Properties
What is it?
International Name - Neostigmini methylsulfas International and Chemical Name: Neostigmine; (N-(meta-dimethylcarbamoyl-oxyphenyl)-trimethylammonium sulfate); Pharmacotherapeutic group. Anticholinesterase agents. Indications for use. Prozerin is used for myasthenia gravis, motor disorders after head trauma, paralysis, during the recovery period after meningitis, poliomyelitis, encephalitis and other neuroinfections, for neuritis, to prevent and treat atony of the intestines and bladder, and sometimes during weak labor. In ophthalmology, Prozerin is prescribed for optic nerve atrophy, rarely for pupil constriction and to reduce intraocular pressure in open-angle glaucoma. As an antidote to muscle relaxants, the drug is prescribed for muscle weakness and respiratory complications at the end of anesthesia using antimadepolarizing curare-like drugs, as well as with madepolarizing muscle relaxants (dithylin) if the latter begin to act as antimadepolarizers ("orbarg block"). Method of administration and dosage. Prozerin is administered subcutaneously and intravenously. In case of myasthenic crisis, Prozerin-Darnitsa is administered subcutaneously in usual doses at short intervals. In particularly severe cases of crisis in adults, the drug is administered intravenously at a dose of 0.5-1 ml of a 0.05% solution in isotonic sodium chloride solution, then 1 ml of a 50% solution of ephedrine hydrochloride is additionally administered subcutaneously in usual doses. If necessary, Prozerin treatment for myasthenia gravis is carried out in conjunction with aldosterone antagonists (spironolactone), anabolic hormones, and corticosteroids. Insufficient doses of the drug may worsen the condition, while high doses may cause a cholinergic crisis, impaired neuromuscular conduction, and respiratory complications. Prozerin treatment for myasthenia gravis is a long-term process. For other diseases, the duration of drug use is 25-30 days. If necessary, the course of treatment is repeated after a 3-4 week break. For labor stimulation, the drug can be administered subcutaneously at 0.5 mg (1 ml of a 0.05% solution) 1-2 times at 1-hour intervals. Simultaneously with the first injection of Prozerin, 1 mg (1 ml of a 0.01% solution) of atropine sulfate is administered subcutaneously once. To block the action of muscle relaxants, atropine sulfate is administered intravenously before Prozerin at a dose of 0.5-0.7 mg (0.5-0.7 ml of a 0.1% solution). After 1.5-2 minutes, after pulse acceleration, 1.5 mg (3 ml of a 0.05% solution) of Prozerin-Darnitsa is administered intravenously. If the effect is insufficient at this dose, Prozerin-Darnitsa is administered again in the same dose (in case of bradycardia, atropine sulfate is administered again). The total amount of Prozerin that can be administered within 20-30 minutes is 5-6 mg (10-12 ml of a 0.05% solution). In ophthalmology, to reduce intraocular pressure in open-angle glaucoma, 1-2 drops of a 0.05% solution of Prozerin-Darnitsa are instilled into the conjunctival sac 1-4 times a day. Maximum doses for adults subcutaneously: single 0.002 g (2 mg), daily 0.006 g (6 mg). For children over 1 year of age, Prozerin is prescribed subcutaneously at 0.00005 g (0.05 mg = 0.1 ml of a 0.05% solution) per year of life, but not more than 0.75 ml of a 0.05% solution per injection. As a rule, Prozerin is prescribed once a day for children, but if necessary, the daily dose of the drug can be divided into 2-3 administrations. In children, any form of Prozerin is used only in inpatient settings!