Drug Detail:Antilirium (Physostigmine [ fye-so-stig-meen ])
Drug Class: Antidotes
Usual Adult Dose for Anticholinergic Syndrome
Post anesthesia care:
Initial dose: 0.5 to 1 mg, IM or slow IV, at no more than 1 mg/minute
- May repeat dose at 10 to 30 minute intervals if desired response is not obtained
Overdose of drugs that cause anticholinergic syndrome:
2 mg, IM or slow IV, at no more than 1 mg/minute
- May repeat dose if life threatening signs (e.g. arrhythmia, convulsions, coma) occur
Usual Pediatric Dose for Anticholinergic Syndrome
0.02 mg/kg, IM or slow IV, at no more than 0.5 mg/minute
- May repeat dose at 5 to 10 minute intervals if toxic effects persist (and no cholinergic effects) until a therapeutic effect is obtained.
Renal Dose Adjustments
Data not available
Liver Dose Adjustments
Data not available
Dose Adjustments
- Discontinue for excessive salivation, emesis, urination, or defecation.
- Reduce dosage for excessive sweating or nausea.
Precautions
Atropine is an antidote for physostigmine. Because of the possibility of hypersensitivity in an occasional patient, atropine sulfate injection should always be at hand when physostigmine is administered.
Dialysis
Data not available
Other Comments
Administration advice:
- Rapid administration can cause bradycardia, hypersalivation leading to respiratory difficulties, and convulsions.
Storage requirements:
- Store at controlled room temperature.
- Protect from light.