Edrophonium

Edrophonium is a short-acting, reversible acetylcholinesterase inhibitor primarily used in veterinary medicine for the diagnosis of **myasthenia gravis** (commonly known as the Tensilon test). It is also utilized to differentiate between myasthenic crisis (under-treatment) and cholinergic crisis (over-treatment), to treat atrial tachycardia via vagal effects, and to reverse non-depolarizing neuromuscular blockade. > **Clinical Warning:** Always have atropine drawn up and ready to administer when performing an edrophonium challenge due to the risk of severe bradycardia or asystole.

กลไกการออกฤทธิ์: Edrophonium acts as a reversible and short-acting competitive inhibitor of the enzyme **acetylcholinesterase** at the neuromuscular junction. **Acetylcholine** release → binds to receptors → normally broken down by acetylcholinesterase. Edrophonium blocks this enzyme → **acetylcholine** accumulates → prolonged and increased stimulation of nicotinic and muscarinic receptors, temporarily improving muscle strength in myasthenia gravis.

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