What are the effects and precautions of neostigmine

Neostigmine is a drug artificially synthesized by modern medical technology. It is mainly used to treat myasthenia gravis. If the drug is taken orally, the absorption effect is not ideal and it has no effect on the central nervous system. Therefore, it is generally used by subcutaneous injection. When using it for treatment, you must communicate carefully with your doctor, because it can cause nausea and vomiting, muscle spasms, and in severe cases, even convulsions, coma, arrhythmia, pupil constriction, language disorders or cardiac arrest. Now let's talk about the effects of neostigmine and the precautions when using it.

1. Pharmacological Action

1. Neostigmine has the strongest excitatory effect on skeletal muscle. In addition to inhibiting AChE, it also directly stimulates the N2 receptors on the skeletal muscle cell membrane and promotes the release of ACh from motor nerve endings.

2. Neostigmine has a strong excitatory effect on the smooth muscles of the gastrointestinal tract and bladder, and can promote the peristalsis of the stomach, small intestine, large intestine and colon.

3. Neostigmine has a weak effect on cardiovascular, glandular, eye, and bronchial smooth muscles.

2. Clinical Application

1. Myasthenia gravis.

2. Postoperative abdominal distension and urinary retention: Neostigmine can excite the gastrointestinal smooth muscle and bladder detrusor muscle, promoting gas discharge and urination.

3. Other applications: paroxysmal supraventricular tachycardia, glaucoma.

4. Rescue of overdose of muscle relaxants: used for rescue of overdose of non-depolarizing skeletal muscle relaxants such as tubocurarine.

3. Notes:

1. Contraindications: It is contraindicated in patients with angina pectoris, epilepsy, bronchial asthma, mechanical intestinal obstruction, ventricular tachycardia, urinary tract obstruction and hyperthyroidism.

2. This drug should be used with extreme caution in patients who have just had bowel or bladder surgery.

3. This product should also be used with caution in certain patients, such as those with arrhythmias, slow heart rate, decreased blood pressure, increased vagal tone and Parkinson's disease.