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Pyridostigmine, Edrophonium and Echothiophate

Pyridostigmine

Muscarinic effects are less marked, more nicotinic effects

Duration of action is long (6 hours) than neostigmine

Use:

Myasthenia gravis

Edrophonium

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

Use:

1. Diagnosis of myasthenia gravis

2. Supraventricular tachycardia

3. Post operational anticurare use

Echothiophate

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

Use:

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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Anticholinesterases

Neostigmine

Physostigmine

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