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Symptoms: Overdosage of Mestinon and other cholinesterase inhibitors can lead to cholinergic crises that manifest themselves in, among other things, pronounced muscle weakness (or exacerbated muscle weakness in patients with myasthenia gravis).
If such a situation is overlooked, life is endangered due to paralysis of the respiratory muscles. Bradycardia and, paradoxically, tachycardia are other possible effects.
Treatment: Countermeasures are the immediate withdrawal of Mestinon or other cholinergics and the slow IV administration of 1-2 mg atropine sulfate. Depending on the pulse rate, the dose is to be repeated at intervals of 2-4 hrs if required.
