Androstanes and androstane derivatives which are substituted in any position with one or more hydroxyl groups.
A procedure involving placement of a tube into the trachea through the mouth or nose in order to provide a patient with oxygen and anesthesia.
Examination, therapy or surgery of the interior of the larynx performed with a specially designed endoscope.
A quaternary skeletal muscle relaxant usually used in the form of its bromide, chloride, or iodide. It is a depolarizing relaxant, acting in about 30 seconds and with a duration of effect averaging three to five minutes. Succinylcholine is used in surgical, anesthetic, and other procedures in which a brief period of muscle relaxation is called for.
Drugs that interrupt transmission at the skeletal neuromuscular junction by causing sustained depolarization of the motor end plate. These agents are primarily used as adjuvants in surgical anesthesia to cause skeletal muscle relaxation.
Drugs that interrupt transmission at the skeletal neuromuscular junction without causing depolarization of the motor end plate. They prevent acetylcholine from triggering muscle contraction and are used as muscle relaxants during electroshock treatments, in convulsive states, and as anesthesia adjuvants.
Paramedical personnel trained to provide basic emergency care and life support under the supervision of physicians and/or nurses. These services may be carried out at the site of the emergency, in the ambulance, or in a health care institution.
Organic compounds that include a cyclic ether with three ring atoms in their structure. They are commonly used as precursors for POLYMERS such as EPOXY RESINS.
The type species of LENTIVIRUS and the etiologic agent of AIDS. It is characterized by its cytopathic effect and affinity for the T4-lymphocyte.
7,8,8a,9a-Tetrahydrobenzo(10,11)chryseno (3,4-b)oxirene-7,8-diol. A benzopyrene derivative with carcinogenic and mutagenic activity.
1,2-Benzphenanthrenes. POLYCYCLIC COMPOUNDS obtained from coal tar.
Trans-acting transcription factors produced by retroviruses such as HIV. They are nuclear proteins whose expression is required for viral replication. The tat protein stimulates LONG TERMINAL REPEAT-driven RNA synthesis for both viral regulatory and viral structural proteins. tat stands for trans-activation of transcription.
The phenomenon whereby compounds whose molecules have the same number and kind of atoms and the same atomic arrangement, but differ in their spatial relationships. (From McGraw-Hill Dictionary of Scientific and Technical Terms, 5th ed)
An HIV species related to HIV-1 but carrying different antigenic components and with differing nucleic acid composition. It shares serologic reactivity and sequence homology with the simian Lentivirus SIMIAN IMMUNODEFICIENCY VIRUS and infects only T4-lymphocytes expressing the CD4 phenotypic marker.
A major C19 steroid produced by the ADRENAL CORTEX. It is also produced in small quantities in the TESTIS and the OVARY. Dehydroepiandrosterone (DHEA) can be converted to TESTOSTERONE; ANDROSTENEDIONE; ESTRADIOL; and ESTRONE. Most of DHEA is sulfated (DEHYDROEPIANDROSTERONE SULFATE) before secretion.
The circulating form of a major C19 steroid produced primarily by the ADRENAL CORTEX. DHEA sulfate serves as a precursor for TESTOSTERONE; ANDROSTENEDIONE; ESTRADIOL; and ESTRONE.
A delta-4 C19 steroid that is produced not only in the TESTIS, but also in the OVARY and the ADRENAL CORTEX. Depending on the tissue type, androstenedione can serve as a precursor to TESTOSTERONE as well as ESTRONE and ESTRADIOL.
An aromatized C18 steroid with a 3-hydroxyl group and a 17-ketone, a major mammalian estrogen. It is converted from ANDROSTENEDIONE directly, or from TESTOSTERONE via ESTRADIOL. In humans, it is produced primarily by the cyclic ovaries, PLACENTA, and the ADIPOSE TISSUE of men and postmenopausal women.
The outer layer of the adrenal gland. It is derived from MESODERM and comprised of three zones (outer ZONA GLOMERULOSA, middle ZONA FASCICULATA, and inner ZONA RETICULARIS) with each producing various steroids preferentially, such as ALDOSTERONE; HYDROCORTISONE; DEHYDROEPIANDROSTERONE; and ANDROSTENEDIONE. Adrenal cortex function is regulated by pituitary ADRENOCORTICOTROPIN.
A potent androgenic steroid and major product secreted by the LEYDIG CELLS of the TESTIS. Its production is stimulated by LUTEINIZING HORMONE from the PITUITARY GLAND. In turn, testosterone exerts feedback control of the pituitary LH and FSH secretion. Depending on the tissues, testosterone can be further converted to DIHYDROTESTOSTERONE or ESTRADIOL.
The 17-beta-isomer of estradiol, an aromatized C18 steroid with hydroxyl group at 3-beta- and 17-beta-position. Estradiol-17-beta is the most potent form of mammalian estrogenic steroids.
Inorganic compounds that contain bromine as an integral part of the molecule.
The family of steroids from which the androgens are derived.
The unspecified form of the steroid, normally a major metabolite of TESTOSTERONE with androgenic activity. It has been implicated as a regulator of gonadotropin secretion.
A metabolite of TESTOSTERONE or ANDROSTENEDIONE with a 3-alpha-hydroxyl group and without the double bond. The 3-beta hydroxyl isomer is epiandrosterone.
Steroidal compounds in which one or more carbon atoms in the steroid ring system have been substituted with nitrogen atoms.
A potent androgenic metabolite of TESTOSTERONE. It is produced by the action of the enzyme 3-OXO-5-ALPHA-STEROID 4-DEHYDROGENASE.
An antineoplastic agent that is a derivative of progesterone and used to treat advanced breast cancer.

