Pyridostigmine (Br)

Pyridostigmine (Br) is a quaternary ammonium cholinesterase inhibitor. Pyridostigmine (Br) is a muscular stimulant. It has longer duration of action than that of neostigmine. Pyridostigmine (Br) is used in the chronic management of myasthenia gravis.Pyridostigmine (Br) is also used to reverse the actions of nondepolarizing neuromuscular blockers after surgery. Pyridostigmine was approved by the FDA in 1955.

Brands
AMINOVEL-600 AMYGRA MATERNA NEUROPLEX BENTABION BENTABION CORAMIN-G ENERGY PLUS
Adult Dose
Dose: 2 to 5 mg/dose
Single Dose: 3.5 (3.5)
Frequency: 2.4 hourly
Route: IV,IM
Instructions:
Neonatal
Dose: 0.625 to 3.75 mg/kg
Single Dose: 2.2 (2.1875)
Frequency: 6 hourly
Route: Oral
Instructions: Initial dose , then adjust according to response
Paedriatic
Dose: 3 mg/kg
Single Dose: 3 (3)
Frequency: 6 hourly
Route: Oral
Instructions: Adjust Dose as per response obtained
Characteristics
. It is of Synthetic origin and belongs to Quaternary Ammonium. It belongs to Cholinestrase inhibitor pharmacological group on the basis of mechanism of action and also classified in Antidotes and Cholinergic Agonist pharmacological group.The Molecular Weight of Pyridostigmine (Br) is 261.10. It is weakly alkaline drug, 4.13% solution of the drug is isotonic and Its pKa is strongly basic.
Contraindications
Pyridostigmine (Br) is contraindicated in conditions like Intestinal obstruction,Urinary obstruction.
Effects
The severe or irreversible adverse effects of Pyridostigmine (Br), which give rise to further complications include Hallucinations, Anxiety, Epilepsy, Disorientation, Loss of consciousness.The signs and symptoms that are produced after the acute overdosage of Pyridostigmine (Br) include Bradycardia, Diarrhea, Dizziness, Sweating, Abdominal pain, Salivation, Depolarizing block.The symptomatic adverse reactions produced by Pyridostigmine (Br) are more or less tolerable and if they become severe, they can be treated symptomatically, these include SweatingX.
Indications
Pyridostigmine (Br) is primarily indicated in conditions like Myasthenia gravis, Paralytic ileus, Urinary retention, Urinary retention.
Interactions
Pyridostigmine (Br) is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementChloroquineChloroquineColistin (Sulphate & Sulphomethate Na)DisopyramideGentamicinHydroxychloroquine (Sulphate)Hydroxychloroquine (Sulphate)Kanamycin (Acid Sulphate)Lithiumlithium interfere with neuromuscular conductionMethocarbamolMethocarbamol may inhibit the effect of pyridostigmine bromide. Methocarbamol should be used with caution in patients with myasthenia gravis receiving anticholinesterase agents.Methylprednisolonecoadministration with corticosteroids such as methylprednisolone result in profound weaknessventilationNeomycinOxytetracycline (Dihydrate)Pantothenic AcidPantothenic Acid may increase the effects of Pyridostigmine (Br).Penicillaminecoadministration may develop myasthenia gravisPolymyxin B (Sulphate)Procainamide (HCl)Procainamide (HCl)Antiarrythmic drugs such as procainamide block the acetylcholine receptorPropafenone (HCl)Propranolol (HCl) coadministration with beta blockers have the potential to aggravate the symptom of myasthenia gravis and also reports of bradycardia and hypotensionventilationQuinidineAntiarrythmic drugs such as quinidine block the acetylcholine receptorStreptomycinTrimeprazine (Tartrate)Verapamil (HCl)coadministration with ca channel blockers such as verapamil may produce an enhance muscle block.manage with Edrophonium These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interfrence
Risks
If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
Syrup Store Between 15°C-30°C. Do not Freeze. Protect from Sunlight and Moisture. Tab Store Between 15°C-30°C. Protect from Sunlight and Moisture.
Warnings
Pyridostigmine should be used with caution in patients with any pre-existing stomach disorders, kidney or urinary problems, ulcers, asthma, epilepsy, heart diseases, thyroid disorders or allergies especially to bromides or anticholinesterases. Notify the doctor if this medication appears to be losing its effect. In some cases, people become insensitive to the medication and it must be stopped for a brief period. It should be used only if clearly needed during pregnancy or lactation.
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