neostigmine bromide /nē′ōstig″mēn/ , a reversible acetylcholinesterase inhibitor. ▪ INDICATIONS: It is prescribed in situations in which it is desirable to potentiate the effects of neuronally released acetylcholine, such as in the treatment of myasthenia gravis and postoperative urinary retention, and to reverse the effects of nondepolarizing neuromuscular blockers. ▪ CONTRAINDICATIONS: Bowel obstruction, urinary tract infection, or known hypersensitivity to this drug or to other bromides prohibits its use. Initial dosages should be administered only in settings equipped for cardiopulmonary resuscitation, and ephinephrine and atropine should be available. ▪ ADVERSE EFFECTS: Overdosage causes cholinergic crisis with widespread muscle weakness and paralysis, including the diaphragm, which can cause severe respiratory depression. Excessive salivation and lacrimation, intestinal cramps, urinary urgency, and convulsions are other adverse effects.
