![]() ![]() Both conditions result in extreme muscle weakness but require radically different treatment. The dose of PREVDUO™ should be reduced if recovery from neuromuscular blockade is nearly complete.Ĭholinergic Crisis: It is important to differentiate between myasthenic crisis and cholinergic crisis caused by overdosage of neostigmine. Neuromuscular Dysfunction: Large doses of PREVDUO ™ administered when neuromuscular blockade is minimal can produce neuromuscular dysfunction. Hypersensitivity: Because of the possibility of hypersensitivity, medications to treat anaphylaxis should be readily available. ![]() Risk of these complications may also be increased in patients with myasthenia gravis. In patients with acute cardiovascular conditions such as coronary artery disease, cardiac arrhythmias or recent acute coronary syndrome, the risk of blood pressure and heart rate complications may be increased. Because of the known pharmacology of neostigmine methylsulfate as an acetylcholinesterase inhibitor, cardiovascular effects such as bradycardia, hypotension or dysrhythmia would be anticipated. Serious Adverse Reactions in Patients with Certain Coexisting Conditions: PREVDUO ™ should be used with caution in patients with coronary artery disease, congestive heart failure, cardiac arrhythmias, recent acute coronary syndrome, hypertension, myasthenia gravis and hyperthyroidism. Consideration should be given to administration of glycopyrrolate prior to neostigmine (i.e., as separate products) in patients with bradycardia or in patients in whom bradycardia, a known risk of neostigmine methysulfate, may cause hemodynamic instability.
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