Clinical Uses
Physostigmine is used to treat myasthenia gravis, glaucoma, Alzheimer's disease and delayed gastric emptying. It has been shown to improve short term memory (Krus et al. 1968). Recently, it has begun to be used in the treatment of orthostatic hypotension.
Because it is a tertiary amine (and thus does not hydrogen bond, making it more hydrophobic), it can cross the blood–brain barrier, and physostigmine salicylate is used to treat the central nervous system effects of atropine, scopolamine and other anticholinergic drug overdoses.
Physostigmine is the antidote of choice for Datura stramonium poisoning. It is also an antidote for Atropa belladonna poisoning, the same as for atropine. It has been also used as an antidote for poisoning with GHB as well, but is poorly effective and often causes additional toxicity, so is not a recommended treatment.
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