Neostigmine

Mechanism of action

Is a cholinesterase inhibitor

Parasympathomimetic agent

Does not cross the blood barrier

Indications

Treatment of myasthenia gravis

Prolonged therapy where no difficulty in swallowing is present

Used to get back function in muscle after surgery

Nursing consideration

Check pulse before giving the drug to bradycardic patients

Monitor pulse, respiration and blood pressure

Report promptly and record accurately the onset of symptoms

Report drug effect and duration of action

Monitor respiration, maintain airway or assisted ventilation

Report to physician if the patient does not urinate within and after the first dose

Contraindications

Hypersensitivity to neostigmine, cholinergics or bromides

Bradycardia

Hypotension

Mechanical distruction of intestinal or urinary tract

Peritonitis

Administration with other cholinergic drugs

Pregnancy

Side effects

Salivation

Increased mucus

Muscle twitching

Vomiting and diarrhea

Slurred speech

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Bowel and abdominal cramps

Shortness of breaths

Increased sweating urination

Storage conditions

Store in a cool, dry place

Temperature must below 25 degrees celcius

Protected from sunlight

Route of administration

Intravenous, it should be given slowly

Intramuscular or subcutaneous, should be given undiluted

Orally, given with food or milk to reduce GI distress