Physostigmine: Difference between revisions
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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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*Excretion minimally via urine | *Excretion minimally via urine | ||
*Onset of action: 15-20min | *Onset of action: 15-20min | ||
==Indications by Condition== | |||
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==See Also== | ==See Also== | ||
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[[Category:Pharmacology]] | [[Category:Pharmacology]] | ||
[[Category:Toxicology]] | |||
Latest revision as of 21:57, 20 March 2026
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
Indications by Condition
The following table is automatically generated from disease/condition pages across WikEM.
| Indication | Dose | Context | Route | Population |
|---|---|---|---|---|
| Jimson weed | 0.5-2mg IV at rate no more than 1mg/min | Severe anticholinergic toxicity | IV | Adult |
| Jimson weed | 0.02mg/kg IV at rate no more than 0.5mg/min | Severe anticholinergic toxicity | IV | Pediatric |