| Download the amazing global Makindo app: Android | Apple | |
|---|---|
| MEDICAL DISCLAIMER: Educational use only. Not for diagnosis or management. See below for full disclaimer. |
Pyridostigmine 💊
⚠️ Important: Pyridostigmine increases acetylcholine at the neuromuscular junction. In excess, it can cause a cholinergic crisis (depolarising block), which may mimic worsening myasthenia. Avoid in patients with severe asthma.
📖 About
- Check full details in the BNF here.
- Often useful for patients who are weakest on waking (short-term symptomatic relief).
⚙️ Mode of Action
- Reversible acetylcholinesterase inhibitor → ↑ acetylcholine at neuromuscular junction.
- Less potent than neostigmine but longer duration of action.
- In excess, may worsen weakness (cholinergic crisis).
💊 Dose Range (monitor LFTs)
| Name | Starting Dose | Frequency | Route |
|---|---|---|---|
| Pyridostigmine (for Myasthenia) | 30–120 mg | QDS | PO (max 450 mg/day usual; up to 1.2 g/day sometimes used).
Consider adding immunosuppression if dose >360 mg/day. |
🔗 Interactions
- See BNF for full details (many possible interactions).
⚠️ Cautions
- Asthma (extreme caution)
- Bradycardia, arrhythmias, recent MI
- Epilepsy, hypotension, parkinsonism
- Peptic ulcer disease, hyperthyroidism
🚫 Contraindications
- Bowel obstruction
- Urinary obstruction
❗ Side Effects
- Excess muscarinic activity: sweating, colic, diarrhoea, salivation, gastric hypersecretion, bradycardia.
- Effects can be reversed with atropine-like drugs.
📚 References
- BNF Online: Pyridostigmine Bromide
- Clinical Pharmacology texts
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
|
|
Categories
- A Level
- About
- Acute Medicine
- Anaesthetics and Critical Care
- Anatomy
- Anatomy and Physiology
- Biochemistry
- Book
- Cardiology
- Collections
- CompSci
- Crib Sheets
- Crib sheets
- Dental
- Dermatology
- Differentials
- Drugs
- ENT
- Education
- Electrocardiogram
- Embryology
- Emergency Medicine
- Endocrinology
- Ethics
- Foundation Doctors
- GCSE
- Gastroenterology
- General Practice
- Genetics
- Geriatric Medicine
- Guidelines
- Gynaecology
- Haematology
- Hepatology
- Immunology
- Infectious Diseases
- Infographic
- Investigations
- Lists
- Mandatory Training
- Medical Students
- Microbiology
- Nephrology
- Neurology
- Neurosurgery
- Nutrition
- OSCE
- OSCEs
- Obstetrics
- Obstetrics Gynaecology
- Oncology
- Ophthalmology
- Oral Medicine and Dentistry
- Orthopaedics
- Paediatrics
- Palliative
- Pathology
- Pharmacology
- Physiology
- Procedures
- Psychiatry
- Public Health
- Radiology
- Renal
- Respiratory
- Resuscitation
- Revision
- Rheumatology
- Statistics and Research
- Stroke
- Surgery
- Toxicology
- Trauma and Orthopaedics
- USMLE
- Urology
- Vascular Surgery