Neostigmine (Prostigmin) Nursing Considerations

Join to watch the full lesson now.

Included In This Lesson

Study Tools


Generic Name


Trade/Brand Name



  • Myasthenia gravis
  • Muscle relaxant reversal


  • Blocks action of acetylcholinesterase
    • Increases level of acetylcholine

Therapeutic Class

Muscle stimulant

Pharmacologic Class

Cholinesterase inhibitor

Nursing Considerations

  • May cause
    • Weakness
    • Hypotension
    • Allergic reactions
    • Muscle twitching
  • Symptoms of overdose
    • Constipation
    • Difficult urination
    • Decreased sexual ability
  • Contraindications
    • Hypersensitivity
    • Peritonitis
    • Mechanical obstruction of intestinal or urinary tract
Join to watch the full lesson now.


Okay, let’s take a look at the drug. Neostigmine also known as Prost stigma. This is an injectable medication, as you can see here, and it also comes in an oral form. So the therapeutic class or how the drug works in the body is a muscle stimulant while the pharmacologic class or the chemical effect of neostigmine is a colon esterase inhibitor. So neostigmine works by blocking the action of acetal colon esterase, which increases the level of acetylcholine neostigmine is used for the treatment of myasthenia gravis, and also as a muscle relaxant reversal agent. And this is a newer indication for this drug. So some of the side effects that Neos can cause are things like nausea, increased saliva, abdominal cramping, and also bradycardia a few of the nursing considerations for neostigmine include it may cause weakness in your patient as well as hypotension allergic reactions and muscle TWI twitching may occur signs of neostigmine overdose include constipation, difficult urination, as well as decreased sexual ability. Contraindications for neostigmine include hypersensitivity peritonitis in your patient or intestinal or urinary tract obstruction. So you want to teach the patient that while they are on this medication, they should document when they take it and how long it lasts. So this will help the provider to make any necessary adjustments to the dose of the drug. So guys here is an interesting fact about neostigmine. It is actually used to reverse the effects of a snake bite. 

That’s it for neostigmine or Prost now go out and be your best self today and as always happy nursing.

Join to watch the full lesson now.