Neostigmine is an anticholinesterase used for the reversal of a competitive neuromuscular blockade. It acts within a minute of injection and lasts up to half an hour. Side effects of neostigmine include enhanced cholinergic transmission at autonomic synapses - increased secretions, bronchoconstriction, bradycardia - and central synapses - first excitation and then depression. These are countered by prior administration of atropine of glycopyrronium.
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