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Mestinon
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== Side effects == Mestinon side effects that are most common include [[Gastrointestinal|gastrointestinal symptoms]] including abdominal cramps, [[diarrhea]] and bloating, a runny nose, [[Muscle fasciculations|muscle twitching]].<ref name="MGhope">{{Cite web|url=https://mghope.org/treatments | title = Treatments | last = ((Myasthenia Gravis Hope Foundation))|first = | authorlink = | date = 2017 | website = Myasthenia Gravis Hope Foundation|language=en-US|archive-url=|archive-date=|url-status=|access-date=2019-04-15}}</ref> Bradycardia, an abnormally slow heart rate may also occur, especially as a result of interaction with specific drugs.<ref name="medicines" /><ref name="drugscom" /><ref name="SmPC">{{Cite web|url=https://www.medicines.org.uk/emc/product/962/smpc | title = Mestinon 60mg Tablets - Summary of Product Characteristics (SmPC) - (eMC)|website=Electronic medicines compendium|access-date=2019-04-15}}</ref> === Gulf War Illness === Pyridostigmine was given to Gulf War personnel to protect them from nerve gas.<ref name="Golomb1999" /><ref>{{Cite book | title = Pyridostigmine Bromide|language=en | url =https://www.ncbi.nlm.nih.gov/books/NBK222848/ | date = 2000|publisher=National Academies Press (US)|first = | last = ((Institute of Medicine (US) Committee on Health Effects Associated with Exposures During the Gulf War)) | last2 = Fulco | first2 = Carolyn E. | last3 = Liverman | first3 = Catharyn T. | last4 = Sox | first4 = Harold C.}}</ref> Dr [[Robert Haley]] reportedly found that pyridostigmine is involved in two of the three syndromes of [[Gulf War Illness]]. He reported that the nerve gasSarin|sarin]] interacted with pyridostigmine; the pesticide [[DEET]] did the same. These interactions (as well as drug alone) caused brain damage to 175,000 US Gulf War personnel.<ref>{{Cite web|url=https://youtu.be/OYKMMbPp_Do?t=546 | title = Dr. Robert Haley, What Caused Gulf War Illness | last = Haley|first = Robert | date = May 6, 2013 | website = YouTube|publisher=David Spencer|archive-url=|archive-date=|url-status=|access-date=}}</ref><ref>{{Cite news | url=https://www.newscientist.com/article/dn6157-gulf-war-veterans-have-fertility-problems/ | title = Gulf war veterans have fertility problems|work=New Scientist|access-date=2018-08-26|language=en-US}}</ref><ref name="Stencel2010">{{Cite web|url=http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=12835 | title = Gulf War Service Linked to Post-Traumatic Stress Disorder, Multisymptom Illness, Other Health Problems, But Causes Are Unclear | last = Stencel|first = Christine | last2 = Burnette | first2 = Alison | date = Apr 9, 2010 | website = |publisher=The National Academies of Sciences Engineering Medicine|language=en|archive-url=|archive-date=|url-status=|access-date=2018-08-26}}</ref><ref name="NS2004">{{Cite news | url=https://www.newscientist.com/article/dn6609-us-in-u-turn-over-gulf-war-syndrome/ | title = US in U-turn over Gulf war syndrome | last = MacKenzie | first = Debora | date = Nov 3, 2004|work=New Scientist|access-date=2018-08-26|archive-url=|archive-date=|url-status=|language=en-US}}</ref> Gulf War Illness, possible interactions with DEET, other pesticides or organic solvents are not mentioned in the patient information.<ref name="medicines" /><ref name="drugscom">{{Cite web|url=https://www.drugs.com/sfx/mestinon-side-effects.html | title = Mestinon Side Effects in Detail|website=Drugs.com|language=en|access-date=2019-04-15}}</ref> === Multiple chemical sensitivity === A 1999 review published by the RAND corporation states that veterans experiencing Gulf War Syndrome had symptoms resembling those of patients with [[Multiple chemical sensitivity]] (MCS), who commonly reported being exposed to pyridostigmine bromide or other AChE-inhibiting agents, nerve agents, pesticides or organic solvents, however there is a lack of peer-reviewed research on this topic.<ref name="Golomb1999">{{Cite web|url=https://www.rand.org/pubs/monograph_reports/MR1018z2.html | title = A Review of the Scientific Literature As It Pertains to Gulf War Illnesses | last = Golomb|first = Beatrice A. | authorlink = | date = 1999 | website = |series=Volume 2: Pyridostigmine Bromide|publisher=RAND Corporation|location=Santa Monica, CA|archive-url=|archive-date=|url-status=|access-date=}}</ref> Increased chemical sensitives are not referred to in the patient information leaflet.<ref name="medicines">{{Cite web|url=https://www.medicines.org.uk/emc/files/pil.962.pdf | title=Mestinon patient info | last = Mylan | first = | authorlink = | date = 2018 | website = Electronic medicines compendium|archive-url=|archive-date=|url-status=|access-date=Apr 15, 2019}}</ref><ref name="drugscom" /> === Overdose risk === Overdose can cause a "cholinergic crisis", which can be very dangerous.<ref name="MGhope" /><ref name="SmPC" />
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