title: Original version Date: 16/10/2018
text: |
  Original version Date: 16/10/2018
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  bet | 390/654 | Sana | 03.01.2022 | Hajmi | 1,5 Mb. | | #14803 |
  Original version Date: 16/10/2018
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  Author: NMF Consensus Group
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  Current Version number: 2
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  Current Version Date: 16/10/2018
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  Risk Rating: Low
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  Due for Review: 16/10/2023
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  Approval by: DTC
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  Approval Date: TBA
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  Neostigmine |
  Revision Date : 24-12-2020
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  Approved: TC, KOH
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  Indication :
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  1] Myasthenia test.
  2] Maintenance, in Neonatal transient myasthenia gravis and Neonatal persistent myasthenia gravis.
  3] Reversal of muscle relaxation.
  Anticholinesterase
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  Dose :
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  Note: Premedication with atropine (20microgram/kg/dose) is
  Recommended.
  1] 150 microg/kg given 30 minutes before feeding.
  2] 150 microg/kg given 30 minutes before feeding.
  3] 30 to 70 microgram/kg/ dose
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  Interval :
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  1] Stat
  2] every 6 to 8 hours increasing the dose on clinical response.
  3] Stat.
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  Route :
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  1] IM
  2] IM/SC
  3] IV over 1 minute
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  Total Daily Dose :
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  Myasthenia gravis
  Obtain specialist advice for long term use
  Reversal of neuromuscular blockade agent (NMBA)
  70 microg/kg
  The selection of the lower or higher dose range depends on the extent of spontaneous recovery that has occurred at the time of administration, the half-life of the NMBA being reversed, and whether there is a need to rapidly reverse the NMBA.
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  Comments :
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  May cause vomiting, increased salivation, diarrhoea, increased bronchial secretions, nystagmus, sweating, hypotension. Contraindicated in mechanical intestinal or urinary obstruction. May result in cardiac arrest, central respiratory depression, pulmonary oedema, convulsions.
  With large doses or intravenous injections, bradycardia may occur, consequently,simultaneous parenteral administration of atropine (in separate syringe) may be advisable. Atropine should always be available to counteract severe cholinergic reactions
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  Supplied as :
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  500 microg/mL and 2500 microg/mL ampoules.
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  Dilution :
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  IV/IM:
  Use undiluted.
  May dilute contents following the below directions for a more dilute preparation.
  Dilution:
  Withdraw 1mL (2500microgams) and make up to a final volume of 16.5mL with a compatible fluid.
  Concentration is 2500micrograms in 16.5mL
  Final concentration is ≈ 150 microgram/mL
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  Stability :
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  Discard unused portion.
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  Storage :
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  Room temperature, protect from light.
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  Compatibility:
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  NS, heparin, 5%D, hydrocortisone, KCl.
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  Incompatibility :
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  Sodium bicarbonate, suxamethonium.
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  Serum Levels :
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  References
  British Medical Association, Royal Pharmaceutical Society. BNF for Children. London: BMJ Group, Pharmaceutical Press; 2019
  Ainsworth SB. Neonatal formulary 7: drug use in pregnancy and the first year of life. Seventh ed. Chichester (West Sussex): John Wiley & Sons Inc.; 2015. 631 p.349
  Truven Health Analytics. Neostigmine. In: NeoFax [Internet]. Greenwood Village (CO): Truven Health Analytics; 2020 [cited 24-12-2020]. Available from: https://neofax.micromedexsolutions.com/
  Women and Newborn Health Service, Government of Western Australia North metropolitan Health Service. Neostiogmine. King Edward Memorial and Perth Childrens Hospital Neonatal Medication Monograph. Internet. 2008 [updated 2018 Aug; cited 24-12-2020]. Available from: https://www.kemh.health.wa.gov.au/
  Takemoto CK, Hodding JH, Kraus DM. Pediatric & neonatal dosage handbook with international trade names index : a universal resource for clinicians treating pediatric and neonatal patients. 24th ed. Hudson (Ohio): Lexicomp; 2401. 2, p1116.
  Department for Health and Ageing, Government of South Australia. Neostigmine. South Australian Neonatal Medicine Guidelines [Internet]. 2019 [updated 2018 Jul 5; cited 24-12-2020]. Available from: https://www.sahealth.sa.gov.au/
  Kemp CA, McDowell JM. Paediatric pharmacopeoia. 13th Ed. Melbourne: Royal Children’s Hospital; 2002. Society of Hospital Pharmacists of Australia. Neotigmine methylsulfate. In: Australian Injectable Drugs Handbook [Internet]. [St Leonards, New South Wales]: Health Communication Network; 2020 [cited 2020 Mar 10]. Available from: http://aidh.hcn.com.au
  King Guide Publications, Inc. Neostigmine methylsulfate. In: King Guide to Parenteral Admixtures [Internet]. Napa, CA; 2019 [cited 2020 Aug 08]. Available from: http://www.kingguide.com.kelibresources.health.wa.gov.au
  Original version Date: 2014
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  Author: AK, JD
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  Current Version number: 2
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  Current Version Date: 24/12/2020
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  Risk Rating: Low
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  Due for Review: 24/12/2025
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  Approval by: DTC
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  Approval Date: TBA
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