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Muscarine-like symptoms (nausea, vomiting, diarrhea, sweating, increased bronchial and salivary secretions and bradycardia) often appear with overdosage ( cholinergic crisis ) An important complication that can arise is obstruction of the airway by bronchial secretions Pharmacokinetics: IV and IM administration Rapid renal excretion, resulting in a short duration of action of 5-10 mins Major drug Interactions: Care should be given when administering this drug to patients with symptoms of myasthenic weakness who are also on anticholinesterase drugs Since symptoms of anticholinesterase overdose (cholinergic crisis) may mimic underdosage (myasthenic weakness), their condition may be worsened by the use of this drug Figure 2

Multiple vitamin injections may be administered during the same visit when clinically appropriate