Neostigmine interaction

Noble, M.D., Peacook, J.H., Hofmann, W.W. (1979). Prednisone-neostigmine interactions at cholingergic jrmctions. Muscle Nerve 2 155-7. 

Nicotinic Receptor Interactions. After producing an initial brief augmentation of the twitch response and fasciculatlons 2-PAM and TMB-4 at 1-20 mg/kg abolished the indirectly stimulated twitch response of skeletal muscle, but did not alter the response to direct stimulation. Neostigmine and edrophonium antagonized, whereas... 

Neostigmine Forms covalent bond with AChE, but hydrolyzed and released Like edrophonium, but longer-acting Myasthenia gravis t postoperative and neurogenic ileus and urinary retention Oral and parenteral quaternary amine, does not enter CNS. Duration 2-4 h Toxicity and Interactions Like edrophonium... 

Since mivacurium is metabolized by plasma cholinesterase, the interaction with the reversal drugs is unpredictable. On one hand, the neuromuscular blockade is antagonized because of increased acetylcholine concentrations in the synapse. On the other hand, mivacurium concentration may be higher because of decreased plasma cholinesterase breakdown of the muscle relaxant. The former effect usually dominates clinically, and mivacurium block is reversed by neostigmine. 

Eisenach JC, Gebhart GF (1995) Intrathecal amitriptyline - tmtinociceptive interactions with intravenous morphine and intrathecal clonidine, neostigmine tmd carbamylchoUne in rats. Anesthesiology 83 1036—1045... 

Interactions. Morphine (also pethidine and possibly other opioids) is potentiated by monoamine oxidase inhibitors. Any central nervous system depressant (including alcohol) will have additive effects. Patients recently exposed to neuromuscular blocking agents (unless this is adequately reversed, e.g. by neostigmine) are particularly at risk from the respiratory depressant effects of morphine. The effect of diuretic drugs may be reduced by release of antidiuretic hormone by morphine. Useful interactions include the potientating effect on pain relief of tricyclic antidepressants and of dexamfetamine. 

The bradycardia produced by digoxin can be enhanced by beta-adrenoceptor antagonists. Neostigmine enhances vagal activity and can aggravate bradycardia (410). An apparent interaction between sotalol and thiazide-induced hypokalemia, resulting in torsade de pointes (411), has prompted the withdrawal of the combination formulation Sotazide. 

Hood DD, Mallak KA, Eisenach JC, Tong C. Interaction between intrathecal neostigmine and epidural clonidine in human volunteers. Anesthesiology 1996 85(2) 315-25. 

Wali FA Interactions of nifedipine and diitiazem with muscle relaxants and reversal of neuromuscular blockade with edrophcxiium and neostigmine. /P awwaco/(1986) 17,244-53. 

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