Physostigmine (Eserine)

Indications
 Oral
Alzheimer's dementia
Adult: Initial dose: 0.5 mg every 2 hr, 6 or 7 times daily until beneficial or adverse effects occur. Max dose: 16 mg/day.
Parenteral
Reversal of anticholinergic effect
Adult: Initial dose: 0.5-2 mg. May be given via slow IV inj or IM, repeated every 20 min until response or adverse effects occur. If initial doses are effective, additional doses of 1-4 mg may be given as necessary at usual intervals of 30-60 minutes as life-threatening signs recur.
Child: For life-threatening situations only: 0.02 mg/kg as initial dose. May be given via slow IV inj or IM, repeated at 5-10 min intervals until response or adverse effects occur or a total dose of 2 mg has been admin.
Parenteral
Stimulate peristalsis in postoperative intestinal atony
Adult: Usual dose: 0.5-2 mg IV or IM inj.
Ophthalmic
Glaucoma
Adult: As sulfate, 0.25% ointment. As salicylate, 0.25% or 0.5% eye drops.
Contraindications
 Acute iritis; acute uveitis; anterior uveitis; some forms of secondary glaucoma.
Warnings / Precautions
 Acute inflammatory disease of the anterior segment of the eye. Discontinue before eye surgery (risk of hyphema). History of retinal detachment, children with myopia. Night driving or hazardous task undertaken in poor illumination. Patients wearing soft contact lenses. Prolonged use may lead to depigmentation of the lid margins in dark-skinned patients.
Adverse Reactions
 Systemic: CNS effects, may produce follicles in the conjunctiva, increased salivation, nausea, vomiting, abdominal cramps, diarrhoea, allergic reactions. Ophthalmic: Ciliary spasm, ocular pain and irritation, blurred vision, lachrymation, myopia, browache, conjunctival vascular congestion, superficial keratitis, vitreous haemorrhage, increased pupillary block, lens opacities (prolonged use).
Potentially Fatal: Respiratory failure.
Overdose Reactions
 May lead to "cholinergic crisis" which include excessive sweating, lachrymation, increased peristalsis, bradycardia and bronchospasm.
Drug Interactions
 Aminoglycosides, clindamycin, colistin, cyclopropane, halogenated inhalational anaesthetics and atropine may antagonise the effects of physotigmine. Quinine, chloroquine, hydroxychloroquine, quinidine, procainamide, propafenone, lithium and β-blockers may reduce treatment efficacy. Prolonged bradycardia may occur when taken with β-blockers. May prolong the action of suxamethonium when used together.
See Below for More physostigmine Drug Interactions
Mechanism of Actions
 Physostigmine is a reversible tertiary amine cholinesterase inhibitor, prolongs and intensifies physiological actions of acetylcholine.
Absorption: Readily absorbed from the GI tract.
Distribution: Crosses the blood brain barrier.
Metabolism: Mainly by hydrolysis of the ester linkages by cholinesterases.
Excretion: Little excreted in urine.
Storage Conditions
 Parenteral: Store at 15-30°C.
ATC Classification
 S01EB05 - physostigmine ; Belongs to the class of parasympathomimetics. Used in the treatment of glaucoma and miosis.
V03AB19 - physostigmine ; Belongs to the class of antidotes. Used in the management of noxious gases poisoning.
Storage
 Parenteral: Store at 15-30°C.
Available As
  • Physostigmine (Eserine) 0.25%

    • Subscribe for latest updates

    Subscribe to our e-mail newsletter to receive updates.

    No comments yet.

    Post Review about Physostigmine (Eserine)


    Physostigmine (Eserine) Containing Brands

    We are Developing Our database, More results coming soon.

    Physostigmine (Eserine) is used in following diseases

    We are Developing Our database, More results coming soon.

    Drug - Drug Interactions of Physostigmine (Eserine)

    We are Developing Our database, More results coming soon.