Neostigmine bromide is a reversible inhibitor of acetylcholinesterase.[1]
AChE (acetylcholinesterase) is a hydrolase that hydrolyzes the neurotransmitter acetylcholine at the neuromuscular junction and cholinergic synaspe. It terminates the signal transductions and plays a role in neuronal apoptosis.
Neostigmine bromide is a quaternary amine that blocked cholinesterase activity to extend and enhance the muscarinic and nicotinic effects of acetylcholine. It is implicated for the treatment of primary open-angle glaucoma, postoperative urinary retention, paralytic ileus, myasthenia gravis etc. It is also reported to be an adjuvant to local anaesthetics and opioids for post-surgical pain after gynaecological or abdominal surgery. [1]
Reference:
[1] El-Kosasy AM, Nebsen M, Abd El-Rahman MK, Salem MY, El-Bardicy MG. Comparative study of 2-hydroxy propyl beta cyclodextrin and calixarene as ionophores in potentiometric ion-selective electrodes for neostigmine bromide. Talanta. 2011 Aug 15;85(2):913-8.