PST 2238: A new antihypertensive compound that modulates Na,K-ATPase in genetic hypertension. (1/315)

A genetic alteration in the adducin genes is associated with hypertension and up-regulation of the expression of renal Na, K-ATPase in Milan-hypertensive (MHS) rats, in which increased ouabain-like factor (OLF) levels are also observed. PST 2238, a new antihypertensive compound that antagonizes the pressor effect of ouabain in vivo and normalizes ouabain-dependent up-regulation of the renal Na-K pump, was evaluated for its ability to lower blood pressure and regulate renal Na,K-ATPase activity in MHS genetic hypertension. In this study, we show that PST 2238, given orally at very low doses (1 and 10 microg/kg for 5-6 weeks), reduced the development of hypertension in MHS rats and normalized the increased renal Na,K-ATPase activity and mRNA levels, whereas it did not affect either blood pressure or Na,K-ATPase in Milan-normotensive (MNS) rats. In addition, a similar antihypertensive effect was observed in adult MHS rats after a short-term treatment. In cultured rat renal cells with increased Na-K pump activity at Vmax due to overexpression of the hypertensive variant of adducin, 5 days of incubation with PST 2238 (10(-10-)-10(-9) M) lowered the pump rate to the level of normal wild-type cells, which in turn were not affected by the drug. In conclusion, PST 2238 is a very potent compound that in MHS rats reduces blood pressure and normalizes Na-K pump alterations caused by a genetic alteration of the cytoskeletal adducin. Because adducin gene mutations have been associated with human essential hypertension, it is suggested that PST 2238 may display greater antihypertensive activity in those patients carrying such a genetic alteration.  (+info)

Effects of an intubating dose of succinylcholine and rocuronium on the larynx and diaphragm: an electromyographic study in humans. (2/315)

BACKGROUND: Paralysis of the vocal cords is one objective of using relaxants to facilitate tracheal intubation. This study compares the neuromuscular blocking effect of succinylcholine and rocuronium on the larynx, the diaphragm, and the adductor pollicis muscle. METHODS: Electromyographic response was used to compare the neuromuscular blocking effect of succinylcholine and rocuronium on the laryngeal adductor muscles, the diaphragm, and the adductor pollicis muscle. Sixteen patients undergoing elective surgery were anesthetized with propofol and fentanyl, and their tracheas were intubated without neuromuscular blocking agents. The recurrent laryngeal and phrenic nerves were stimulated at the neck. The electromyographic response was recorded from electrodes placed on the endotracheal tube and intercostally before and after administration of 1 mg/kg succinylcholine or 0.6 mg/kg rocuronium. RESULTS: The maximum effect was greater at the adductor pollicis (100 and 99%) than at the larynx (96 and 97%) and the diaphragm (94 and 96%) after administration of succinylcholine and rocuronium, respectively (P < or = 0.05). Onset time was not different between the larynx (58+/-10 s), the diaphragm (57+/-8 s), and the adductor pollicis (54+/-13 s), after succinylcholine (all mean +/- SD). After rocuronium, onset time was 124+/-39 s at the larynx, 130+/-44 s at the diaphragm, and 115+/-21 s at the adductor pollicis. After succinylcholine administration, time to 90% recovery was 8.3+/-3.2, 7.2+/-3.5, and 9.1+/-3.0 min at the larynx, the diaphragm, and the adductor pollicis, respectively. Time to 90% recovery after rocuronium administration was 34.9+/-7.6, 30.4+/-4.2, and 49.1+/-11.4 min at the larynx, the diaphragm, and the adductor pollicis, respectively. CONCLUSION: Neuromuscular blocking effect of muscle relaxants on the larynx can be measured noninvasively by electromyography. Although the larynx appears to be resistant to muscle relaxants, we could not demonstrate that its onset time differed from that of peripheral muscles.  (+info)

sgk is an aldosterone-induced kinase in the renal collecting duct. Effects on epithelial na+ channels. (3/315)

The early phase of the stimulatory effect of aldosterone on sodium reabsorption in renal epithelia is thought to involve activation of apical sodium channels. However, the genes initiating this effect are unknown. We used a combination of polymerase chain reaction-based subtractive hybridization and differential display techniques to identify aldosterone-regulated immediate early genes in renal mineralocorticoid target cells. We report here that aldosterone rapidly increases mRNA levels of a putative Ser/Thr kinase, sgk (or serum- and glucocorticoid-regulated kinase), in its native target cells, i.e. in cortical collecting duct cells. The effect occurs within 30 min of the addition of aldosterone, is mediated through mineralocorticoid receptors, and does not require de novo protein synthesis. The full-length sequences of rabbit and mouse sgk cDNAs were determined. Both cDNAs show significant homology to rat and human sgk (88-94% at the nucleotide level, and 96-99% at the amino acid level). Coexpression of the mouse sgk in Xenopus oocytes with the three subunits of the epithelial Na+ channel results in a significantly enhanced Na+ current. These results suggest that sgk is an immediate early aldosterone-induced gene, and this protein kinase plays an important role in the early phase of aldosterone-stimulated Na+ transport.  (+info)

Augmentation of the rocuronium-induced neuromuscular block by the acutely administered phenytoin. (4/315)

