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Pyridostigmine, Edrophonium and Echothiophate


Muscarinic effects are less marked, more nicotinic effects

Duration of action is long (6 hours) than neostigmine


Myasthenia gravis


Alcoholic in nature.

Does not possess carbamyl group

It has shorter duration of action because:

1. Binds only with anionic site

2. Weak hydrogen electrostatic bonds are formed with enzymes.

Muscarinic effects are less marked, more nicotinic effects


1. Diagnosis of myasthenia gravis

2. Supraventricular tachycardia

3. Post operational anticurare use


Mechanism of Action:

It has longer duration of action because:

    1. Binds both sites of the enzyme –active and anionic
    2. Bond formed is stable

Has both Muscarinic effects and Nicotinic effects


In the treatment of glaucoma only in refractory cases as can lead to cataract formation.

It is poorly lipid soluble as cannot cross blood brain barrier, thus is only topically effective.

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