title: Efficacy of intranasal administration of neostigmine in myasthenic patients.
abstract: 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.
authors.affiliation: Istituto Neurologico C. Besta, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Sghirlanzoni
authors.forename: D
authors.initials: D
authors.lastname: Pareyson
authors.forename: C
authors.initials: C
authors.lastname: Benvenuti
authors.forename: G
authors.initials: G
authors.lastname: Cei
authors.forename: V
authors.initials: V
authors.lastname: Cosi
authors.forename: M
authors.initials: M
authors.lastname: Lombardi
authors.forename: M
authors.initials: M
authors.lastname: Nicora
authors.forename: R
authors.initials: R
authors.lastname: Ricciardi
authors.forename: F
authors.initials: F
authors.lastname: Cornelio
mesh_terms: 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
chemical_list: D000336:Aerosols; D009388:Neostigmine; D011729:Pyridostigmine Bromide