Effects of pyridostigmine: A Synthesis of Findings from 14 Studies

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Original Abstract of the Article

Main Research Findings

Pyridostigmine is a medication that is commonly used to treat myasthenia gravis, a condition where the body's immune system attacks the nerves that control muscle movement. 14 examined the effects of pyridostigmine on the blood-brain barrier, which is a protective layer that shields the brain from harmful substances. This study found that pyridostigmine did not increase the permeability of the blood-brain barrier in rats, suggesting that its effects on the central nervous system may occur through indirect mechanisms. 9 investigated the effectiveness of pyridostigmine in reducing heart rate in patients with heart failure, comparing it to the drug ivabradine. Both medications were successful in reducing heart rate and improving exercise capacity, neurohormonal balance, and inflammatory profiles. 4 explored the impact of pyridostigmine on esophageal and pharyngeal motility in patients with dysphagia, a condition marked by difficulty swallowing. This study revealed that pyridostigmine significantly improved esophageal contractility in these patients. 3 investigated the effects of pyridostigmine on preeclampsia, a serious pregnancy complication characterized by high blood pressure. This study found that pyridostigmine could mitigate the symptoms of preeclampsia in pregnant rats. 8 compared the recovery of gastrointestinal motility after laparoscopic cholecystectomy, a surgical procedure to remove the gallbladder, using either sugammadex or a combination of pyridostigmine and glycopyrrolate. The study showed that sugammadex contributed more effectively to the recovery of gastrointestinal motility compared to pyridostigmine and glycopyrrolate. 6 investigated the toxicity and oxidative damage caused by pyridostigmine, DEET, and permethrin on human brain endothelial cells and astrocytes. The study indicated that exposure to these compounds, particularly in conjunction with depleted uranium, could significantly increase nitric oxide levels in these brain cells. investigated the effects of pyridostigmine and digoxin on baroreflex abnormalities in patients with postural tachycardia syndrome. This study revealed that both medications could potentially improve these abnormalities. 10 examined the impact of pyridostigmine on resistance exercise training in rats after myocardial infarction, a heart attack. This study showed that pyridostigmine could improve the benefits of resistance exercise training in these rats. 11 studied the effects of pyridostigmine on SH-SY5Y cells, a model system used to study neuroblastoma, a type of nerve cell cancer. The study found that pyridostigmine did not cause significant toxicity or neurodegeneration in these cells. compared the effects of sugammadex, neostigmine, and pyridostigmine on postoperative nausea and vomiting. The study found that sugammadex and pyridostigmine might reduce the incidence of postoperative nausea and vomiting compared to neostigmine. 13 examined the effects of pyridostigmine on chronic Chagas heart disease in mice. The study revealed that pyridostigmine significantly reduced myocardial inflammation, fibrosis, and hypertrophy in these mice. 12 compared the effects of sugammadex and pyridostigmine-glycopyrrolate on postoperative nausea and vomiting. This study found that sugammadex might be more beneficial for reducing postoperative nausea and vomiting than a combination of pyridostigmine and glycopyrrolate. 2 assessed the effectiveness and side effects of pyridostigmine in treating myasthenia gravis. The study found that pyridostigmine was effective in treating myasthenia gravis but also had a high incidence of side effects. 1 evaluated the cardiorespiratory effects of pyridostigmine in healthy subjects using exercise stress testing. This study found that pyridostigmine decreased heart rate both at rest and during exercise.

Benefits and Risks

Benefits Summary

Pyridostigmine is a medication that is commonly used to treat myasthenia gravis. It is effective in treating myasthenia gravis and can also help reduce heart rate and improve exercise capacity. It can also improve esophageal contractility in patients with dysphagia and mitigate the symptoms of preeclampsia in pregnant rats. Additionally, it may reduce the incidence of postoperative nausea and vomiting.

Risks Summary

Pyridostigmine can cause various side effects, including gastrointestinal problems (abdominal pain, diarrhea, constipation), urinary problems (frequent urination, difficulty urinating), heart problems (decreased heart rate, decreased blood pressure), respiratory problems (difficulty breathing), and nervous system problems (dizziness, headache, sweating). It is essential to consult a doctor before taking pyridostigmine and to be aware of the potential side effects.

Comparison Across Studies

Commonalities

Most studies suggest that pyridostigmine has several beneficial effects, such as reducing heart rate, improving exercise capacity, enhancing gastrointestinal motility, and potentially mitigating the severity of some medical conditions. These effects are likely attributed to pyridostigmine's ability to increase acetylcholine levels, a neurotransmitter involved in muscle function and various bodily processes.

Differences

The specific effects and side effects of pyridostigmine can vary between studies. For instance, the effects of pyridostigmine on the blood-brain barrier and the prevalence of specific side effects can differ. These variations could be due to factors such as study design, participant characteristics, and the specific dosage and duration of treatment.

