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 Neostigmine methylsulfate
 Anticholinesterase drugs . The active component acts neostigmine methylsulfate . The medicament reversibly blocked cholinesterase That causes accumulation acetylcholine , Leads to an increase of its effect on organs and tissues, the conductivity of the active component restores neuromuscular junctions. Neostigmine increases the secretion of the glands, uryazhaetsya pulse causes bronhoreyu, hypersalivation Narrows pupils, increases the acidity of gastric juice, tones smooth muscle of the intestine, reduces the rate of intraocular pressure leads to cyclospasm In moderate increases skeletal muscle tone causes bronchoconstriction, increases the tone of the bladder. Neostigmine produced in the form of granules, a solution, a tablet form.

Indications:

Neostigmine appoint at paralysis , Motor disorders after traumatic brain injury in myasthenia At polio , After suffering meningitis When the weakness of labor, encephalitis, optic nerve atrophy, with neuritis , Open-form of glaucoma, bladder atony, atony of the digestive tract. The drug eliminates residual disorder of neuromuscular transmission after the application of non-depolarizing muscle relaxants .

Contraindications:


Neostigmine is not prescribed for vagotomy, hyperkinesia, epilepsy, intolerance methyl sulfate neostigmine, when expressed form of atherosclerosis, asthma, angina , Ischemic heart disease, hyperthyroidism, arrhythmia, bradycardia, mechanical osbtruktsii digestive tract, peritonitis, ulcerative lesions of the stomach and intestines, with hypertrophy of the prostate, a mechanical obstruction of the urinary tract, pregnancy, during intoxication in debilitated children, acute infectious diseases, during lactation.

Side effect:

Neostigmine causes increased peristalsis , Nausea, flatulence, vomiting, spasmodic contraction of the intestine, hypersalivation , Violations of of view of, miosis, drowsiness, loss of consciousness, of vertigo, tachycardia, bradycardia, arrhythmia, nonspecific changes on the ECG, AV-blockade of, cardiac arrest, nodal rhythm, bronchospasm, respiratory depression, shortness of breath, a spasm of skeletal musculature, tremor, profuse sweating, speeded up emiction, dysarthria , Convulsions, muscle twitching language allergies.

Overdose:

Cramps, salivation, bronchospasm, reduction in blood pressure, increased peristalsis, cholinergic crisis Twitching muscles of the tongue. Treatment involves the timely introduction of atropine 0, 1% solution of 1 milliliter, anticholinergics, metatsina.

Mode of application:

Neostigmine take pills three times a day for 30 minutes before a meal for 10-15 milligrams. The day of not more than 50 mg, the maximum single dose - 15 mg. Babies drug is recommended to appoint a pellet, which was dissolved in boiling water. Neostigmine injected subcutaneously at 0, 5-2 mg 1-2 times a day. The larger the amount of drug administered during the day, while the patient is in the highest degree of fatigue. When myasthenic crisis with difficulty swallowing and breathing administered 0, 05% solution of 0, 5-1 ml intravenously, subcutaneously, then, following a time interval. In order to reduce intraocular pressure Neostigmine instilled up to 4 times a day, 1-2 drops of 0, 5% in each conjunctival sac.

Special instructions:

Parenteral drug Neostigmine in high doses requires the appointment of atropine. In the case of cholinergic (an overdose) or the myasthenic (introduction of insufficient therapeutic dose) crisis conducted a thorough differential diagnosis due to similarity of symptoms.

Drug Interactions:

M-holinoblokatory, metacin, weaken the severity of atropine m-cholinomimetic effects   (gipersalivacia, increased peristalsis the digestive system, narrowing of the pupil, bradycardia). In myasthenia recommended given in combination with corticosteroids and aldosterone antagonists, anabolic hormones . Neostigmine strengthens and lengthens the action of depolarizing muscle relaxants ; eliminates and reduces the effect of muscle relaxants antidepolyarizuyuschih. Children with myasthenia gravis, when taking anticholinergic drugs, kanamifina, streptomycin , Neomycin, antiarrhythmic agents, antibiotics, general anesthetics Neostigmine drugs administered with caution.



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