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Atropine/Neostigmine
Atropine blocks acetylcholine at muscarinic receptors while neostigmine inhibits acetylcholinesterase, creating opposing effects that together counteract organophosphate or carbamate poisoning.
Atropine blocks acetylcholine at muscarinic receptors while neostigmine inhibits acetylcholinesterase, creating opposing effects that together counteract organophosphate or carbamate poisoning. Used for Organophosphate or carbamate pesticide poisoning, Nerve agent exposure.
At a glance
| Generic name | Atropine/Neostigmine |
|---|---|
| Sponsor | Hadassah Medical Organization |
| Drug class | Antidote combination; anticholinergic + cholinesterase inhibitor |
| Target | Muscarinic acetylcholine receptors (atropine); acetylcholinesterase (neostigmine) |
| Modality | Small molecule |
| Therapeutic area | Toxicology / Emergency Medicine |
| Phase | FDA-approved |
Mechanism of action
Atropine is an anticholinergic agent that competitively blocks muscarinic acetylcholine receptors, reducing excessive cholinergic stimulation caused by organophosphate compounds. Neostigmine inhibits acetylcholinesterase, the enzyme that breaks down acetylcholine, which seems counterintuitive but works by reactivating acetylcholinesterase and restoring nicotinic function at the neuromuscular junction. Together, this combination addresses both muscarinic (via atropine) and nicotinic (via neostigmine) manifestations of organophosphate poisoning.
Approved indications
- Organophosphate or carbamate pesticide poisoning
- Nerve agent exposure
Common side effects
- Tachycardia
- Dry mouth
- Blurred vision
- Muscle fasciculations
- Bronchospasm
Key clinical trials
- Impact of Sugammadex Versus Neostigmine on Early Postoperative Pulmonary Function (NA)
- A Comparative Study Between Combination of Propofol and Dexmedetomidine Versus Propofol Alone in Anesthesia for Rigid Bronchoscopy by Using the Patient State Index Monitor (PHASE4)
- NMBA Reversal and Postoperative Urinary Retention
- Neuromuscular Blocking Agents on Gastrointestinal Function Following Colorectal Surgery (PHASE3)
- Emergence Agitation (NA)
- Efficacy, Safety, and Pharmacokinetics of Sugammadex (MK-8616) for Reversal of Neuromuscular Blockade in Pediatric Participants Aged Birth to <2 Years (MK-8616-169) (PHASE4)
- Effects Of Anaesthesia on Intraocular Pressure in Robotic Prostate Surgery (NA)
- Using Diaphragm Ultrasonography, Sugammadex Recovers Diaphragmatic Function More Effectively Than Neostigmine. (PHASE1)
Primary sources
Every claim on this page is sourced from regulatory or scientific primary sources. See our editorial policy for full methodology.
| Source | Used for |
|---|---|
| ClinicalTrials.gov | Trial enrolment, design, endpoints, results |
Competitive intelligence
For the full competitive landscape — auto-detected comparators, recent regulatory actions across the set, upcoming PDUFA, patent timeline, sponsor landscape:
- Atropine/Neostigmine CI brief — competitive landscape report
- Atropine/Neostigmine updates RSS · CI watch RSS
- Hadassah Medical Organization portfolio CI