Neostigmine is classified as what type of agent?

Neostigmine is classified as an indirect cholinergic agonist because it works by inhibiting the enzyme acetylcholinesterase, which breaks down acetylcholine in the synaptic cleft. By preventing the degradation of acetylcholine, neostigmine effectively increases the levels of acetylcholine available to activate cholinergic receptors at the neuromuscular junction and in the central nervous system. This action is particularly useful in treating conditions such as myasthenia gravis, where increased acetylcholine activity can help improve muscle strength and function.

The classification is essential in understanding its pharmacological effects. Indirect cholinergic agonists like neostigmine enhance cholinergic transmission by amplifying the effects of endogenous acetylcholine rather than directly stimulating the receptors themselves, distinguishing them from other types of agents.