Two nurses are discussing the major differences between physostigmine (Antilirium) and neostigmine (Prostigmin). One nurse correctly makes which statement about physostigmine (Antilirium)?
a. "It is not effective for treating poisoning by muscarinic blocking drugs."
b. "It can readily cross the blood-brain barrier."
c. "It does not cause any side effects."
d. "It can be given by all routes."
ANS: B
The basic pharmacology of physostigmine is nearly identical to that of neostigmine, except that physostigmine readily crosses membranes, including the blood-brain barrier; neostigmine does not. Physostigmine and neostigmine are both effective for treating poisoning by muscarinic blocking drugs. Neither physostigmine nor neostigmine is devoid of side effects. Physostigmine can be given only intramuscularly (IM) or intravenously (IV); neostigmine is given orally (PO), IM, IV, and subcutaneously (subQ).
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