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Physostigmine and its place in modern anaesthesiology and intensive care


Authors: L. Hess 1;  J. Málek 2;  J. Schreiberová 3
Authors‘ workplace: Centrum experimentální medicíny, IKEM Praha 1;  Klinika anesteziologie a resuscitace 3. LF UK a FNKV, Praha Klinika anesteziologie, resuscitace a intenzivní medicíny, FN Hradec Králové 2
Published in: Anest. intenziv. Med., 17, 2006, č. 6, s. 287-294
Category: Anaesthesiology - Comprehensive Report

Overview

Physostigmine was isolated from Calabar (ordeal) beans in 1864 and used for glaucoma therapy. Nowadays its main indication is the treatment of the central anticholinergic syndrome which is a relatively common complication of general anaesthesia and analgesic sedation in the ICU. The pharmacokinetic and pharmacodynamic properties and interactions of physostigmine with drugs commonly used in anaesthesia (volatile anaesthetics, propofol, benzodiazepines, opioides and dehydrobenzperidole) are described. A short review of the central anticholinergic syndrome symptoms and therapy is presented. Physostigmine effects on ethyl alcohol intoxication, muscle shivering and Alzheimer’s disease are also mentioned.

Key words:
physostigmine – history – pharmacology – central anticholinergic syndrome


Labels
Anaesthesiology, Resuscitation and Inten Intensive Care Medicine
Topics Journals
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