NEOSTIGMINE-skeletal muscle relaxants

INTRODUCTION
A cholinesterase inhibitor used in the treatment of myasthenia gravis and to reverse the effects of muscle relaxants such as gallamine and tubocurarine. Neostigmine, unlike physostigmine, does not cross the blood-brain barrier.

PHARMACOLOGICAL ACTION
Neostigmine is used for the symptomatic treatment of myasthenia gravis by improving muscle tone. Pharmacodynamics Neostigmine is a cholinesterase inhibitor used in the treatment of myasthenia gravis and to reverse the effects of muscle relaxants such as gallamine and tubocurarine. Neostigmine, unlike physostigmine, does not cross the blood-brain barrier. By inhibiting acetylcholinesterase, more acetylcholine is available in the synapse, therefore, more of it can bind to the fewer receptors present in myasthenia gravis and can better trigger muscular contraction.

USES
Used to treat myasthenia gravis.
It is used as muscle retention.
It is used for urinary retention.

SIDE EFFECTS
Bradycardia
Nausea
Vomiting
Allergic reaction

DRUG DRUG INTERACTIONS
Neostigmine + Nadolol = Neostigmine may increases the bradycardial effect of nadolol.
Neostigmine + Procyclidine = the therapeutic effect of procyclidine may decrease.

REFERENCE:
 Tripathi K.D,"Essentials of medical pharmacology",7th edition,page no 105,108,107,109,350,354