http://www.fpnotebook.com/

Physostigmine

Indications
1. Incapacitating Agent exposure (e.g. BZ, Agent 15)
2. AntiCholinergic Overdose (e.g. Atropine)
Pharmacokinetics
1. Reversibly binds acetylcholinesterase
2. Related to Pyridostigmine
3. Lasts only 45-60 minutes
4. May require frequent redosing as below
Routes
1. Intramuscular
  1. Adults: 0.05 mg/kg
  2. Child: 0.02 mg/kg
2. Intravenous: 30 ug/kg slower than 1 mg per minute
3. Oral: 60 ug/kg (bitter taste, dilute in juice)
Protocol example in Adults
1. Initial: 2-3 mg IM
2. Repeat: every 30-60 minutes prn mental status
3. Maintenance: 2-4 mg IV slowly every 2-4 hours prn
4. Taper: Slowly taper over hours to 4-5 days

Navigation Tree

Please see the Terms and Conditions. Please also see the privacy statement regarding advertising on this page. Although access to this page is not restricted, the information found here is intended for use by medical providers. Patients should address specific medical concerns with their physicians.

This page was written by Scott Moses, MD, and was last revised 1/26/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 5.0.