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Notes: Chemically related to neostigmine, but has a longer duration of action and less GI effects Pyridostigmine & The 1990-1991 Persian Gulf War Syndrome Because pyridostigmine is a highly ionized quaternary ammonium compound, under normal conditions it does not readily cross the blood-brain barrier (BBB) (Dunn et al, 1997

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This is a topic that deserves open discussion