Physostigmine

Physostigmine works on chemicals in the body that manage the signals from the nervous system to the muscles for muscle movement.

Physostigmine is used to counteract the effects of certain drugs or substances that disrupt this communication between nerves and muscles. These substances include atropine, scopolamine, belladonna, antihistamines, some antidepressants, and other anticholinergic (AN tye KOE lin ER jik) drugs.

Physostigmine may also be used for reasons not mentioned in this medication guide.

Physostigmine is injected into a muscle or into a vein through an IV. A healthcare provider will give you this injection.

When injected into a vein, physostigmine must be given slowly.

Your breathing, blood pressure, oxygen levels, and other vital signs will be watched closely while you are receiving physostigmine.

You may need repeat doses of physostigmine, depending on how your body responds to it. Your doctor will decide how long to treat you with physostigmine.

In an emergency, you might not be able to inform your caregivers about your health issues. Ensure that any doctor treating you later knows you have received physostigmine.

You should not be treated with physostigmine if you are allergic to it, or if you have:

• asthma;
• diabetes;
• bladder obstruction or other urination problems;
• a blockage in your digestive tract (stomach or intestines);
• heart disease; or
• gangrene (damaged skin and muscle tissue caused by infection or lack of blood supply).

If possible before you receive physostigmine, tell your doctor if:

• you have a sulfite allergy;
• you have recently taken Ultracet (acetaminophen with tramadol); or
• you regularly take bupropion (Wellbutrin, Zyban, Aplenzin, Forfivo, and others).

In an emergency situation, it may not be possible to tell your caregivers if you are pregnant or breast-feeding. Make sure any doctor caring for your pregnancy or your baby knows you have received this medicine.

Get emergency medical help if you notice signs of an allergic reaction: hives; trouble breathing; swelling of your face, lips, tongue, or throat.

Tell your caregivers immediately if you experience:

• more frequent urination or bowel movements;
• stomach cramps;
• severe or worsening nausea or vomiting;
• increased sweating;
• blurred vision; or
• too much saliva in your mouth.

Common side effects of physostigmine may include:

• nausea, vomiting;
• increased salivation; or
• slow heartbeats.

This is not a complete list of side effects, and others may happen. Call your doctor for medical advice about side effects. You can report side effects to the FDA at 1-800-FDA-1088.

Usual Adult Dose for Anticholinergic Syndrome:

Post anesthesia care:Initial dose: 0.5 to 1 mg, IM or slow IV, at no more than 1 mg/minute-May repeat dose at 10 to 30 minute intervals if desired response is not obtainedOverdose of drugs that cause anticholinergic syndrome:2 mg, IM or slow IV, at no more than 1 mg/minute-May repeat dose if life threatening signs (e.g. arrhythmia, convulsions, coma) occur

Usual Pediatric Dose for Anticholinergic Syndrome:

0.02 mg/kg, IM or slow IV, at no more than 0.5 mg/minute-May repeat dose at 5 to 10 minute intervals if toxic effects persist (and no cholinergic effects) until a therapeutic effect is obtained.Maximum dose: 2 mg

Because you will receive physostigmine in a clinical setting, it is unlikely that you will miss a dose.

Since physostigmine is given by a healthcare professional in a medical setting, an overdose is unlikely to happen.

Follow your doctor's instructions about any restrictions on food, drinks, or activities.

Other drugs may interact with physostigmine, including prescription and over-the-counter medicines, vitamins, and herbal products. Inform each of your health care providers about all medicines you are currently using and any medicine you begin or stop using.