Neostigmine is the drug of choice in case of?

When is neostigmine the “drug of choice”?

Neostigmine is the drug of choice in myasthenia gravis, especially during myasthenic crisis (worsening weakness with respiratory failure due to neuromuscular junction blockade). It works by inhibiting acetylcholinesterase, which increases acetylcholine at the neuromuscular junction.

What does it treat in practical terms?

In a myasthenic crisis, neostigmine helps improve muscle strength (including respiratory muscles), though patients still often need ventilatory support depending on severity.

What condition is it not typically for?

Neostigmine is used for disorders like myasthenia gravis and curare/neuromuscular blocker reversal, but it is not the standard drug of choice for cholinergic (overstimulation) crisis, where weakness occurs from excessive acetylcholine activity.