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Neostigmine, sold under the brand name Bloxiverz, among others, is a medication used to treat myasthenia gravis, Ogilvie syndrome, and urinary retention without the presence of a blockage. [ 3 ] [ 4 ] It is also used in anaesthesia to end the effects of non-depolarising neuromuscular blocking medication . [ 3 ]
Some elements of the cholinergic crisis can be reversed with antimuscarinic drugs like atropine or diphenhydramine, but the most dangerous effect — respiratory depression, cannot. [ 6 ] The neuromuscular junction, where the brain communicates with muscles (like the diaphragm , the main breathing muscle), works by acetylcholine activating ...
Neuromuscular function monitoring and the use of the appropriate dosage of sugammadex to reverse blockade produced by rocuronium can reduce the incidence of postoperative residual curarization. [6] In this study, with usual care group receiving reversal with neostigmine resulted in a residual blockade rate of 43%. [citation needed]
Topical atropine is used as a cycloplegic, to temporarily paralyze the accommodation reflex, and as a mydriatic, to dilate the pupils. [15] Atropine degrades slowly, typically wearing off in 7 to 14 days, so it is generally used as a therapeutic mydriatic, whereas tropicamide (a shorter-acting cholinergic antagonist) or phenylephrine (an α-adrenergic agonist) is preferred as an aid to ...
The typical dose is 1.5 mg/kg IV given three minutes prior to intubation. [34] Atropine may also be used as a premedication agent in pediatrics to prevent bradycardia caused by hypoxia, laryngoscopy, and succinylcholine. Atropine is a parasympathetic blocker. The common premedication dose for atropine is 0.01–0.02 mg/kg.
Acetylcholine hyperpolarizes the sinoatrial node; this is overcome by MRAs, and thus they increase the heart rate. If atropine is given by intramuscular or subcutaneous injection, it causes initial bradycardia. This is because when administered intramuscularly or subcutaneously atropine acts on presynaptic M1 receptors (autoreceptors).
In the 1850s, atropine was used as antispasmodic in asthma treatment and as morphine antidote for its mydriatic effect. [4] Bezold and Bloebaum showed that atropine blocked the effects of vagal stimulation on the heart in 1867. Subsequently in 1872, Heidenhain found its ability to prevent salivary secretion. [6]
In newborns, a 0.15 mg/kg dose of neostigmine administered subcutaneously produces a response within ten minutes. In infants, the drug is administered intravenously at a dose of 0.2 mg/kg. [ 4 ] Improvement of diplopia is often used as an evaluation item because in this case, placebo effect can be excluded.