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Edrophonium chloride
Edrophonium chloride (Enlon, Tensilon)
Edrophonium
(ed-roh-FOH-nee-um)
Pregnancy Category: C Enlon Reversol Tensilon (Rx)
Edrophonium chloride and Atropine sulfate
Edrophonium chloride and Atropine sulfate
Edrophonium
(ed-roh-FOH-nee-um)
Pregnancy Category: C Enlon-Plus (Rx)

Classification: Cholinesterase inhibitor, indirectly-acting

See Also: See also Neostigmine and Atropine sulfate.

Action/Kinetics: By increasing the duration of action at the motor end plate, edrophonium causes a transient increase in muscle strength in myasthenia gravis clients and either no change or a slight weakness in muscle strength in clients with other disorders. Atropine counteracts the muscarinic side effects that will occur due to edrophonium (e.g., increased secretions, bradycardia, bronchoconstriction). Onset: IM, 2-10 min; IV, <1 min. Duration: IM 5-30 min; IV, 10 min. Eliminated through the kidneys.

Uses: Edrophonium: Differential diagnosis of myasthenia gravis. Adjunct to evaluate requirements for treating myasthenia gravis. Adjunct to treat respiratory depression due to curare and similar nondepolarizing agents such as gallamine, pancuronium, and tubocurarine.
Edrophonium and Atropine: To antagonize or reverse nondepolarizing neuromuscular blocking agents. Adjunct to treat respiratory depression caused by overdosage of curare.

Contraindications: Edrophonium combined with atropine in the differential diagnosis of myasthenia gravis.

Special Concerns: Edrophonium combined with atropine is not effective against depolarizing neuromuscular blocking agents.

How Supplied: Edrophonium chloride: Injection: 10 mg/mL. Edrophonium chloride and Atropine sulfate: Injection: 10 mg-0.14 mg/mL

Dosage
•Edrophonium, IV Differential diagnosis of myasthenia gravis.
IV, Adults: 2 mg initially over 15-30 sec; with needle in place, wait 45 sec; if no response occurs after 45 sec inject an additional 8 mg. If a cholinergic reaction is obtained following 2 mg (muscarinic side effects, skeletal muscle fasciculations, increased muscle weakness), test is discontinued and atropine, 0.4-0.5 mg, is given IV. The test may be repeated in 30 min. Pediatric, up to 34 kg, IV: 1 mg; if no response after 45 sec, can give up to 5 mg. Pediatric, over 34 kg, IV: 2 mg; if no response after 45 sec, can give up to 10 mg in 1-mg increments q 30-45 sec. Infants: 0.5 mg. If IV injection is not feasible, IM can be used.
To evaluate treatment needs in myasthenic clients.
1 hr after PO administration of drug used to treat myasthenia, give edrophonium IV, 1-2 mg. (NOTE: Response will be myasthenic in undertreated clients, adequate in controlled clients, and cholinergic in overtreated clients.)
Curare antagonist.
Slow IV: 10 mg over 30-45 sec to detect onset of cholinergic reaction; repeat if necessary to maximum of 40 mg. Should not be given before use of curare, gallamine, or tubocurarine.
•Edrophonium, IM Differential diagnosis of myasthenia gravis.
Adults: 10 mg; if hyperreactivity occurs, retest after 30 min with 2 mg IM to rule out false negative. Pediatric, up to 34 kg: 2 mg; more than 34 kg: 5 mg. (There is a 2-10-min delay in reaction with IM route.)
•Edrophonium and Atropine, IV
Adults: 0.5-1 mg/kg edrophonium and 0.007-0.014 mg/kg atropine.