新斯狄明

用途

• Diagnosis of myasthenia gravis / Antagonism of non-depolarizing neuromuscular block
• Diagnosis of myasthenia gravis / Antagonism of non-depolarizing neuromuscular block

給藥方式

可能的副作用

• Nausea and vomiting
• Increased salivation (ptyalism)
• Diarrhoea
• Muscle fasciculations and cramps
• Weakness and paralysis (with overdose)
• Severe bradyarrhythmias or asystole
• Miosis and nystagmus
• Hypotension
• Bronchoconstriction and increased bronchial secretions

注意事項與禁忌

• Mechanical gastrointestinal obstruction
• Mechanical urinary tract obstruction
• Peritonitis
• Use with **extreme caution** in patients with: * **Bronchial disease** (especially feline asthma) * **Bradycardia** and other arrhythmias * **Hypotension** * **Renal impairment** * **Epilepsy** > Always have **atropine** (0.05 mg/kg IV) available for immediate administration when using neostigmine to diagnose myasthenia gravis.

藥物相互作用

• Aminoglycosides: May antagonize the neuromuscular effects of neostigmine
• Clindamycin: May antagonize the neuromuscular effects of neostigmine
• Halogenated inhalational anaesthetics: May antagonize the neuromuscular effects of neostigmine
• Quinine and related compounds: May increase clinical severity of myasthenia gravis and reduce neostigmine effectiveness
• Beta-blockers: May reduce effectiveness in myasthenia gravis; concurrent use may result in severe bradycardia
• Suxamethonium: Neostigmine inhibits its metabolism, prolonging and enhancing its clinical effect (combined use not recommended)
• Non-depolarizing muscle relaxants: Neostigmine antagonizes their effect (therapeutic use)
• Atropine: Antagonizes the muscarinic effects of neostigmine (used therapeutically to manage side effects)

常見問題