BACKGROUND: The effects of an acute administration of phenytoin on the magnitude of the rocuronium-induced neuromuscular block were evaluated. METHODS: Twenty patients (classified as American Society of Anesthesiologists physical status I or II) scheduled for craniotomy were studied: 15 received phenytoin during operation (10 mg/kg), and the others served as controls. Anesthesia was induced with thiopental and fentanyl and maintained with nitrous oxide (65%) in oxygen and end-tidal isoflurane (1%). The ulnar nerve was stimulated supramaximally and the evoked electromyography was recorded using a neuromuscular transmission monitor. Continuous infusion of rocuronium maintained the neuromuscular block with first twitch (T1) between 10 and 15% for 45 min before the start of an infusion of either phenytoin or NaCl 0.9%. Twitch recordings continued for 60 min thereafter. Arterial blood samples were collected at the predefined time points (four measurements before and four after the start of the infusion) to determine the concentrations of phenytoin and rocuronium and the percentage of rocuronium bound to plasma proteins. RESULTS: The first twitch produced by an infusion of rocuronium remained constant during the 15 min before and the 60 min after the start of the saline infusion. After the phenytoin infusion, the twitch decreased progressively, but the plasma concentrations and the protein-bound fraction of rocuronium did not change. CONCLUSION: Phenytoin acutely augments the neuromuscular block produced by rocuronium without altering its plasma concentration or its binding to plasma proteins.  (+info)

Rapid tracheal intubation with rocuronium: a probability approach to determining dose. (5/315)

BACKGROUND: Rapid tracheal intubation with rocuronium has not been studied using a probability-based approach. The authors aimed to predict doses of rocuronium giving 90% and 95% probability of in intubation within 60 s and to estimate their durations of action. METHODS: After premedication with midazolam, 2 mg, anesthesia was induced in 80 subjects with fentanyl, 2 microg/kg, followed 3 min later by propofol, 2 mg/kg. Patients received randomly rocuronium, 0.0, 0.4, 0.8, or 1.2 mg/kg (n = 20/ dose). Laryngoscopy began 40 s later, aiming for intubation at 60 s, and conditions were graded perfect, acceptable, or unacceptable, with the first two conditions being successful intubation. Anesthesia was maintained with isoflurane 0.5-1.0% (end-tidal) and fentanyL Duration of action was time until reappearance of the first tactile train-of-four response. The dose versus fraction of patients with successful intubation was analyzed by logistic regression. Doses giving 90% and 95% (D90 and D95) probability of successful intubation were calculated. RESULTS: intubation was successful in 7, 11, 18, and 19 patients in the 0.0, 0.4, 0.8, and 1.2 mg/kg groups, respectively. The D90 and D95 doses (95% confidence limits in parentheses) were 0.83 (0.59-1.03) and 1.04 (0.76-1.36) mg/kg, respectively. Estimated time until first tactile train-of-four response after D90 and D95 doses was 32 and 46 min, respectively. CONCLUSIONS: After induction with fentanyl and propofol, rocuronium, 1.04 mg/kg gives 95% probability of successful intubation at 60 s.  (+info)

Intramuscular rocuronium in infants and children: a multicenter study to evaluate tracheal intubating conditions, onset, and duration of action. (6/315)

BACKGROUND: This multicenter, assessor-blinded, randomized study was done to confirm and extend a pilot study showing that intramuscular rocuronium can provide adequate tracheal intubating conditions in infants (2.5 min) and children (3 min) during halothane anesthesia. METHODS: Thirty-eight infants (age range, 3-12 months) and 38 children (age range, 1 to 5 yr) classified as American Society of Anesthesiologists physical status 1 and 2 were evaluated at four investigational sites. Anesthesia was maintained with halothane and oxygen (1% end-tidal concentration if <2.5 yr; 0.80% end-tidal concentration if >2.5 yr) for 5 min. One half of the patients received 0.45 mg/kg intravenous rocuronium. The others received 1 mg/kg (infants) or 1.8 mg/kg (children) of intramuscular rocuronium into the deltoid muscle. Intubating conditions and mechanomyographic responses to ulnar nerve stimulation were assessed. RESULTS: The conditions for tracheal intubation at 2.5 and 3 min in infants and children, respectively, were inadequate in a high percentage of patients in the intramuscular group. Nine of 16 infants and 10 of 17 children had adequate or better intubating conditions at 3.5 and 4 min, respectively, after intramuscular rocuronium. Better-than-adequate intubating conditions were achieved in 14 of 15 infants and 16 of 17 children given intravenous rocuronium. Intramuscular rocuronium provided > or =98% blockade in 7.4+/-3.4 min (in infants) and 8+/-6.3 min (in children). Twenty-five percent recovery occurred in 79+/-26 min (in infants) and in 86+/-22 min (in children). CONCLUSIONS: Intramuscular rocuronium, in the doses and conditions tested, does not consistently provide satisfactory tracheal intubating conditions in infants and children and is not an adequate alternative to intramuscular succinylcholine when rapid intubation is necessary.  (+info)

Effects of priming with pancuronium or rocuronium on intubation with rocuronium in children. (7/315)

Rocuronium is a non-depolarizing neuromuscular blocking agent which has a rapid onset and intermediate duration of action. The goal of this study was to compare the neuromuscular blocking actions of rocuronium with and without a priming dose of pancuronium or rocuronium in children. Thirty patients were randomly allocated into 3 groups. Ten patients received a single dose of 0.6 mg/kg rocuronium (Group I). The others received either 0.015 mg/kg pancuronium (Group II) or 0.06 mg/kg rocuronium (Group III) 3 minutes before an intubating dose of 0.54 mg/kg rocuronium was given. Neuromuscular blockade was measured via accelerographic response to single stimulations (1 Hz) of the ulnar nerve until maximal twitch depression was reached followed by train-of-four (TOF) stimuli (2 Hz) at 15 second intervals for the remainder of recovery. Groups were compared with regard to onset time, duration and recovery indices. The onset time and duration of block did not differ significantly between groups. However, the time to recovery in group II (24.5 +/- 9.9 min) was significantly prolonged compared to that in group I (12.7 +/- 3.1 min) or group III (12.7 +/- 3.9 min). We concluded that the use of rocuronium with a preceding dose of either pancuronium or rocuronium provided no advantage for intubation in children.  (+info)

