Physostigmine

Frequency Not Defined

Seizure

Cardiovascular collapse

Bradycardia

Bronchospasm

Dyspnea

Diaphoresis

Diarrhea

Hyperperistalsis

Cholinergic Sx

Hallucinations

Pregnancy Category: C

Lacation: Unknown if excreted in breast milk; caution advised

Pregnancy Categories

A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA:Information not available.

Physostigmine is used in the treatment of:

• Abnormalities, Drug-Induced
• Drug Toxicity
• Glaucoma

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

You should not be treated with physostigmine if you are allergic to it, or if you have:

• asthma;

• diabetes;

• bladder obstruction or other urination problems;

• a blockage in your digestive tract (stomach or intestines);

• heart disease; or

• gangrene (damaged skin and muscle tissue caused by infection or lack of blood supply).

If possible before you receive physostigmine, tell your doctor if:

• you have a sulfite allergy;

• you have recently taken Ultracet (acetaminophen with tramadol); or

• you regularly take bupropion (Wellbutrin, Zyban, Aplenzin, Forfivo, and others).

In an emergency situation it may not be possible to tell your caregivers if you are pregnant or breast-feeding. Make sure any doctor caring for your pregnancy or your baby knows you have received this medicine.

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
• Upset stomach or throwing up.
• Very loose stools (diarrhea).
• Passing urine more often.
• Seizures.
• More saliva.
• Sweating a lot.
• Slow heartbeat.

• If you need to store physostigmine at home, talk with your doctor, nurse, or pharmacist about how to store it.

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution, Injection, as salicylate:

Generic: 1 mg/mL (2 mL)

No dosage adjustment provided in manufacturer’s labeling.

No dosage adjustment provided in manufacturer’s labeling.

Increased aminotransferase [ALT/AST] (S), increased amylase (S)

Frequency not defined.

Cardiovascular: Asystole, bradycardia, palpitations

Central nervous system: Hallucination, nervousness, restlessness, seizure, twitching

Dermatologic: Diaphoresis

Gastrointestinal: Diarrhea, frequent bowel movements, nausea, salivation, stomach pain, vomiting

Genitourinary: Urinary frequency

Hypersensitivity: Hypersensitivity reaction

Ophthalmic: Lacrimation, miosis

Respiratory: Bronchospasm, dyspnea, pulmonary edema, respiratory distress, respiratory paralysis

In general, medications used as antidotes should take into consideration the health and prognosis of the mother; antidotes should be administered to pregnant women if there is a clear indication for use and should not be withheld because of fears of teratogenicity (Bailey, 2003).