Neostigmine

Neostigmine chemical structure
Neostigmine

(m-hydroxyphenyl)trimethyl-, dimethylcarbamate(ester) ammonium
CAS number
59-99-4
ATC code
N07AA01, S01EB06
Chemical formula C12H19N2O2
Molecular weight 223.294
Bioavailability  ?
Metabolism  ?
Elimination half-life  ?
Excretion  ?
Pregnancy category  ?
Legal status  ?
Routes of administration  ?

Neostigmine is a parasympathomimetic, specifically, a reversible cholinesterase inhibitor. By interfering with the breakdown of acetylcholine, neostigmine indirectly stimulates both nicotinic and muscarinic receptors.

Clinical Uses

It is used to improve muscle tone in people with Myasthenia gravis and routinely in anesthesia at the end of an operation to reverse the effects of non-depolarising muscle relaxants such as vecuronium.

It can also be used for urinary retention resulting from general anaesthetic and to treat curariform drug toxicity.

Neostigmine will cause slowing of the heart rate (bradycardia), for this reason it is usually given along with a parasympatholytic drug such as atropine or glycopyrrolate.

Neostigmine is available under several trade names such as Prostigmin (ICN).

Sources

  • Brenner, G. M. (2000). Pharmacology. Philadelphia, PA: W.B. Saunders Company. ISBN 0-7216-7757-6
  • Canadian Pharmacists Association (2000). Compendium of Pharmaceuticals and Specialties (25th ed.). Toronto, ON: Webcom. ISBN 0-919115-76-4

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