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 详细处方信息以本药内容附件PDF文件（20122618001635.pdf）的“原文Priscribing Information”为准
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部分中文溴吡斯的明处方资料（仅供参考）

分类名称
一级分类：神经系统药物 二级分类：作用于自主神经系统的药物 三级分类：抗胆碱酯酶药 
 
药品英文名
Pyridostigmine Bromide
 
药品别名
吡斯的明、吡啶斯的明、溴化吡啶斯的明、美斯的侬、美定隆、溴吡啶斯的明、Bromurede、Mestinon、Regonol、Pyridostigmine bromide
 
药物剂型
1.片剂：60mg；
2.注射剂(粉)：1mg，5mg，10mg；
3.糖浆剂：12mg(1ml)；
4.缓释片：180mg。
 
药理作用
本品为季铵化合物。作用类似新斯的明。作用开始较迟，而持续时间较长。
 
药动学
本品难从胃肠道吸收。既被胆碱酯酶水解，也在肝内代谢。本品主要以原药和代谢物随尿排出。本品极少进入CSF，但可透过胎盘，少量进入乳汁。
 
适应证
重症肌无力、麻痹性肠梗阻，也可用于逆转非除极肌松药产生的神经肌肉阻滞，但一般认为其效力不如新斯的明。虽然也可用于术后尿潴留，但当前常被导尿管所取代。
 
禁忌证
1.对本品过敏者、孕妇和哺乳者禁用。
2.机械性肠梗阻和尿路梗阻者禁用。
 
注意事项
1.慎用：(1)支气管哮喘患者；(2)术后肺不张或肺炎患者；(3)心律失常尤其是房室传导阻滞者。
2.药物对妊娠的影响：孕妇给药后，由于子宫肌收缩，可引起早产。FDA妊娠分类为C类。
3.药物对哺乳的影响：少量可分泌入乳汁中。常用剂量时，婴儿通过乳汁摄入的药物量极少，乳母可安全用药。
4.重症肌无力患者：重症肌无力患者用药须谨慎，过量时可造成神经肌接头的除极型阻滞，出现肌无力现象，即“胆碱能危象”。
5.注射给药限用于拮抗非除极肌松药，注射给药后应作严密观察。
6.口服用的糖浆或缓释片一般仅供重症肌无力治疗用。因缓释片的用量大，毒性反应也较多发生，小儿一般不用。
7.本药的某些不良反应(如心动过缓，唾液多和胃肠道症状等)比新斯的明轻。
8.使用本药应严格遵守医嘱用药，并按时做记录；漏服药后不可服用双倍量；重症肌无力患者用量要恰到好处，过量时可发生胆碱能危象。
9.本药过量的特征有：视物模糊、恶心、呕吐或(和)腹泻，严重时可导致低血钾、呼吸短促、呼吸困难、喘鸣或(和)胸闷、唾液和气管支气管黏液分泌增多，甚至可引起肺不张、胃痉挛性疼痛、脉搏减慢等，由于毒蕈样作用，可导致上肢、颈、肩、舌等处肌肉出现麻痹状态，言语不清、行动不便、步态不稳、神志不清、抽搐或阵挛等。本药中毒量时出现胆碱能危象，临床表现系胆碱样和毒蕈样毒性反应的混合。使用阿托品或东莨菪碱均能予以解除。
 
不良反应
1.长期口服可出现溴化物的反应，如皮疹、乏力、恶心和呕吐等，且比溴新斯的明严重。
2.可出现轻度的抗胆碱酯酶的毒性反应，如腹痛、腹泻、唾液增多、气管内黏液分泌增加、出汗、缩瞳、血压下降和心动过缓等，一般均能自行消失。
3.凡是对溴化物过敏者，对本品也过敏。
 
用法用量
1.治疗重症肌无力：每天总量为0.3～1.2g，也有专家认为日总量不应超过720mg。全日用量，应分次给予，包括夜间；如有必要，在明显乏力的时候，应给予较大部分的药量。儿童用量为每天7mg/kg，5～6次分服。每天可逐步增加剂量15～30mg，总用量为每天30～360mg。也可采用肌内注射，严重病例还可很缓慢静脉注射。不过，静脉注射有一定的危险性，应备好阿托品，以抵消严重的毒蕈碱反应。
2.新生儿肌无力：可肌内注射50～150μg/kg，或口服5～10mg，每4～6小时1次。不过，临床更愿意使用新斯的明。
3.逆转由非除极肌松药产生的神经肌肉阻滞：可静脉给予本品10～20mg，此前，先给予阿托品0.6～1.2mg，以抵消任何毒蕈碱作用。格隆溴铵可用来替代阿托品。
4.治疗麻痹性肠梗阻和术后尿潴留：可口服本品60～240mg。
 
