Pyridostigmine PDF

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Summary

Pyridostigmine...

Description

CLASS: Cholinergic

GENERIC NAME: Pyridostigmine

TRADE NAMES: Mestinon, Mestinon SR, Mestinon Timespan, Regonol MOA: inhibits the breakdown of acetylcholine to prolong its effects (includes smooth muscle contractions, dilates blood vessels, increases bodily secretions, and slows heart rate) INDICATIONS: Used to increase strength of muscles in those with myasthenia gravis, can reverse nondepolarizing neuromuscular blocking agents, prophylaxis of fatal effects of poisoning CONTRAINDICATIONS/PRECAUTIONS: hypersensitivity to drug or to bromides, mechanical obstruction of the GI tract, known alcohol intolerance with syrups Precautions includes asthma, ulcer disease, cardiovascular disease, epilepsy, hyperthyroidism; with OB patients can cause uterine irritability after IV administration near term; there are not established precautions with breastfeeding moms or pediatric patients. INTERACTIONS with other Drugs/Substances: can be antagonized by drugs with anticholinergic effects (such as antihistamines, antidepressants, atropine, haloperidol, phenothiazines, procainamide, quinidine, disopyramide); prolongs the action of depolarizing muscle-relaxing agents and cholinesterase inhibitors PATIENT RESPONSE / REACTIONS: COMMON SIDE EFFECTS: ADVERSE REACTIONS: S/S TOXICITY: not noted TOXICITY/OVERDOSE TX: bronchospasm, excessive DESIRED OUTCOME: improved SEIZURES, dizziness, atropine is the antidote secretions, bradycardia, muscular function in patients with weakness, bronchospasms, abdominal cramps, myasthenia gravis, prevents soman hypotension, bradycardia, abdominal cramps, diarrhea, excessive nerve gas toxicity, reversal of salivation, nausea, paralysis from nondepolarizing diarrhea, excessive salivation, nausea, vomiting, sweating neuromuscular blocking agents vomiting, sweating, rashes

NURSING ACTIONS: give orally with food or milk to minimize side effects, oral not interchangeable with IV (parenteral is 30 times more potent), do not crush

ASSESS: assess pulse, respiratory rate, and BP prior to administration

CARE/IMPLEMENT: keep fluid intake up, take with food or milk

SPECIAL CONSIDERATIONS/NOTES: IV dose is 30 times more potent that oral dose

TEACH: take as directed, do not skip or double up doses, take med at prescribed time to avoid adverse effects, carry identification with disease and medication regimen

EVALUATE: monitor pulse, respiratory rate, and BP; evaluate for desired outcome (improved chewing, swallowing, and extremity strength)...