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(1) Mechanism of action: Pyridostigmine is a reversible acetylcholinesterase inhibitor that prevents acetylcholine (ACh) breakdown at the neuromuscular junction, thereby increasing neurotransmitter availability and enhancing neuromuscular transmission

F., Bunch, L., Romer, M

C.IngoldI.et al

Dis Model Mech

This process depends on: Vitamin B6 (P5P) as an essential enzyme cofactor Adequate availability of glycine and glutamate Sufficient cellular energy (ATP) Proper liver and mitochondrial function When this pathway is inefficient, glutathione production may be impaired even if homocysteine, B12, or folate levels appear normal