Physostigmine
Physostigmine Uses, Dosage, Side Effects, Food Interaction and all others data.
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.
Physostigmine is a parasympathomimetic, specifically, a reversible cholinesterase inhibitor which effectively increases the concentration of acetylcholine at the sites of cholinergic transmission. Physostigmine is used to treat glaucoma. Because it crosses the blood-brain barrier, it is also used to treat the central nervous system effects of atropine overdose and other anticholinergic drug overdoses. Physostigmine can reverse both central and peripheral anticholinergia.
| Trade Name | Physostigmine |
| Availability | Prescription only |
| Generic | Physostigmine |
| Physostigmine Other Names | Eserine, Physostigmine, Physostol |
| Related Drugs | Antilirium |
| Weight | 1mg/ml, |
| Type | Injectable Solution, Injection, Ophthalmic |
| Formula | C15H21N3O2 |
| Weight | Average: 275.3461 Monoisotopic: 275.163376931 |
| Groups | Approved, Investigational |
| Therapeutic Class | |
| Manufacturer | |
| Available Country | United States |
| Last Updated: | September 19, 2023 at 7:00 am |
Uses
Physostigmine is a cholinesterase inhibitor used to treat glaucoma and anticholinergic toxicity.
For the treatment of glaucoma, and in the treatment of severe anticholinergic toxicity.
Physostigmine is also used to associated treatment for these conditions: Anticholinergic Syndrome
How Physostigmine works
Physostigmine inhibits acetylcholinesterase, the enzyme responsible for the breakdown of used acetylcholine. By interfering with the metabolism of acetylcholine, physostigmine indirectly stimulates both nicotinic and muscarinic receptors due to the consequential increase in available acetylcholine at the synapse.
Toxicity
Side effects include increased sweating, loss of bladder control, muscle weakness, nausea, vomiting, diarrhea, or stomach cramps or pain, shortness of breath, tightness in chest, or wheezing, slow or irregular heartbeat, unusual tiredness or weakness, watering of mouth, blurred vision or change in near or distant vision, and eye pain.
Food Interaction
No interactions found.Physostigmine Drug Interaction
Moderate: sodium biphosphate / sodium phosphateUnknown: charcoal, amphetamine / dextroamphetamine, epinephrine, RHO Immunoglobulin , multivitamin with minerals, multivitamin, multivitamin, methylcellulose, fat emulsion, pancrelipase, amyl nitrite/sodium nitrite/sodium thiosulfate, digoxin immune fab, ocular lubricant ophthalmic, erythromycin, fentanyl, gentamicin, sodium glycerophosphate, furosemide, acetaminophen
Physostigmine Disease Interaction
Major: bradycardia, bronchospasm, coronary artery disease, parkinsonism, PUD, seizures, asthma, cardiovascular disease, diabetes, GI/UT obstructionModerate: hyperthyroidism
Innovators Monograph
You find simplified version here Physostigmine
FAQ
What is Physostigmine used for?
Physostigmine use in the treatment of glaucoma and the treatment of anticholinergic toxicity. It is useful to treat the central nervous system effects of anticholinergic toxicity due to its ability to cross the blood-brain barrier.
How safe is Physostigmine?
Physostigmine alone was safely used to treat 74.3% (n = 142) of patients in our cohort.Physostigmine may be considered as a safe first-line therapy to treat anticholinergic delirium.
How does Physostigmine work?
Physostigmine work by interfering with the metabolism of acetylcholine.
What are the common side effects of Physostigmine?
Common side effects of Physostigmine are include:
- excessive saliva production.
- excessive sweating.
- nausea.
- vomiting.
- diarrhea.
- stomach cramps.
Is Physostigmine safe during pregnancy?
Physostigmine should be used during pregnancy only if the possible benefit outweighs the possible risk to the unborn baby. No studies have been done in animals, and no well-controlled studies have been done in pregnant women.Physostigmine should be given to a pregnant woman only if clearly needed.
Is Physostigmine safe during breastfeeding?
Benefit should outweigh risk.Because of its low molecular weight, excretion into breast milk is probable.
How long does Physostigmine take to work?
Topical administration of Physostigmine produces an IOP reduction that begins in 10–30 minutes, reaches a maximum in 1–2 hours, and lasts for 4–6 hours.
How is Physostigmine taken?
Physostigmine is injected into a muscle or into a vein through an IV. A healthcare provider will give you this injection. When injected into a vein, physostigmine must be given slowly.
When do I give Physostigmine?
Physostigmine treatment may be indicated for patients with moderate to severe anticholinergic poisoning with evidence of both peripheral and central toxicity.
Can I take Physostigmine for a long time?
Patients are not likely to require further Physostigmine redosing more than 6.5 h from their first dose.
Who should not take Physostigmine?
In an emergency situation it may not be possible to tell your caregivers about your health conditions. Make sure any doctor caring for you afterward knows you have received physostigmine.
What happens if I miss a dose?
Apply the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and apply the next one as directed. Do not use a double dose of this medication.
What happens if I overdose of Physostigmine?
Flush the eye with water and seek emergency medical attention if an overdose is suspected.Symptoms of a physostigmine ophthalmic overdose may include sweating, nausea, vomiting, diarrhea, watering mouth, tearing eyes, fainting, difficulty breathing, and an irregular heartbeat.
Does Physostigmine cause bronchoconstriction?
Patients with asthma should not be given physostigmine because it can worsen bronchoconstriction.Physostigmine can alter insulin requirements so it also should not be used in patients with diabetes mellitus.
How long does Physostigmine stay in my system?
Because the clinical duration of action of Physostigmine is short (20 to 90 minutes) compared with that of antipsychotic agents, resolution of the anticholinergic stigmata after Physostigmine administration should not alter patient disposition.
What does Physostigmine do to muscles?
Physostigmine affects chemicals in the body that control the signals sent from the nervous system to the muscles to activate muscle movement.
How do you administer Physostigmine?
Administer 0.5 – 1 mg IV as a slow push over 5 minutes and repeat every 10 minutes until the desired clinical effects are observed. It is rare for more than 4 mg to be required. The duration of action is much shorter than most cases of anticholinergic delirium.
