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Physostigmine

Trade names are Antilirium and Isopto Eserine.

Drug can be administered by intravenous, intramuscular, and ophthalmic routes.

A parasympathomimetic alkaloid, specifically, a reversible cholinesterase inhibitor.

Acts by interfering with the metabolism of acetylcholine.

Acts as a covalent inhibitor of acetylcholinesterase.

Acetylcholinesterase is the enzyme responsible for the breakdown of acetylcholine at the neuromuscular junction.

The drug indirectly stimulates both nicotinic and muscarinic acetylcholine receptors.

Uses include treatment glaucoma, Alzheimer’s disease, delayed gastric emptying, improvement in short term memory and the treatment of orthostatic hypotension.

As a tertiary amine, it can cross the blood–brain barrier.

Can be used to treat the central nervous system effects of atropine, scopolamine, and other anticholinergic drug overdoses.

An antidote for atropine poisoning.

Functions as an acetylcholinesterase inhibitor preventing the hydrolysis of acetylcholine by acetylcholinesterase at the transmitted sites of acetylcholine.

The inhibition of the acetylcholinesterase enhances the effect of acetylcholine, making it useful for the treatment of cholinergic disorders and myasthenia gravis.

Useful in treating mydriasis since it is has a mitotic function of causing pupillary constriction.

Increases outflow of the aqueous humor in the eye, making it useful in the treatment of glaucoma.

An overdose can cause cholinergic syndrome.

Drug side effects include: nausea, vomiting, diarrhea, anorexia, dizziness, headache, stomach pain, sweating, dyspepsia, and seizures.

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