Neostigmine & pyridostigmine

Keyword

Neostigmine & Pyridostigmine

Mechanism

Specific Cholinesterase inhibitors

Dose

1. Neostigmine
   1. mild-to-moderate muscle relaxation : 0.04 mg/kg (or 2.5 mg)
   2. intense muscle relaxation : 0.08 mg/kg (or 5 mg)
   3. maximal dose : 5 mg
2. Pyridostigmine
   1. 0.2 mg/kg (total 20mg in adult)까지 쓸 수 있음.

Prior or concomitant administration of an anticholinergic agent

• muscarinic side effect를 최소화하기 위하여 anticholinergic agent를 함께 투여.
1. Neostigmine
   1. 0.2mg glycopyrrolate (mobinul) per 1mg neostigmine
2. Pyridostigmine
   1. 0.05mg glycopyrrolate per 1mg pyridostigmine
   2. 0.1 mg atropine per 1mg pyridostigmine

Reference

Miller’s Anesthesia, 8th edition, Ch.35, P.1006,