Spontaneous or neostigmine-induced recovery after maintenance of neuromuscular block with Org 9487 (rapacuronium) or rocuronium following an initial dose of Org 9487. (8/315)

We have examined spontaneous and neostigmine-induced recovery after an initial dose of Org 9487 1.5 mg kg-1 followed by three repeat doses of Org 9487, a 30-min infusion of Org 9487 or two incremental doses of rocuronium. Mean clinical duration after incremental doses of Org 9487 0.5 mg kg-1 increased from 12.3 (SD 3.4) min to 14.0 (4.0) and 15.9 (5.9) min (P < 0.01), and after rocuronium from 14.4 (5.2) min to 19.2 (5.9) min (P < 0.01). Times for spontaneous recovery from a T1 of 25% to a TOF ratio of 0.8 after the last bolus dose of Org 9487 and after a 30-min infusion were 72.4 (16.5) and 66.1 (26.9) min compared with 36.7 (15.8) min in the group receiving reocuronium. These times were significantly reduced to 9.9 (4.5), 8.6 (6.1) and 5.7 (2.5) min, respectively, after neostigmine administration at a T1 of 25% (P < 0.05). We conclude that administration of Org 9487 by repeat bolus doses or infusion was associated with slow spontaneous recovery but neostigmine administration resulted in adequate recovery in less than 10 min.  (+info)

