Neostigmine (Prostigmin)

Question 1

Neostigmine (Prostigmin) class

Answer 1

Acetylcholinesterase inhibitor

Question 2

Neostigmine (Prostigmin) MOA

Answer 2

ACh will accumulate at NMJ to compete with residual ND NMB for available nicotinic ACh receptors

Question 3

Neostigmine (Prostigmin) dosage

Answer 3

60-80 mcg/kg but will see 40-70 mcg/kg

MAX: 5mg

Question 4

Neostigmine (Prostigmin) characteristics

Answer 4

O: 5-10 min

P: n/a

D: 45-90 min

Question 5

Neostigmine (Prostigmin) E/M

Answer 5

50% renal excretion

Question 6

Neostigmine (Prostigmin) considerations

Answer 6

MUST have at least ONE twitch

To minimize muscarinic cv effects of AChE inhibitors, give anticholinergic (glycopyrrolate 7-15 mcg/kg)

Caution w/: brady, bronchial asthma, epilepsy, arrhythmias, peptic ulcer, peritonitis, or mech obstruction of intestines or urinary tract