Pyridostigmine

Category: pharmacological

Aliases: Mestinon

Pharmacological Mechanism

Reversible peripheral acetylcholinesterase inhibitor — quaternary ammonium prevents BBB penetration → no CNS effects. First-line symptomatic therapy for myasthenia gravis. Cholinergic crisis at overdose; nicotine-receptor desensitization under-treats severe cases.

Half-Life (t½)

PO: 3.5h, IV: 1.62h

Dosing Guidelines

• PO: Typical 60 mg (Range: 30–600 mg)

Target Organ Systems

• nervous

Pathways It Modulates

• Acetylcholine synthesis + degradation (inhibitor) — AChE — myasthenia gravis
• Nicotinic ACh receptor pharmacology (activator) — NMJ ACh prolongation (myasthenia gravis Rx)

Chemical Identifiers

• PubChem CID: 4991
• Formula: C9H13N2O2+
• Molecular weight: 261.1 g/mol
• InChIKey: RVOLLAQWKVFTGE-UHFFFAOYSA-N
• SMILES: C[N+]1=CC=CC(=C1)OC(=O)N(C)C

References

• PMID 3987173