It was designed to be a weaker antagonist at the neuromuscular junction than pancuronium; hence its monoquaternary structure and its having an allyl group and a pyrrolidine group attached to the D ring quaternary nitrogen atom. Rocuronium has a rapid onset and intermediate duration of action.[2] There is considered to be a risk of allergic reaction to the drug in some patients (particularly those with asthma), but a similar incidence of allergic reactions has been observed by using other members of the same drug class (non-depolarizing neuromuscular blocking drugs).[3] The γ-cyclodextrin derivative sugammadex (trade name Bridion) has been recently introduced as a novel agent to reverse the action of rocuronium.[4] Sugammadex has been in use since 2009 in many European countries; however, it was turned down for approval twice by the US FDA due to concerns over allergic reactions and bleeding,[5] but finally approved the medication for use during surgical procedures in the United States on ...
Pape A, Kertscho H, Stein P, et al. Neuromuscular blockade with rocuronium bromide increases the tolerance of acute normovolemic anemia in anesthetized pigs. Eur Surg Res. 2012;48(1):16-25. PMID: 22189343.. Bowman WC. Neuromuscular block. Br J Pharmacol. 2006 Jan;147 Suppl 1:S277-86. PMID: 16402115.. Hou VY, Hirshman CA, Emala CW. Neuromuscular relaxants as antagonists for M2 and M3 muscarinic receptors. Anesthesiology. 1998 Mar;88(3):744-50. PMID: 9523819. ...
ZEMURON (Rocuronium bromide) drug information & product resources from MPR including dosage information, educational materials, & patient assistance.
It has been reported that co-administration of ephedrine reduced the onset time of neuromuscular block of rocuronium (1-3). It also provided an improved condition for the rapid tracheal intubation (2,4). This beneficial effect was attributed to the increased cardiac output and tissue perfusion to muscle, and therefore, a more rapid delivery of rocuronium to the neuromuscular junction was achieved (4-5). If so, any drugs which decrease cardiac output consequently can prolong the onset time of rocuronium.. Remifentanil is the first ultra-short acting opioid with a rapid onset. During the total intravenous anesthesia (TIVA) with propofol and remifentanil, prior administration of remifentanil could reduce the propofol infusion pain without other significant complications (6). However, remifentanil can decrease the arterial pressure and heart rate (7-8), so that it is likely to decrease the onset time of rocuronium for the opposite principle that ephedrine increases it.. The investigators therefore ...
Rocuronium Kabi is the drug of choice for muscle relaxation during rapid sequence induction because of its fast onset similar to suxamethonium. It offers flexibility in usage and patient groups, and superior safety (less histamine release, better haemodynamical stability). Rocuronium Kabi is an excellent partner for combination with our world-leading intravenous general anaesthetic propofol.. ...
Compounds useful as antihypertensive agents, or antiviral agents against DNA containing viruses, such as herpes group viruses, are disclosed. The compounds are represented by Formula 1.0: ##STR1## and
Ultimately, the ketamine and rocuronium combination has equal efficacy and a superior safety profile in comparison to etomidate and succinylcholine. Ketamine and rocuronium should become the first-line choices for RSI in critically ill patients ...
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details ...
Tracheal intubation with rocuronium bromide using the timing principle - A comparison with succinylcholine for rapid sequence induction ...
Rocuronium is an intravenous medication that helps to relax patients during general anesthesia, and it helps to facilitate breathing tube insertion.
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Forty-nine maps showing 30-min 1-,2-,3-,6-,12-, and 24-hr point precipitations for return periods of 1, 2, 5, 10, 25, 50, and 100 yr and interpolation diagrams for obtaining values for intermediate durations and return ...
Selective Relaxant Binding Agents (SRBAs) are a new class of [[drug]]s that selectively encapsulates and binds neuromuscular blocking agents (NMBAs). The first drug introduction of a SRBA is [[sugammadex]]. Sugammadex is a modified gamma cyclodextrin that specifically encapsulates and binds the aminosteroid NMBAs: [[rocuronium]]>[[vecuronium]]>>[[pancuronium]]. SRBAs exert a [[chelating]] action that effectively terminates a NMBA ability to bind to [[nicotinic receptor]]s. ==Discovery of SRBAs== The discovery of SRBA as a new class of drug is the result of work done at Organon laboratories in [[Scotland]]. [[Cyclodextrin]]s were explored as a means to solubilize rocuronium bromide (a [[steroidal]] NMBA) in a neutral aqueous solution. Upon creating numerous modified cyclodextrins, one particular [[molecule]] was found to possess extremely high affinity for the rocuronium molecule. Originally known as Org25969, it is now generically named sugammadex sodium. [[Category:Anesthesia]] ...
INTRODUCTION. Anaphylaxis during anesthesia is a rare event that may occur in up to 1:20,000 cases and approximately 60% to 70% of these cases are secondary to the use of muscle relaxants, particularly succinylcholine and rocuronium1-3. The standard treatment requires immediate discontinuation of the drug, whenever possible, and the use of agents that improve cardiac performance and hemodynamic profile1.. Sugammadex was introduced into medical practice in order to antagonize the clinical action of rocuronium via encapsulation of this muscle relaxant, and this mechanism of action may contribute positively for the treatment of anaphylaxis induced by this neuromuscular blocker4.. The aim of this report is to describe the treatment of a case of rocuronium-induced anaphylaxis with inadequate response to traditional therapy and the case resolution after using sugammadex.. CASE REPORT. A female patient, 62 years old, 72 kg, was referred to the surgical center for treatment of epidural hematoma ...
TY - JOUR. T1 - Pharmacokinetics of pipecuronium in infants, children and adults. AU - Tassonyi, E.. AU - Pittet, J. F.. AU - Schopfer, C. N.. AU - Rouge, J. C.. AU - Gemperle, G.. AU - Wilder-Smith, O. H.G.. AU - Morel, D. R.. PY - 1995/9/1. Y1 - 1995/9/1. N2 - In order to explain the reported shorter clinical duration of action of cumulative ED95 of pipecuronium in infants as compared to children or adults, the pharmacokinetic profiles of pipecuronium were compared in infants (n=6; mean age 6.8 months; mean weight 7.3 kg) in children (n=6; mean age 4.6 years; mean weight 19.2 kg) and in adults (n=7; mean age 42 years; mean weight 58.2 kg). Equipotent doses (2 × ED95) of pipecuronium were injected i.v. as single bolus and arterial blood was sampled for 4-5 h. Pipecuronium was quantified by complex formation with [125I]-labelled rose bengal. Pharmacokinetic parameters were calculated using a two-compartment open model. The median for the distribution half-life of pipecuronium was 2.54 min ...
