Neostigmine

Neostigmine

Neostigmine is a parasympathomimetic that acts as a reversible acetylcholinesterase inhibitor. It is used medically to treat myasthenia gravis, ogilvie syndrome, and postoperative distention. Additionally, neostigmine can reverse the effects of non-depolarizing neuromuscular-blocking drugs.

Medical uses

Neostigmine is used to improve muscle tone in people with myasthenia gravis and to reverse the effects of muscle relaxants such as vecuronium and rocuronium at the end of surgery.

Pharmacology

Neostigmine binds to the active site of acetylcholinesterase and therefore inhibits the breakdown of acetylcholine, increasing the amount of available acetylcholine. This action stimulates nicotinic and muscarinic receptors, enhancing the parasympathetic nervous system's effects.

Side effects

Common side effects of neostigmine can include nausea, increased salivation, abdominal cramps, and diarrhea. In some cases, it can also cause a slow heart rate, low blood pressure, and muscle weakness.

History

Neostigmine was first synthesized by Aeschlimann and Reinert in 1931 and was introduced for medical use in 1932.

See also

• Pyridostigmine
• Edrophonium
• Physostigmine

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  Neostigmine chemical structure

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  Neostigmine ball-and-stick model