Paper I
2017 August (Supplementary) (2010 Scheme) · 40 marks · 120 min

Question

Neostigmine.

Q33 marksShort Notes

Answer

Neostigmine is a reversible anticholinesterase (carbamate).

Mechanism of action

  • Reversibly inhibits acetylcholinesterase, increasing acetylcholine levels at cholinergic synapses; also has some direct nicotinic agonist action at the neuromuscular junction
  • Quaternary compound — does not cross the blood-brain barrier

Uses

  • Reversal of non-depolarizing neuromuscular blockade (post-surgery)
  • Myasthenia gravis (both diagnosis and treatment)
  • Paralytic ileus, urinary retention (postoperative, non-obstructive)

Adverse effects

  • Muscarinic effects: bradycardia, salivation, bronchospasm, GI cramps, diarrhoea
  • Cholinergic crisis with overdose
  • Given with atropine to counteract muscarinic side effects when used for reversal of neuromuscular block

Other Years Asked


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