Pyridomine Injection (Pyridostigmine Bromide)

Adult dosage

1. Reversal agent or antagonist for nondepolarizing muscle relaxants before and after surgery: Usually, 10-20 mg (0.1-0.25 mg per kg of body weight) of pyridostigmine bromide is injected. When this medicine is administered intravenously, it is advisable to administer atropine sulfate 0.6-1.2 mg or glycopyrrolate (in an amount that can produce an effect equivalent to that of atropine) immediately before or at the same time as this medicine to reduce adverse effects such as bradycardia or excessive secretions. 2. 1) For use during myasthenic crisis before or after surgery, during delivery, or after delivery: An amount equivalent to 1/30 of the oral dose (2-6 mg) is administered by intramuscular injection or slow intravenous injection. 2. 3) For use to maintain appropriate muscle tone in a pregnant woman during delivery or to protect the newborn immediately after birth: Inject 1 hour before the second stage of labor.

Children's dosage

2. 2) For newborns born to mothers with symptoms of myasthenia who temporarily have difficulty breathing, swallowing, or feeding: Administer by intramuscular injection an amount equivalent to 0.05-0.15 mg per kg of body weight.

This medication should be cut carefully when opening the ampoule as glass fragments could mix in; extreme caution is needed to prevent glass shards from entering. Special care should be taken when used in children or the elderly. This medication should not be administered to patients with allergic reactions to this drug or other anticholinesterases, patients with obstructions or strictures in the gastrointestinal or urinary tract, patients with bronchial asthma or spastic bronchitis, patients with iritis, hyperthyroid patients, patients with muscle tone disorders, patients with Parkinson's syndrome, patients who are in shock after surgery or have cardiovascular problems, and patients receiving certain muscle relaxants (such as succinylcholine). Careful administration is needed in patients with renal dysfunction, patients with peptic ulcers, patients who have had gastrointestinal surgery, diabetic patients, patients with liver damage (who should have regular liver function tests), patients with heart failure, patients who have recently suffered myocardial infarction, and patients with arrhythmias or bradycardia, and hypotension. Overdosage of this medication can produce symptoms such as respiratory muscle paralysis, muscle cramps, abdominal pain, diarrhea, sweating, and miosis. In such cases, administration should be stopped immediately and atropine should be given intravenously. If necessary, ensure the airway through the use of artificial respiration or tracheostomy. This medication may cause side effects such as diarrhea, nausea, vomiting, abdominal pain, tearing, sweating, increased bronchial secretion, and vascular congestion; if symptoms are severe, atropine may be administered to relieve the symptoms. If a skin rash occurs, stop administration immediately. Caution is needed in patients with myasthenia gravis as symptoms may worsen, and appropriate measures should be taken to distinguish between myasthenic crises and cholinergic crises. This medication is primarily excreted through the kidneys, so patients with poor renal function should have their doses reduced, and bradycardia may occur during administration, which can be controlled by atropine. Arrhythmia patients should be particularly cautious when administering atropine. This medication may increase the side effects when used with certain muscle relaxants, so co-administration should be avoided, and caution is warranted when used with anticholinergic drugs as side effects may be masked, posing a risk of overdose. The safety of this medication has not been established in pregnant or breastfeeding women; it should be carefully administered only when the necessity for treatment outweighs the risks. In cases of breastfeeding, it is advisable to avoid breastfeeding during administration. Elderly patients may experience prolonged retention of the drug in the body due to reduced renal function, so treatment should start at a lower dose and the patient's condition should be closely monitored.

• respiratory muscle paralysis
• tonic seizure
• abdominal pain
• diarrhea
• sweating
• relaxation
• miosis
• nausea
• vomiting
• abdominal distension

This medication should be stored in a tightly sealed container that blocks light, and it is best kept at room temperature between 1 and 30 degrees Celsius. Storing it this way helps maintain the efficacy and safety of the drug.

Appearance

Colorless and transparent liquid or brown ampoule

Package unit

50 ampoules/box [(1mL/ampoule)]