Pyridostigmine Bromide

Pyridostigmine Bromide (Mestinon) is a parasympathomimetic and a reversible cholinesterase inhibitor. Pyridostigmine Bromide inhibits acetylcholinesterase in the synaptic cleft, thus slowing down the hydrolysis of acetylcholine. It is a quaternary carbamate inhibitor of cholinesterase that does not cross the blood-brain barrier, and it is taken daily in anticipation of an attack, which carbamylates about 30% of peripheral cholinesterase enzyme. The carbamylated enzyme eventually regenerates by natural hydrolysis and excess ACh levels revert to normal.