Pyridostigmine Flashcards

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Questions and Answers

What is the trade name of pyridostigmine?

Mestinon

Regonol

Mestinon SR

All of the above (correct)

What is the pregnancy category of pyridostigmine?

Category C

What therapeutic class does pyridostigmine belong to?

Antimyasthenics

What pharmacological class is pyridostigmine part of?

Cholinergics Signup and view all the answers

List one indication for the use of pyridostigmine.

Increase muscle strength in myasthenia gravis Signup and view all the answers

What is the action of pyridostigmine on acetylcholine?

Inhibits the breakdown of acetylcholine Signup and view all the answers

What is one therapeutic effect of pyridostigmine?

Improved muscular function in patients with myasthenia gravis Signup and view all the answers

How is pyridostigmine absorbed after oral administration?

Poorly absorbed Signup and view all the answers

Pyridostigmine is safe to use during pregnancy.

False Signup and view all the answers

Does pyridostigmine cross the placenta?

Yes Signup and view all the answers

What is the half-life of pyridostigmine for oral administration?

3.7 hr Signup and view all the answers

The contraindication for pyridostigmine includes hypersensitivity to _____.

pyridostigmine or bromides Signup and view all the answers

List two adverse reactions of pyridostigmine.

Seizures, dizziness Signup and view all the answers

What are the common routes for administering pyridostigmine?

PO, IV, IM Signup and view all the answers

What conditions does pyridostigmine treat?

Myasthenia gravis, reverses non-depolarizing neuromuscular blocking agents Signup and view all the answers

What is the typical dosage of pyridostigmine for adults?

30-60 mg every 3-4 hrs initially Signup and view all the answers

What is the recommended dosage of pyridostigmine for children?

7 mg/kg/day in 5-6 divided doses Signup and view all the answers

What is the antidote use of pyridostigmine?

10-20 mg IV for non-depolarizing neuromuscular blocking agents Signup and view all the answers

Study Notes

Pyridostigmine Overview

Trade Names: Mestinon, Mestinon SR (Canada), Mestinon Timespan, Regonol
Pregnancy Category: C (risk cannot be ruled out)

Classification

Therapeutic Class: Antimyasthenics
Pharmacologic Class: Cholinergics

Indications

Increases muscle strength in myasthenia gravis.
Reverses effects of nondepolarizing neuromuscular blocking agents.
Provides prophylaxis against nerve agent soman toxicity.

Mechanism of Action

Inhibits breakdown of acetylcholine (anticholinesterase effect).
Causes miosis, increased intestinal/skeletal muscle tone, bronchial/ureteral constriction, bradycardia, increased salivation, lacrimation, and sweating.

Therapeutic Effects

Improves muscular function in myasthenia gravis patients.
Reverses paralysis due to nondepolarizing neuromuscular blockers.
Prevents toxicity from soman nerve gas.

Pharmacokinetics

Absorption: Poor after oral administration, requires larger oral doses.
Distribution: Crosses the placenta.
Metabolism: Processed by plasma cholinesterases and the liver.

Half-Life

Oral administration: Approximately 3.7 hours.
Intravenous administration: Approximately 1.9 hours.

Time/Action Profile

Oral: Onset 30-35 min, Duration 3-6 hr.
Oral-SR: Onset 30-60 min, Duration 6-12 hr.
Intramuscular: Onset 15 min, Duration 2-4 hr.
Intravenous: Onset 2-5 min, Duration 2-3 hr.

Contraindications

Hypersensitivity to pyridostigmine or bromides.
Mechanical GI or GU tract obstruction.
Known alcohol intolerance (for syrup formulation).

Precautions

History of asthma, ulcer disease, cardiovascular disease, epilepsy, hyperthyroidism.
Caution in pregnant women; risk of uterine irritability and transient muscle weakness in newborns during lactation.

Adverse Reactions/Side Effects

CNS effects: Seizures, dizziness, weakness.
EENT effects: Lacrimation, miosis.
Respiratory: Bronchospasm, excessive secretions.
Cardiovascular: Bradycardia, hypotension.
Gastrointestinal: Abdominal cramps, diarrhea, excessive salivation, nausea, vomiting.
Dermatologic: Sweating, rashes.
Life-threatening symptoms are emphasized in capital letters.

Drug Interactions

Potential antagonism with anticholinergic drugs (e.g., antihistamines, antidepressants).
Prolongation of effects with muscle-relaxing agents and cholinesterase inhibitors.
Increased toxicity when used with other cholinesterase inhibitors (e.g., echothiophate).

Administration Routes

Available routes: Oral (PO), Intravenous (IV), Intramuscular (IM).

Dosing Guidelines

Adults: PO 30-60 mg every 3-4 hours, usual maintenance 600 mg/day; IM/IV 2 mg (1/30 of oral dose), repeat every 2-3 hours if needed.
Children: 7 mg/kg/day in 5-6 divided doses.
Neonates: 50-150 mcg/kg every 4-6 hours.
Antidote dosing: IV 10-20 mg with pre-treatment of atropine.

Soman Exposure Prevention

Adults: PO 30 mg every 8 hours before exposure, discontinue upon contact with the agent.

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Test your knowledge on pyridostigmine with these flashcards. Covering trade names, pregnancy category, therapeutic classification, pharmacological class, and indications, this quiz is an essential tool for students and professionals alike.