Efficacy of intranasal administration of neostigmine in myasthenic patients.
The efficacy of intranasally administered neostigmine was tested in 22 patients with generalized myasthenia gravis (MG). Topical therapy to the highly vascularized oropharynx proved to be quickly effective in 5-15 min both clinically and electrophysiologically. Twenty-eight MG patients were then recruited from different centres and their morning doses of oral pyridostigmine were substituted with intranasal neostigmine over a period of 2 or 3 weeks. Intranasal neostigmine proved to be equally efficacious in this regimen. No side-effect was noted even in 4 patients treated in this way for 1 year. Intranasal administration of anti-acetylcholinesterase may be very beneficial: (1) for patients with irregular absorption of oral doses; (2) early in the morning and every time a fast and temporary effect is needed; (3) in bulbar impairment and emergencies, in which a handy atomizer may be life-saving.
Sghirlanzoni
A
A
Istituto Neurologico C. Besta, Milan, Italy.
Pareyson
D
D
Benvenuti
C
C
Cei
G
G
Cosi
V
V
Lombardi
M
M
Nicora
M
M
Ricciardi
R
R
Cornelio
F
F
D000281:Administration, Intranasal; D000336:Aerosols; D001327:Autoimmune Diseases / Q000188:drug therapy* / Q000503:physiopathology; D004334:Drug Administration Schedule; D004341:Drug Evaluation; D006801:Humans; D007275:Injections, Intravenous; D009132:Muscles / Q000503:physiopathology; D009157:Myasthenia Gravis / Q000188:drug therapy* / Q000503:physiopathology; D009388:Neostigmine / Q000008:administration & dosage / Q000627:therapeutic use*; D010865:Pilot Projects; D011729:Pyridostigmine Bromide / Q000627:therapeutic use; D012720:Severity of Illness Index
D000336:Aerosols; D009388:Neostigmine; D011729:Pyridostigmine Bromide