Neostigmine/glycopyrronium bromide

Neostigmine/glycopyrronium bromide is a combination medication used in the management of myasthenia gravis and to reverse the effects of non-depolarizing muscle relaxants after surgery. It contains two active ingredients: neostigmine, a cholinesterase inhibitor, and glycopyrronium bromide, an anticholinergic agent.

Pharmacology

Neostigmine works by inhibiting the action of acetylcholinesterase, an enzyme that breaks down acetylcholine in the synapse. By preventing the breakdown of acetylcholine, neostigmine increases the amount of acetylcholine available to stimulate muscle contraction, thereby improving muscle strength in conditions like myasthenia gravis.

Glycopyrronium bromide, on the other hand, is an anticholinergic agent. It works by blocking the action of acetylcholine on its receptors in the body. This helps to reduce the side effects of neostigmine, such as excessive salivation and sweating, which are caused by overstimulation of the parasympathetic nervous system.

Clinical Use

Neostigmine/glycopyrronium bromide is used in the treatment of myasthenia gravis, a neuromuscular disease that causes weakness and rapid fatigue of the voluntary muscles. It is also used to reverse the effects of non-depolarizing muscle relaxants after surgery.

Side Effects

The most common side effects of neostigmine/glycopyrronium bromide include dry mouth, blurred vision, and urinary retention. These are mainly due to the anticholinergic effects of glycopyrronium bromide. Other side effects can include abdominal cramps, increased heart rate, and changes in blood pressure.

Contraindications

Neostigmine/glycopyrronium bromide is contraindicated in patients with known hypersensitivity to either of the active ingredients. It is also contraindicated in patients with certain medical conditions, such as glaucoma, myasthenia gravis, and certain types of heart disease.

See Also

• Myasthenia gravis
• Cholinesterase inhibitor
• Anticholinergic