Consistency and Contradictions

While pyridostigmine demonstrates potential benefits in several areas, the research findings can sometimes be inconsistent, particularly regarding specific effects and side effects. For example, studies on the impact of pyridostigmine on the blood-brain barrier have produced conflicting results. This inconsistency highlights the need for more extensive research to fully understand the complex effects of this medication.

Real-World Application

Pyridostigmine is commonly used to treat myasthenia gravis, but its potential benefits and risks should be carefully considered before starting treatment. It is important to discuss the potential risks and benefits with your doctor before taking this medication. It's crucial to be aware of potential side effects and to consult your physician if any concerning symptoms develop.

Limitations of Current Research

The current body of research on pyridostigmine has several limitations. Some studies may have had relatively small sample sizes, which can affect the generalizability of the findings. Additionally, research on the long-term effects and side effects of pyridostigmine is still ongoing. More comprehensive research with larger sample sizes and longer follow-up periods is needed to fully understand the potential benefits and risks of pyridostigmine.

Future Directions

Future research should focus on addressing the limitations of current studies. Larger, well-designed clinical trials are essential to confirm the effectiveness and safety of pyridostigmine in different conditions. More research is needed to investigate the long-term effects and side effects of pyridostigmine, particularly in vulnerable populations such as pregnant women and individuals with underlying health conditions.

Conclusion

Pyridostigmine is a valuable medication for treating myasthenia gravis and might have benefits in other conditions. However, it's essential to consider the potential risks and benefits, particularly the possibility of side effects. More research is needed to fully understand the long-term effects and safety of pyridostigmine in various clinical settings. It's important to consult a healthcare professional to discuss whether pyridostigmine is appropriate for your individual situation.

Literature analysis of 14 papers
Positive Content
11
Neutral Content
1
Negative Content
2
Article Type
3
0
0
0
14
1.

Exercise stress testing in healthy subjects during cholinergic stimulation after a single dose of pyridostigmine.

Author: SerraS M, CostaR V, BastosB G, Bousquet SantosK, RamalhoS H, da NóbregaA C

Decreases heart rate

Pyridostigmine, at a dose of 45mg, decreases heart rate at rest and during exercise without interfering with exercise tolerance or ventilation variables.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

2.

The effectiveness and side effects of pyridostigmine in the treatment of myasthenia gravis: a cross-sectional study.

Author: Remijn-NelissenLinda, VerschuurenJan J G M, TannemaatMartijn R

Treats myasthenia gravis
Side effects

This study assessed the effectiveness, prevalence of side effects, and net benefit of pyridostigmine, a drug used in the symptomatic treatment of myasthenia gravis (MG). It highlighted the common side effects of pyridostigmine and the reasons for discontinuation.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

3.

Pyridostigmine ameliorates preeclamptic features in pregnant rats by inhibiting tumour necrosis factor-α synthetsis and antagonizing tumour necrosis factor-α-related effects.

Author: Issotina ZibrilaAbdoulaye, WangZheng, AliMd Ahasan, OseiJames Ampofo, SunYuyao, ZafarSalman, LiuKaili, LiChunfang, KangYuming, LiuJinjun

Blood pressure reduction
Preeclampsia treatment

Pyridostigmine (PYR) is an anti-inflammatory drug that has been shown to reduce blood pressure in preeclampsia models. This study investigates the potential therapeutic effects of PYR in preeclampsia models, specifically its effects on blood pressure and other pathological features.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

5.

Supine Parasympathetic Withdrawal and Upright Sympathetic Activation Underly Abnormalities of the Baroreflex in Postural Tachycardia Syndrome: Effects of Pyridostigmine and Digoxin.

Author: StewartJulian M, WarsyIrfan A, VisintainerPaul, TerilliCourtney, MedowMarvin S

[Figure: see text].

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

7.

Comparison of the Effects of Sugammadex, Neostigmine, and Pyridostigmine on Postoperative Nausea and Vomiting: A Propensity Matched Study of Five Hospitals.

Author: KimJong Ho, LimMan-Sup, ChoiJun Woo, KimHaewon, KwonYoung-Suk, LeeJae Jun

PONV reduction
General anesthesia

This study compared the effects of sugammadex, neostigmine, and pyridostigmine on postoperative nausea and vomiting in patients undergoing general anesthesia.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

8.

Neuromuscular blockade reversal with sugammadex versus pyridostigmine/glycopyrrolate in laparoscopic cholecystectomy: a randomized trial of effects on postoperative gastrointestinal motility.

Author: AnJihyun, NohHeeyun, KimEunju, LeeJihyang, WooKyeongyoon, KimHyunkyum

GI motility recovery
impede bowel movements

This study compared the effects of sugammadex, a selective relaxant reversal agent, with pyridostigmine and glycopyrrolate on gastrointestinal (GI) motility recovery after laparoscopic cholecystectomy. Sugammadex demonstrated a faster recovery of GI motility compared to the traditional combination of pyridostigmine and glycopyrrolate.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

9.

