Indications Reversal of non-depolarising neuromuscular blockade.

Cautions: asthma (extreme caution), bradycardia, arrhythmias, recent myocardial infarction, epilepsy, hypotension, parkinsonism, vagotonia, peptic ulceration, hyperthyroidism, renal impairment.

Contra-indications: intestinal or urinary obstruction

Side Effects: nausea, vomiting, increased salivation, diarrhoea, abdominal cramps (more marked with higher doses); signs of overdosage include bronchoconstriction, increased bronchial secretions, lacrimation, excessive sweating, involuntary defaecation and micturition, miosis, nystagmus, bradycardia, heart block, arrhythmias, hypotension, agitation, excessive dreaming, and weakness eventually leading to fasciculation and paralysis.

Dose: by IV injection, 1-5 mg or 1 mg/20 kg. after or with atropine sulfate 0.6-1.2 mg.

Pregnancy: Antimyasthenics have not been reported to cause birth defects; however, muscle weakness has occurred temporarily in some newborn babies whose mothers took antimyasthenics during pregnancy.

Breast feeding: Antimyasthenics have not been reported to cause problems in nursing babies.