicated in patients with: known hypersensitivity to neostigmine methylsulfate (known hypersensitivity reactions have included urticaria
• angioedema
• erythema multiforme
• generalized rash
• facial swelling

FDA Warnings

5 WARNINGS AND PRECAUTIONS Bradycardia : Atropine or glycopyrrolate should be administered prior to administration of neostigmine methylsulfate injection to lessen risk of bradycardia ( 5
, atropine sulfate or glycopyrrolate) should be administered prior to Neostigmine Methylsulfate Injection administration to lessen the risk of bradycardia [ see Dosage and Administration ( 2
In patients with certain cardiovascular conditions such as coronary artery disease, cardiac arrhythmias or recent acute coronary syndrome, the risk of blood pressure and heart rate complications may be increased
Risk of these complications may also be increased in patients with myasthenia gravis

Known Side Effects

7 documented side effects by frequency

Drug Not Working

1-10%

Low Blood Pressure

1-10%

Rapid Heart Rate

1-10%

Nausea

1-10%

Fever

1-10%

Shortness of Breath

0.1-1%

Abdominal Pain

0.1-1%

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Formulations

Dosage Forms

Tablet

Route

Intravenous