Neostigmine drug profile

Neostigmine bromide is an indirectly acting parasympathomimetic agent. The action is produced by blocking the cholinesterase enzyme which breakdown the acetylcholine. Hence, there is an increase in the availability of acetylcholine.

IUPAC

3-{[(Dimethylamino)carbonyl]oxy}-N,N,N-trimethyl benzene ammonium bromide

Synonyms of neostigmine

Prostigmine, Myostigmin, Tilstigmin

Route of synthesis

Separate neostigmine into three parts - Benzene Ring, Trimethyl Ammonium group, and Dimethylaminocarbonyl group. Keeping in mind, we selected "m-chloro-N,N-dimethyl amino benzene" as starting material. To this, adding potassium hydroxide (KOH) results in an intermediate compound.

To the intermediate compound, add dimethylamino carbonyl chloride. Again, K + Cl is removed and intermediate is produced.

Now, in the last step, add methyl bromide (CH3Br). Simple, addition takes place in the dimethylamino group and it becomes neostigmine bromide.

Synthesis of neostigmine

Mechanism of Neostigmine

Enzyme inhibition

Neostigmine and other indirectly acting parasympathomimetics inhibit enzyme acetylcholinesterase reversibly. This results in greater availability of acetylcholine at its site of action.

Uses

Neostigmine acts as a miotics hence used in glaucoma. Also, used to prevent the formation of adhesions between the iris and lens or iris and cornea.

Used in the myasthenia gravis, an autoimmune disorder where the development of antibodies to nicotinic receptors takes place. Neostigmine is the starter of the treatment with 15 mg orally every 6 hours.