Description
Pyridostigmine bromide Pharmacodynamics
Pyridostigmine bromide inhibits cholinesterase. It belongs to the non-directly acting cholinomimetics. Inhibition of the enzyme promotes the accumulation of acetylcholine at the receptors in the cholinergic synapses, resulting in a more pronounced and long-lasting effect of acetylcholine. The drug mainly acts on the peripheral nervous system. It does not affect central nervous system functions, since due to low lipid solubility it does not penetrate through the blood-brain barrier.
Indications
Myasthenia gravis (gravis).
Contraindications
Hypersensitivity to pyridostigmine bromide and other components of the drug;
– Prior administration of depolarizing myorelaxants (suxamethonium, decamethonium bromide);
– iritis;
– chronic obstructive bronchitis, bronchial asthma;
– Obturative (mechanical) intestinal obstruction;
– Obstruction of the biliary and urinary tracts;
– Spastic conditions of the gastrointestinal tract;
– myotonia;
– Shock in the postoperative period;
– pregnancy;
– lactation period;
– under 18 years of age.
Dosage and administration
- Inside, with water.
- The dose and duration of treatment is determined by the physician, depending on the course of the disease and the patient’s response to treatment.
- Myasthenia gravis
- For symptomatic treatment of myasthenia gravis in adults it is recommended to use 1-3 tablets of pyridostigmine bromide 3-4 times a day (180-720 mg per day).
- Myasthenia gravis patients require careful individual selection of the dose depending on the course of the disease and the patient’s response to treatment. The above doses are only recommendations, but the maximum daily dose of 720 mg should not be exceeded.
- Treatment of patients with kidney disease
- Patients with kidney diseases should take the preparation in low dosage, because pyridostigmine bromide in unchanged form is excreted mainly by kidneys (75%). At a creatinine level of 2 mg/dL, half the maintenance dose should be used or the interval between doses should be doubled accordingly. Therefore, the required dose should be chosen individually for each patient, depending on the response to therapy with the drug. A careful medical examination is recommended.
