Stigmine

Pyridostigmine, a stigmine derivative.

Stigmine refers to a class of acetylcholinesterase inhibitors.

Examples include:

Drug Primary use
Physostigmine Anticholinergic poisoning, glaucoma
Neostigmine Reversal of neuromuscular blockade, myasthenia gravis
Pyridostigmine Myasthenia gravis
Distigmine Urinary retention, myasthenia gravis
Rivastigmine Alzheimer's disease and Parkinson's disease dementia

Pharmacology

Stigmines are acetylcholinesterase inhibitors that increase the concentration of acetylcholine at cholinergic synapses by inhibiting its enzymatic breakdown. As a result, they enhance cholinergic neurotransmission at neuromuscular junctions and other cholinergic sites in the body.[1]

Medical uses

Various stigmine derivatives are used in medicine. Pyridostigmine and neostigmine are commonly used in the treatment of myasthenia gravis, while neostigmine is also used to reverse non-depolarizing neuromuscular blockade after surgery. Rivastigmine is used in the treatment of dementia associated with Alzheimer's disease and Parkinson's disease.[2]

History and etymology

The name "stigmine" is derived from physostigmine, a naturally occurring acetylcholinesterase inhibitor isolated from the Calabar bean (Physostigma venenosum). Later synthetic and semisynthetic acetylcholinesterase inhibitors adopted the suffix "-stigmine", leading to names such as neostigmine, pyridostigmine, and distigmine.[3]

References

  1. ^ Mehndiratta, Man Mohan; Pandey, Sanjay; Kuntzer, Thierry (2014-10-13). "Acetylcholinesterase inhibitor treatment for myasthenia gravis". The Cochrane Database of Systematic Reviews. 2014 (10) CD006986. doi:10.1002/14651858.CD006986.pub3. ISSN 1469-493X. PMC 7390275. PMID 25310725.
  2. ^ Neely, Grant A.; Sabir, Sarah; Kohli, Arpan (2026), "Neostigmine", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID 29261883, retrieved 2026-06-04
  3. ^ Obi, Juliet O.; Ikeme, Anthony C.; Nwakama, Patrick E.; Undieh, Ashiwel S. (2023-02-28). "The Calabar bean and physostigmine: from African ethno-jurisprudence to medicinal discovery and modern pharmacotherapeutics". American Journal of Pharmacotherapy and Pharmaceutical Sciences. 2. doi:10.25259/AJPPS_2023_001. ISSN 2835-253X.

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