Exciting the lower esophagus and promoting peristalsis

Gastric smooth muscle contracts and gastric acid secretion increases

Promote the elimination of intestinal contents (especially the colon)

heart rate slows down

Decreased cardiac output

Neostigmine, pyridostigmine, ambucilium chloride

Note: The drug has a short action time and needs to be administered repeatedly.

Neostigmine: subcutaneous or intramuscular injection, 0.5 mg each time

Neostigmine bromide: oral, 15-30 mg, slow onset

Physostigmine, demethonium bromide

Used for short-term first aid of angle-closure glaucoma and long-term treatment of open-angle glaucoma.

Neostigmine, efonolamine, galantamine

Physostigmine can cross the blood-brain barrier and is used to treat central anticholinergic drug poisoning. However, because physostigmine has severe central toxicity, it is only used in patients with elevated body temperature or supraventricular tachycardia.

absorb

distributed

metabolism

excretion

Stimulant effects: skeletal muscle > gastrointestinal smooth muscle > glandular, ocular, cardiovascular and bronchial smooth muscle

Myasthenia gravis, postoperative abdominal distension, urinary retention, intestinal paralysis

Cholinergic crisis, nausea and vomiting, abdominal pain, myotremors

mechanical intestinal obstruction, urinary tract obstruction

absorb

distributed

metabolism

excretion

Myasthenia gravis, postoperative functional flatulence, urinary retention

Diagnosis of myasthenia gravis

Treat acute glaucoma

After the symptoms of acute glaucoma are relieved, pilocarpine is used to maintain the therapeutic effect.

Can be used alternately with pilocarpine to enhance mydriasis

accommodative paralysis

Large dose poisoning can cause respiratory paralysis

Significant miosis of pupils, eyeball pain, conjunctival congestion, ciliary muscle spasm, blurred vision, eyebrow pain

A tight feeling in the chest, increased glandular secretion, and dyspnea caused by contraction of bronchial smooth muscles

Anorexia, nausea, vomiting, abdominal pain, diarrhea

blood pressure drops, heart rate slows

Sweating, fasciculations, muscle weakness, muscle paralysis

First, excitement and restlessness, followed by convulsions, then depression, confusion, ataxia, delirium, and coma.

Foaming at the mouth, difficulty breathing, tears, penile erection, profuse sweating, incontinence of urine and feces, slowed heart rate, decreased blood pressure

Respiratory failure and secondary cardiovascular dysfunction

Skin absorption: wash with warm water and soap

Mouth: Extract gastric juice and poisons, use lukewarm 2% sodium bicarbonate solution (except trichlorfon, which can be converted into dichlorvos) or 1% saline to repeatedly gastric lavage until the washout has no pesticide smell, and then use magnesium sulfate for catharsis.

Eyes: Clean with 2% sodium bicarbonate or 0.9% sodium chloride solution for several minutes

atropine

AChE resurrection drug

Combination medication

Take medication as early as possible

Take adequate medication

Repeat medication

Maintain airway patency: endobronchial suction, artificial respiration, oxygen administration

Diazepam 5-10 mg intravenously to continuously suppress convulsions

Anti-shock