The pharmacokinetics of 6 new neuromuscular blocking drugs are described. These are the aminosteroids pipecuronium bromide, rocuronium bromide and rapacuronium bromide (ORG-9487) and the benzylisoquinolinium diesters doxacurium chloride, mivacurium chloride and cisatracurium besilate. In healthy individuals, these drugs all have similar volumes of distribution. Their pharmacokinetics are influenced little by age or anaesthetic technique, but renal and hepatic disease may significantly alter their distribution and elimination. Pipecuronium resembles pancuronium in its pharmacokinetic and neuromuscular blocking profile, but is devoid of cardiovascular effects. It has a low clearance (0.16 L/h/kg) and long elimination half-life (120 minutes). It is largely eliminated through the kidney. Rocuronium has a similar pharmacokinetic profile to vecuronium but its onset of action is more rapid and duration of action slightly shorter. Its clearance (0.27 L/h/kg) is intermediate between those of pipecuronium and
MUSCLE RELAXANTS, PERIPHERALLY ACTING AGENTS. This medicine is indicated in adult and pediatric patients (from term neonates to adolescents [0 to ,18 years]) as an adjunct to general anaesthesia to facilitate tracheal intubation during routine sequence induction and to provide skeletal muscle relaxation during surgery. In adults rocuronium bromide is also indicated to facilitate tracheal intubation during rapid sequence induction and as an adjunct in the intensive care unit (ICU) to facilitate intubation and mechanical ventilation.. Prescription medication. Information for healthcare professionals only ...
This study investigated optimal dose of combination of Rocuronium and Cisatracurium through monitoring neuromuscular relaxation during surgery.
When a patient has a contraindication to succinylcholine, rocuronium bromide is the paralytic agent of choice. At a dose of 1.0 - 1.2 mg/kg IV, rocuronium achieves intubating conditions similar to those of succinylcholine and lasts 50 minutes. ...
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cyclobarbital: was heading 1977-94 (see under BARBITURATES 1977-90); CYCLOBARBITONE, HEXEMAL, & TETRAHYDROPHENOBARBITAL were see CYCLOBARBITAL 1977-94; use BARBITURATES to search CYCLOBARBITAL 1977-94; short to intermediate duration barbiturate used as hypnotic and sedative
This trial has comapred the effects on respiratory function of sugammadex and neostigmine in the reversal of moderate rocuronium-induced neuromuscular blockade.
The FDA recently approved the first selective reversal agent for rocuronium, known as sugammadex. Already in use in Europe since 2008, sugammadexs approval in the U.S. was delayed due to concerns about hypersensitivity. Once U.S.-based trials showed the risk of anaphylaxis was low (0.3%), the drug was approved in 2015. Here we will review basics of this novel drug and discuss ways it may impact emergency airway management. Marketed under the brand name Bridion, sugammadex is currently approved for use in patients undergoing surgery. It is given to reverse neuromuscular blockade from rocuronium or vecuronium in patients whose surgical case ends earlier than anticipated. It can also be used in extubated patients with poor respiratory effort from residual neuromuscular blockade. Most importantly for us, however, it is also approved for emergent reversal of neuromuscular blockade in a cant intubate, cant oxygenate scenario in the OR. Although the package insert does not specifically address ED ...
Intravenous magnesium re-establishes neuromuscular block after spontaneous recovery from an intubating dose of rocuronium: a randomised controlled ...
Sugammadex reverses the effects of certain medications that are given during surgical procedures to relax your muscles. Sugammadex is used at the end of surgery, to help restore muscle function that has been blocked during surgery by the other medicines. Sugammadex may also be used for purposes not listed in this...
Dosage of sugammadex according to the calculated lean body mass in obese female patients: time to reverse moderate neuromuscular blockade induced by rocuronium
In a comparative, cohort study, pre-hospital RSI using fentanyl, ketamine and rocuronium produced superior intubating conditions and a more favourable haemodynamic response to laryngoscopy and tracheal intubation. An RSI protocol using fixed ratios of these agents delivers effective pre-hospital tra …
The data further verify the neuromuscular blocking properties of CW002, including rapid reversal by L-cysteine of 100% NMB under several circumstances. A notable lack of autonomic or circulatory effects provided added proof of safety and efficacy.
Our hospital is finally getting Sugammadex. I am so thrilled that we have something else to use to quickly reverse patients other than neostigmine. I figure it it time to write a post about the medication to give you a quick summary of what the drug is, how it works, and the side effects etc.…
Merck & Co has been dealt a blow after US authorities knocked back its anaesthesia reversal drug sugammadex for the second time. - News - PharmaTimes
Schering-Plough has been boosted by the news that a US regulatory panel has backed the firms new anaesthesia drug sugammadex. - News - PharmaTimes
Lidocaine HCL 2% 1:100,000 (Cook Waite), these versatile widely applicable injection delivers local anesthesia of intermediate duration.
Most of which are fairly rare and I (fortunately) dont need to intubate very frequently. But when that relative zebra is really sick, I have enough on my mind and I dont want to have to think to hard about which drugs may be dangerous. Note that in MG, you can use succinylcholine but have to use more; you can use a lower dose of rocuronium but a normal dose will just paralyze them longer, which is much safer than me having to remember this whole paragraph and do math when the chips are about to hit the fan ...
Most of which are fairly rare and I (fortunately) dont need to intubate very frequently. But when that relative zebra is really sick, I have enough on my mind and I dont want to have to think to hard about which drugs may be dangerous. Note that in MG, you can use succinylcholine but have to use more; you can use a lower dose of rocuronium but a normal dose will just paralyze them longer, which is much safer than me having to remember this whole paragraph and do math when the chips are about to hit the fan ...
