Physostigmine

Question 1

Brand Name

Answer 1

Antilirium

Question 2

Broad category/Class

Answer 2

Anticholinesterase

Question 3

Structure Considerations

Answer 3

Carbamoyl ester and a tertiary amine (Highly lipid soluble and crosses BBB)

Question 4

MOA

Answer 4

same

Question 5

Indications

Answer 5

• Central Anticholinergic syndrome
• Other drug toxicity from cyclic antidepressants, antihistamines, antipsychotics, and anticonvulsants

Question 6

Other Indications

Answer 6

Postop shivering reduction

Question 7

Standard Dosing

Answer 7

0.1-0.3 mg/kg

Question 8

Adult dosing administration considerations

Answer 8

Given slowly in 1-2 mg doses

Question 9

Max dose

Answer 9

3 mg

Question 10

Onset

Answer 10

5 mins

Question 11

Duration

Answer 11

1-2 hours

Question 12

Metabolism

Answer 12

Plasma esterases (Rapid may need repeat dosing)

Question 13

Anticholinergic Crisis Symptoms

Answer 13

Dry skin/Mucous membranes
Flushing
Hyperthermia
Confusion, delerium, hallucinations, agitation, restlessness
HTN (Hypotension later)
Urinary retention
Tachycardia
Mydriasis