专家点评
本品起效缓慢，作用较溴化新斯的明弱但持续时间较久，引起的心动缓慢、唾液分泌和消化道反应较轻。一般认为本品对抗非除极化型肌松药过量的效果不如新斯的明好。

Regonol
Pronunciation: peer-id-oh-STIG-meen
Generic Name: Pyridostigmine
Brand Name: Regonol

Regonol is used for:
Treating myasthenia gravis. It may also be used for other conditions as determined by your doctor.

Regonol is a cholinesterase inhibitor. It works by improving nerve impulses in muscles so that the muscles are better able to work.

Do NOT use Regonol if:
•you are allergic to any ingredient in Regonol
•you are taking quinine or quinidine
•you have a stomach, intestinal, or urinary blockage

Contact your doctor or health care provider right away if any of these apply to you.

Before using Regonol:
Some medical conditions may interact with Regonol. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
•if you are pregnant, planning to become pregnant, or are breast-feeding
•if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
•if you have allergies to medicines, foods, or other substances
•if you have heart problems (eg, heart block, slow heartbeat), a urinary tract infection, asthma, or kidney problems

Some MEDICINES MAY INTERACT with Regonol. Tell your health care provider if you are taking any other medicines, especially any of the following:
•Quinine or quinidine because effectiveness of Regonol may be decreased
•Succinylcholine because actions and side effects may be increased by Regonol
This may not be a complete list of all interactions that may occur. Ask your health care provider if Regonol may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Regonol:
Use Regonol as directed by your doctor. Check the label on the medicine for exact dosing instructions.
•Regonol is usually administered as an injection at your doctor's office, hospital, or clinic. If you are using Regonol at home, carefully follow the injection procedures taught to you by your health care provider.
•If Regonol contains particles or is discolored, or if the vial is cracked or damaged in any way, do not use it.
•Keep this product, as well as syringes and needles, out of the reach of children and away from pets. Do not reuse needles, syringes, or other materials. Dispose of properly after use. Ask your doctor or pharmacist to explain local regulations for proper disposal.
•If you miss a dose of Regonol, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Regonol.

Important safety information:
•Before you have any medical or dental treatments, emergency care, or surgery, tell the doctor or dentist that you are using Regonol.
•Use Regonol with extreme caution in CHILDREN. Safety and effectiveness have not been confirmed.
•PREGNANCY and BREAST-FEEDING: If you become pregnant while taking Regonol, discuss with your doctor the benefits and risks of using Regonol during pregnancy. Regonol is excreted in breast milk. If you are or will be breast-feeding while you are using Regonol, check with your doctor or pharmacist to discuss the risks to your baby.

Possible side effects of Regonol:
All medicines may cause side effects, but many people have no, or minor, side effects. When used in small doses, no COMMON side effects have been reported with this product. Seek medical attention right away if any of these SEVERE side effects occur:
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); diarrhea; fainting; increased production of saliva; increased sweating; muscle weakness; nausea; small pupils; stomach cramps; trouble breathing; vision changes; vomiting; weakness.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include diarrhea; fainting; increased production of saliva; increased sweating; muscle weakness; nausea; small pupils; stomach cramps; trouble breathing; vision changes; vomiting; weakness.

Proper storage of Regonol:
Regonol is usually handled and stored by a health care provider. If you are using Regonol at home, store Regonol as directed by your pharmacist or health care provider. Keep Regonol out of the reach of children and away from pets.

General information:
•If you have any questions about Regonol, please talk with your doctor, pharmacist, or other health care provider.
•Regonol is to be used only by the patient for whom it is prescribed. Do not share it with other people.
•If your symptoms do not improve or if they become worse, check with your doctor.
•Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Regonol. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

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 详细处方信息以本药内容附件PDF文件（20122618001635.pdf）的“原文Priscribing Information”为准
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