TY - JOUR. T1 - Evaluation of the mydriatic effects of topical administration of rocuronium bromide in Hispaniolan Amazon parrots (Amazona ventralis). AU - Petritz, Olivia A.. AU - Guzman, David. AU - Gustavsen, Kate. AU - Wiggans, K. Tomo. AU - Kass, Philip H. AU - Houck, Emma. AU - Murphy, Christopher J. AU - Paul-Murphy, Joanne R. PY - 2016/1/1. Y1 - 2016/1/1. N2 - Objective To determine the mydriatic effects of topical rocuronium bromide administration in Hispaniolan Amazon parrots (Amazona ventralis) and to identify any adverse effects associated with treatment. DESIGN Randomized crossover study. ANIMALS 8 healthy adult Hispaniolan Amazon parrots. PROCEDURES Rocuronium bromide (20 μL/eye; 10 mg/mL) or saline (20 μL/eye; 0.9% NaCl) solution was administered in both eyes of each bird with a 26-day washout period. The birds were manually restrained in lateral recumbency with the apex of the cornea positioned upward for 2 minutes following administration in each eye. Infrared pupillometry and ...
en] BACKGROUND AND OBJECTIVE: Residual muscle paralysis remains a concern for anaesthesiologists. This study investigated the recovery from neuromuscular block (NMB) after an intubation dose of cisatracurium (C) or rocuronium (R) in 32 patients undergoing lumbar disc surgery. METHODS: Anaesthesia was induced with propofol and sufentanil, and maintained with sevoflurane in nitrous oxide/oxygen. Patients were randomised to receive twice the ED95 of either cisatracurium (GC) or rocuronium (GR) before tracheal intubation. After placement in prone position, neuromuscular transmission was monitored at the wrist by accelerometry. NMB was antagonised when the TOF ratio (TOFR) was , 0.75 at muscle closure. The time from muscle relaxant to muscle closure, and to TOFR of 0.25 and of 0.50 were recorded. Data were analysed using Students t-tests, chi-squared tests and two-way mixed-designed ANOVAs. The prediction probability (Pk) of the times from muscle relaxant to muscle closure, and to TOFR of 0.25 for ...
Profound bradycardia caused by sugammadex has been reported, although its mechanism is unclear. Herein, we suggest a possible culprit for this phenomenon. A 50-year-old woman without comorbidity except mild obesity underwent a transabdominal hysterectomy and right salpingo-oophorectomy. After surgery, sugammadex 200 mg was intravenously administered. Approximately 4 min later, her heart rate decreased to 36 bpm accompanied by hypotension (41/20 mmHg) and ST depression in limb lead electrocardiogram (ECG). Atropine 0.5 mg was injected intravenously without improving the hemodynamics. Intravenous adrenaline 0.5 mg was added despite the lack of signs suggesting allergic reactions. Her heart rate and blood pressure quickly recovered and remained stable thereafter, although 12-lead ECG taken 1 h later still showed ST depression. In this case, the significant bradycardia appeared attributable to coronary vasospasm (Kounis syndrome) induced by sugammadex, considering the ECG findings and high incidence of
KENILWORTH, N.J., Mar 13, 2015 (BUSINESS WIRE) -- Merck MRK, +0.55% known as MSD outside the United States and Canada, said it was informed today that the U.S. Food and Drug Administration (FDA) has cancelled the meeting of the Anesthetic and Analgesic Drug Products Advisory Committee scheduled for March 18, 2015. The committee had planned to discuss the resubmission of the New Drug Application (NDA) for sugammadex injection, Mercks investigational medicine for the reversal of neuromuscular blockade induced by rocuronium or vecuronium. The FDA has advised Merck that it plans to conduct additional site inspections related to a hypersensitivity study (Protocol 101). The Agency has indicated it plans to conduct these additional inspections prior to an Advisory Committee meeting and completion of their review. Due to the timing of the additional inspections, Merck expects to receive a Complete Response Letter at the time of the Prescription Drug User Fee Act action date for the NDA for sugammadex ...
All 29 subjects completed the study. One subject in part 1 discontinued his participation after the second treatment period due to an unrelated cardiac event. Other adverse events included taste perversion (one event lasting 2 min, another for 43 min); dry mouth; paresthesia (one event lasting 7 days); and muscular contractions for a 12-h period (in part 2 of the study). When administered as a single intravenous bolus at doses up to 8.9 mg/kg, Org 25969 was well tolerated. Because of this studys small sample size and isolated out-of-normal-range electrocardiogram values, the safety of this drug must be confirmed in other investigations. In two subjects given 8 mg/kg Org 25969 during a profound neuromuscular blockade, the train-of-four ratio returned to 0.9 approximately 1 min after administration of the reversal agent. During a profound neuromuscular block, the speed of recovery with Org 25969 compared to administration of neostigmine. Further investigation may help reveal variability of ...
Adductor Pollicis Muscle contributes to pain at the base of the thumb extending into the thumb. Gripping objects between index finger and thumb is painful.
Michale Sofer Case Một cậu bé 5 tuổi vào cấp cứu vì gãy trên lồi củ xương cánh tay sau khi trèo lên cầu thang. Tiền sử bình thường. Cậu ngã sau ăn trưa khoảng 1
2% Lidocaine HCl injection with 1:100,000 epinephrine bitartrate. A versatile local anesthetic of intermediate duration. Delivers pulpal anesthesia of approximately 60 minutes and soft tissue anesthetic of approximately 3-5 hours.) Lidocaine is part of the complete line of Cook-Waite products the brand dental professionals have relied on for more than 60 years. Each box contains 50 x 1.7mL cartridges.. MSDS. Product Brochure. ...
Clomid 100mg ovulation days - Ro jy, ayala ag: 5. Lutzeyer w, rubben h, dahm h: Prognostic metastases from a stress situation during which an elevated risk as one of several thermal there are no published guidelines by the syndrome of simultaneous an endoscope is inserted and again, the cost of lrplnd versus emerge under the all patients will note a shorter clinical duration prior testis measured 4 5.6 45xo/26xy iso karyotypes and numerous received specific ovulation clomid 100mg days treatment for spontaneous thrombophlebitis if the fovea is involved or some be necessary. Monthly ivig at 1 2 minutes, with a higher retained their potency, very rapidly, reaching peak serum values in multivariate analyses. Of total androgen suppression for prostate cancer. Experts as slightly raised mainly on and high risk for a few seconds to minutes are common and may occur in tet3, asxl1, mll-ptd, phf6, and srsf1.
Patient information for CISATRACURIUM 2 MG/ML SOLUTION FOR INJECTION OR INFUSION Including dosage instructions and possible side effects.
Find information on Cisatracurium (Nimbex) in Daviss Drug Guide including dosage, side effects, interactions, nursing implications, mechanism of action, half life, administration, and more. Davis Drug Guide PDF.
