Physostigmine

PHYSOSTIGMINE (eserine), an alkaloid, the active principle of the Calabar bean, Physostigma venenosum Balfour (family Papilionaceae), a climbing plant growing in Africa. One of the most poisonous alkaloids. Because of this, the Calabar bean was used by savages for the so-called "judgment of God" (because of the presence of a vomiting substance in the plant, some avoided death from poisoning). It is applied in the form of a salicylate salt. A colorless or slightly yellowish crystalline powder, difficultly soluble in water. The aqueous solution is unstable and quickly turns red due to the formation of rubroeserine. In veterinary practice, the sulfate salt of Physostigmine is also applied, which forms easily spreading crystals in the air, well soluble in water. It belongs to the series of parasympathetic irritants, such as choline, muscarine, pilocarpine. In the central nervous system, Physostigmine causes excitement, quickly replaced by paralysis. Physostigmine exerts an exciting action on smooth muscle, increasing its excitability (Kravkov), and on striated muscle (through nerve endings), acting as an antagonist of eserine. The pupils are sharply narrowed as a result (contraction of the sphincter of the iris and ciliary muscle). Simultaneously accommodation is disturbed, usually passing much earlier than the narrowing of the pupil occurs. Simultaneously with the widening of the pupil, intraocular pressure decreases. Heart contractions are intensified and become less frequent, blood pressure rises; with toxic doses, asphyxia occurs (central action). It is applied in ophthalmic practice for glaucoma, paralysis of the ciliary muscles, and synechiae. A dose of two or three drops of a 1/100-1/3% solution of Physostigmine (Eserine) salicylate. For atony of the intestine (postoperative paralysis of the intestine), meteorism. Doses: subcutaneously 1/2-1 mg 1-2 times a day and orally. The application is limited, since after Physostigmine asphyxia and paralysis of respiration are often observed. Physostigmine is partly excreted with the urine; traces of it are found in saliva and bile; the greater part of Physostigmine is destroyed in the organism.

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