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Edrophonium (Tensilon, Reversol, Enlon)

Category:

  • Cholinergic Muscle Stimulant

Description:

  • Facilitates transmission of impulses across myoneural junction by inhibiting destruction of acetycholine by cholinesterase

Indications:

  • Curare antidote

  • Diagnosis of myasthenia gravis

  • Differentiate between cholinergic crisis and myasthenia gravis crisis

  • Evaluation of treatment requirements in myasthenia gravis

Contraindications:

  • Mechanical, intestinal, and urinary obstructions

Precautions:

  • Pregnancy category C; ionized at physiologic pH, not expected to cross placental barrier or excreted in breast milk

  • May cause premature labor

  • Seizure disorders, bronchial asthma, recent coronary occlusion, hyperthyroidism

  • Dysrhythmias, peptic ulcer, megacolon, poor GI motility, bradycardia, hypotension

Adverse Reactions (Side Effects):

  • CNS: dizziness, drowsiness, headache, incoordination, seizures, sweating, paralysis, weakness, loss of consciousness

  • CV: AV block, bradycardia, cardiac arrest, dysrhythmias, , syncope, hypotension, tachycardia

  • EENT: blurred vision, lacrimation, miosis, visual changes

  • GI: cramps, diarrhea, dysphagia, increased peristalsis, increased salivary and gastric secretions, nausea, vomiting

  • GU: Frequency, incontinence, urgency

  • MS: arthralgia, fasciculations, muscle cramps and spasms, weakness

  • RESP: bronchospasm, dyspnea, laryngospasm, respiratory arrest, respiratory depression, increased tracheobronchial secretions

  • SKIN: rash, urticaria

Dosage:

Administered IV/IM

  • Adult: 

    • Diagnosis of myasthenia gravis: 

      • IV 1-2mg over 15-30 seconds, then 8mg if no response

      • IM 10mg; if cholinergic reaction occurs, retest after ½ hour with 2mg IM

    • Evaluation of treatment requirements in myasthenia gravis: 

      • IV 1-2mg 1 hour after PO dose of anticholinesterase

      • if strength improves, an increase in neostigmine or pyridostigmine is indicated

    • Differentiation of myasthenic crisis from cholinergic crisis: 

      • IV 1mg, if no response in 1 minute, may repeat

      • myasthenic crisis clear improvement in respiration

      • cholinergic crisis increased oropharyngeal secretions and further weakening of respiratory muscles (intubation and controlled respiration may be required)

    • Curare antagonist: 

      • IV 10mg over 30-45 seconds; may repeat; not to exceed 40mg

  • Child: 

    • Diagnosis of myasthenia gravis: 

      • IV 0.04 mg/kg given over 1 minute followed by 0.16 mg/kg given within 45 seconds if no response

      • >34 kg IM 2mg

      • <34 kg IM 1mg

      • infant 0.1mg, followed by 0.4mg if no response, not to exceed 0.5mg

    • Evaluation of treatment requirements in myasthenia gravis: 

      • IV 0.04 mg/kg given 1 hour after PO intake of drug being used in treatment

      • if strength improves, an increase in neostigmine or pyridostigmine is indicated

 

 

 


The information contained here is an abbreviated summary. For more detailed and complete information, consult the manufacturer's product information sheets or standard textbooks

Source: Operational Medicine 2001,  Health Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington, D.C., 20372-5300

This information is provided by The Brookside Associates.  The Brookside Associates, LLC. is a private organization, not affiliated with any governmental agency. The opinions presented here are those of the author and do not necessarily represent the opinions of the Brookside Associates or the Department of Defense. The presence of any advertising on these pages does not constitute an endorsement of that product or service by either the US Department of Defense or the Brookside Associates. All material presented here is unclassified.

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