Physostigmine: Difference between revisions
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==General== | ==General== | ||
*Type: | *Type: [[acetylcholinesterase inhibitor]] | ||
*Dosage Forms: | *Dosage Forms: IV/IM | ||
*Common Trade Names: | *Common Trade Names: Antilirium | ||
*As opposed to [[pyridostigmine]], physostigmine does cross the blood brain barrier | |||
==Adult Dosing== | ==Adult Dosing== | ||
===[[Anticholinergic toxicity]]=== | ===[[Anticholinergic toxicity]]=== | ||
*0.5- | *0.5-2 mg IV over 5 min | ||
===Non-depolarizing neuromuscular blockade reversal=== | |||
*0.5-1 mg IM/IV q10 min prn | |||
==Pediatric Dosing== | ==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== | ==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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==Contraindications== | ==Contraindications== | ||
*Allergy to class/drug | *Allergy to class/drug | ||
*[[TCA toxicity]] | |||
**Can cause [[asystole]] | |||
==Adverse Reactions== | ==Adverse Reactions== | ||
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==Pharmacology== | ==Pharmacology== | ||
* | *Reversible AChE inhibitor, that increases concentration of acetylcholine | ||
*Metabolism | *Indirectly stimulates both nicotinic and muscarinic ACh receptors | ||
*Excretion | *Metabolism via CYP450 | ||
*Excretion minimally via urine | |||
*Onset of action: 15-20min | *Onset of action: 15-20min | ||
==See Also== | ==See Also== | ||
==References== | |||
<references/> | <references/> | ||
[[Category: | |||
[[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