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