Page 48 - pharma 1 theoretical updated MNU_Neat

Clinical pharmacy 2024/2025 Level 3 Pharm D Pharmacology 1 (PO 502)

2) Physostigmine 3) Edrophonium

• Natural alkaloid Like neostigmine in structure but

• Affinity to cholinesterase is l0,000 differ in:
times >Ach. 1. Rapid onset & short duration of
• 3ry amine ➔ absorbed from G.I.T action.

& penetrate BBB ➔ has CNS 2. Weak as anticholinesterase, but
effects. more selective & powerful for
• Act on both muscarinic & myasthenia Gravis.

nicotinic receptors. 3. Used for diagnosis of myasthenia
• Used as miotic and in treatment of Gravis & to differentiate between

glaucoma. myasthenia gravis & cholinergic
 limited uses due to its CNS effect crisis.

Side effects:

Like other choline esters, blocked by atropine.

 Another reversible cholinesterase inhibitor

 Pyridostigmine:

➢ Pyridostigmine is the current drug of choice, with superior pharmacokinetics and
reduced side effects compared to neostigmine.
➢ Used In treating myasthenia gravis.
 Distigmine

➢ is similar to pyridostigmine and neostigmine but has a longer duration of action.
 Rivastigmine
➢ is a parasympathomimetic or cholinergic agent for the treatment of mild to

moderate dementia of the Alzheimer's type.
➢ Rivastigmine is a cholinesterase inhibitor that inhibits both butyrylcholinesterase
and acetylcholinesterase.

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