Physostigmine: Difference between revisions
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*Dosage Forms: IV/IM | *Dosage Forms: IV/IM | ||
*Common Trade Names: Antilirium | *Common Trade Names: Antilirium | ||
*As opposed to [[pyridostigmine]], physostigmine does cross the blood brain barrier | |||
==Adult Dosing== | ==Adult Dosing== | ||
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==Special Populations== | ==Special Populations== | ||
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: | *[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C | ||
*Lactation: | *Lactation: | ||
*Renal Dosing | *Renal Dosing | ||
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*Allergy to class/drug | *Allergy to class/drug | ||
*[[TCA toxicity]] | *[[TCA toxicity]] | ||
**Can cause [[asystole]] | |||
==Adverse Reactions== | ==Adverse Reactions== | ||
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[[Category:Pharmacology]] | [[Category:Pharmacology]] | ||
[[Category:Toxicology]] | |||
Latest revision as of 21:40, 23 September 2019
General
- Type: acetylcholinesterase inhibitor
- Dosage Forms: IV/IM
- Common Trade Names: Antilirium
- As opposed to pyridostigmine, physostigmine does cross the blood brain barrier
Adult Dosing
Anticholinergic toxicity
- 0.5-2 mg IV over 5 min
Non-depolarizing neuromuscular blockade reversal
- 0.5-1 mg IM/IV q10 min prn
Pediatric Dosing
- 0.02 mg/kg repeat every 5-10 minutes until adequate response, max of 2 mg
- No faster than 0.5 mg/min
Special Populations
- Pregnancy Rating: C
- Lactation:
- Renal Dosing
- Adult
- Pediatric
- Hepatic Dosing
- Adult
- Pediatric
Contraindications
- Allergy to class/drug
- TCA toxicity
- Can cause asystole
Adverse Reactions
- Side effects: bradycardia, dysrhythmias, cholinergic excess
- Always have atropine at the bedside for bradycardia or cholinergic excess
Pharmacology
- Reversible AChE inhibitor, that increases concentration of acetylcholine
- Indirectly stimulates both nicotinic and muscarinic ACh receptors
- Metabolism via CYP450
- Excretion minimally via urine
- Onset of action: 15-20min