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Physostigmine
- Indications
- Incapacitating Agent exposure (e.g. BZ, Agent 15)
- Anticholinergic overdose (e.g. Atropine)
- Pharmacokinetics
- Reversibly binds acetylcholinesterase
- Related to Pyridostigmine
- Lasts only 45-60 minutes
- May require frequent redosing as below
- Routes
- Intramuscular
- Adults: 0.05 mg/kg
- Child: 0.02 mg/kg
- Intravenous: 30 ug/kg slower than 1 mg per minute
- Oral: 60 ug/kg (bitter taste, dilute in juice)
- Protocol example in Adults
- Initial: 2-3 mg IM
- Repeat: every 30-60 minutes prn mental status
- Maintenance: 2-4 mg IV slowly every 2-4 hours prn
- Taper: Slowly taper over hours to 4-5 days
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| Definition (MSH) | A cholinesterase inhibitor that is rapidly absorbed through membranes. It can be applied topically to the conjunctiva. It also can cross the blood-brain barrier and is used when central nervous system effects are desired, as in the treatment of severe anticholinergic toxicity. |
| Definition (CSP) | cholinergic alkaloid with anticholinesterase activity used topically to produce pupillary constriction and decrease of intraocular pressure in glaucoma and parenterally to reverse the CNS effects produced by overdosage of anticholinergic drugs. |
| Concepts | Organic Chemical (T109)
, Pharmacologic Substance (T121)
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| English | Physostigmine, PHYSOSTIGMINE PREPARATION |
| Spanish | fisostigmina |
| Credits | Derived from the NIH UMLS (Unified Medical Language System)
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