Effects of Heart Rate Reduction With Either Pyridostigmine or Ivabradine in Patients With Heart Failure: A Randomized, Double-Blind Study.

Author: VillacortaAline Sterque, VillacortaHumberto, CaldasJosé Antônio, PrechtBernardo Campanário, PortoPilar Barreto, RodriguesLetícia Ubaldo, NevesMárcio, XavierAnalucia Rampazzo, KanaanSalim, MesquitaCláudio Tinoco, da NóbregaAntônio Cláudio Lucas

Improved exercise capacity
Improved inflammatory profile
Improved neurohormonal profile
Reduced heart rate
None reported

Both ivabradine and pyridostigmine significantly reduced heart rate in patients with chronic heart failure, with improvements in exercise capacity and neurohormonal and inflammatory profiles.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

10.

Pyridostigmine Improves the Effects of Resistance Exercise Training after Myocardial Infarction in Rats.

Author: FerianiDaniele J, Coelho-JúniorHélio J, de OliveiraJuliana C M F, DelbinMaria A, MostardaCristiano T, DouradoPaulo M M, CaperutoÉrico C, IrigoyenMaria C C, RodriguesBruno

Exercise training
MI treatment
PYR treatment

This study investigated the effects of resistance training combined with pyridostigmine bromide (PYR) treatment on cardiac and autonomic function, as well as on the inflammatory profile after myocardial infarction (MI) in rats. The results suggest that the combination of resistance training and PYR may be a good therapeutic strategy for MI.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

11.

Effects of Pyridostigmine bromide on SH-SY5Y cells: An in vitro neuroblastoma neurotoxicity model.

Author: AzzolinVerÔnica Farina, BarbisanFernanda, LenzLuana Suéling, TeixeiraCibele Ferreira, FortunaMilena, DuarteThiago, DuarteMarta Maria Frescura Medeiros, da CruzIvana Beatrice Mânica

Cell proliferation
Mitochondrial activity
Genotoxicity

This study investigates the potential neurotoxicity of pyridostigmine bromide (PB), a commonly used acetylcholinesterase inhibitor. Results suggest that PB, at therapeutic doses, did not cause significant oxidative stress or neurodegeneration in neural SH-SY5Y cells. However, at higher concentrations, PB exhibited genotoxic effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

12.

Effects of sugammadex vs. pyridostigmine-glycopyrrolate on post-operative nausea and vomiting: propensity score matching.

Author: LeeO H, ChoiG J, KangH, BaekC W, JungY H, WooY C, OhJ, ParkY H

Less antiemetics
Reduced PONV

Sugammadex was found to be more beneficial for post-operative nausea and vomiting (PONV) than pyridostigmine-glycopyrrolate mixture in patients who received opioid-based IV-PCA.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

13.

Effects of cholinergic stimulation with pyridostigmine bromide on chronic chagasic cardiomyopathic mice.

Author: de CubaMarília Beatriz, MachadoMarcus Paulo Ribeiro, FarnesiThais Soares, AlvesAngelica Cristina, MartinsLivia Alves, de OliveiraLucas Felipe, CapitelliCaroline Santos, LeiteCamila Ferreira, SilvaMarcos Vinícius, MachadoJuliana Reis, KappelHenrique Borges, de CamposHelioswilton Sales, PaivaLuciano, GomesNatália Lins da Silva, FaleirosAna Carolina Guimarães, BrittoConstança Felicia de Paoli de Carvalho, SavinoWilson, MoreiraOtacílio Cruz, RodriguesVirmondes, MontanoNicola, Lages-SilvaEliane, RamirezLuis Eduardo, da SilvaValdo Jose Dias

Reduced myocardial inflammation

This study assessed the effects of pyridostigmine bromide (Pyrido) on experimental chronic Chagas heart disease in mice. Pyrido treatment significantly reduced myocardial inflammatory infiltration, fibrosis, and hypertrophy. This suggests that Pyrido may have a neuroimmunomodulatory role in the evolution of the inflammatory-immune response to Trypanosoma cruzi during chronic Chagas heart disease.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

14.

Gulf War illness: Effects of repeated stress and pyridostigmine treatment on blood-brain barrier permeability and cholinesterase activity in rat brain.

Author: AmouretteChristine, LamproglouIoannis, BarbierLaure, FauquetteWilliam, ZoppeAmélie, ViretRoselyne, DiserboMichel

Cognitive dysfunction

This study found no evidence of pyridostigmine crossing the blood-brain barrier in rats subjected to repeated stress. This suggests that pyridostigmine’s central effects under stress may be mediated by indirect mechanisms originating from a peripheral pathway.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

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