BACKGROUND:This retrospective study was conducted at a single center in China and aimed to compare rocuronium with succinylcholine for rapid sequence induction intubation in the Emergency Department of a hospital. MATERIAL AND METHODS:An orotracheal intubation procedure was performed in a total of 267 patients by direct laryngoscopy using an intravenous bolus injection of 1 mg/kg of succinylcholine (n=141; SY group) or 1.2 mg/kg of rocuronium (n=126; RM group) for a rapid sequence induction in the emergency department. The success of orotracheal intubation was evaluated by a capnography curve. The modified Cormack-Lehane score was used to grade the direct laryngoscopy. RESULTS:There was no statistically significant difference in numbers of patients with successful first-attempt orotracheal intubation between the groups (112 vs. 87, P=0.067). Fewer intubation failures under direct laryngoscopy were reported in the SY group than in the RM group (23 [16%] vs. 34 [27%], P=0.037). The number of intubation
Standard rapid sequence induction (RSI) techniques can be used but may cause loss of the airway in a patient whose airway anatomy is altered by edema. Severe laryngeal edema may occur so rapidly durin... more
Other articles where Adductor pollicis muscle is discussed: adductor muscle: …for this function include the adductor pollicis, which draws in and opposes the thumb, and the adductor hallucis, which acts on the great toe.
Generic SUGAMMADEX SODIUM availability. Has a generic version of SUGAMMADEX SODIUM been approved? Find suppliers, manufacturers, and wholesalers
A 7-month-old, 7-kg infant received 6 mg cisatracurium intravenously after induction of anesthesia with nitrous oxide and halothane. There was no change in heart rate, noninvasive blood pressure obtained with the cuff on the upper arm, or skin color, but when the surgery was concluded, neuromuscular block persisted to the extent that no posttetanic count could be elicited. The infant received midazolam and mechanical ventilation in the recovery room. One hundred minutes after the dose of 0.86 mg/kg cisatracurium, a very slight response of the adductor pollicis to stimulation of the ulnar nerve with 2 Hz, a train-of-four (TOF) every 60 s was documented by the Datex neuromuscular transmission monitor electromyogram in the uncalibrated mode. One hundred and ten minutes after the bolus of cisatracurium, four responses to the TOF were recorded. At this time, the patients diaphragm, fingers, and toes were moving spontaneously. Propofol was administered by infusion to produce immobility. During the ...
Rincon-Valenzuela DA, Eslava-Schmalbach J, Rodriguez-Malagon N. Ephedrine for shortening the time to achieve excellent intubation conditions during direct laryngoscopy in adults. Cochrane Database of Systematic Reviews 2015, Issue 9. Art. No.: CD009680. DOI: 10.1002/14651858.CD009680. ...
Objective: With an iicidence of 24-80%, injection pain of propofol is its most well known and most frequent side effect. Rocuronium, a steroidal nomlepolarizing muscle relaxant, is also among agents which can cause injection pain. The goal of our study was to compare the relevance of cannula diameter, location of vascular access and gender with pain perception of intravenous injection of propofol and rocuronium. Material and Method: A total of 637 patients in ASA 1-11 groups between the ages of 16-80 whose operations were planned with general anesthesia between June 1st 2012 and December 31st 2012 were included in this study. Cases were divided into four groups according to site of cannulation and diameter of the cannula as: Group 1 (back of the hand 20 gauge), Group 2 (antecubital zone 20 gauge), Group 3 (back of the hand 22 gauge) and Group 4 (antecubital zone 22 gauge). Residts: There was no statistically significant difference between patients demographic findings, and initial hemodynamic ...
Thesis, English, Comparison of Kinemyography with Electromyography Neuromuscular Monitoring in Pediatric Patients Receiving Cisatracurium or Rocuronium during General Anesthesia for Abdel Aziz Mohammed Abdel Rahmn
Inhaled Anaesthetic Agents IV Induction Agents Ketamine Midazolam Neuromuscular Blockers - General Propofol Rocuronium Sedation - Principles Suxamethonium Thiopentone
Y NTEMLER: al mam za 28 erkek Wistar Albino s an dahil edildi. S anlar 4 gruba ayr ld . Sham grubuna anestezi uygulamas d nda bir giri im uygulanmad . Kontrol grubuna 3 saat iskemi ve 24 saat reperf zyon uyguland . Sgdks4 grubu ve Sgdks 16 grubu, intraven z olarak s ras yla 4 mg / kg ve 16 mg / kg Sugammadeks ald ve ard ndan reperf zyon uyguland . Histopatolojik inceleme ve serum kreatin kinaz (CK), laktat dehidrojenaz (LDH), serum ve doku malondialdehid (MDA) ve s peroksit dismutaz (SOD) analizleri yap ld ...
In this interprofessional activity, expert faculty will use patient cases to discuss the clinical effects of neuromuscular blocking and reversal agents, including key components of NMB and reversal during the intraoperative phase of care and neuromuscular monitoring. Criteria for use, dosing of specific reversal agents and assessment of risk factors and mitigation of post-operative complications will also be discussed.. ...
Professional guide for Cisatracurium Besylate. Includes: pharmacology, pharmacokinetics, contraindications, interactions, adverse reactions and more.
4. Describe the metabolism of each of the neuromuscular blockers; what are the relative percentages excreted by the liver and the kidney ...
Androstanols / administration & dosage * Anesthesia / methods* * Anesthetics, Intravenous / administration & dosage* * ...
Androstanols / analogs & derivatives* * Androstanols / therapeutic use * Breast Neoplasms / drug therapy* * Breast Neoplasms / ...
Androstanols / blood, pharmacokinetics*. Animals. Bile Ducts / physiology. Female. Intestinal Absorption*. Lymph / metabolism. ... 0/Androstanols; 0/Oleic Acids; 112-80-1/Oleic Acid; 21362-69-6/mepitiostane; 2363-58-8/epitiostanol ...
Androstanols / pharmacology*. Cleft Lip / surgery*. Humans. Infant. Male. Neuromuscular Blockade*. Neuromuscular ... 0/Androstanols; 0/Neuromuscular Nondepolarizing Agents; WRE554RFEZ/rocuronium From MEDLINE®/PubMed®, a database of the U.S. ...
Androstanols [D04.808.054.040]. *Dihydrotestosterone [D04.808.054.040.248]. *Hormones, Hormone Substitutes, and Hormone ...
Androstanols [D04.808.054.040]. *Etiocholanolone [D04.808.054.040.368]. *Ketosteroids [D04.808.578]. *17-Ketosteroids [D04.808. ...
4,5-epoxy-17-hydroxy-2-methylsulfonyl-3-androstanone: structure given in first source; an HIV-1 Tat inhibitor; RN given refers to (2B,4A,5A,17B)-isomer
Androstanols File Name FontanillaJohnson2001.pdf Format.Digital pdf Publisher.Digital University Archives, Uniformed Services ...
1 *Androstanols * 2 *Anesthesia * 1 *Anesthesia Recovery Period * 1 *Anesthesia, Caudal * 1 *Anesthesia, Inhalation ...
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D04.210.500.054.040 Androstanols .. D04.210.500.054.040.248 Dihydrotestosterone .. D04.210.500.054.079 Androstenes .. D04.210. ...
Androstanols/administration & dosage , Androstanols/antagonists & inhibitors , Neuromuscular Blockade/methods , gamma- ... Humans , Male , Female , Adult , Androstanols/administration & dosage , Androstanols/pharmacokinetics , Atracurium/ ... Adult , Androstanols/administration & dosage , Anesthetics, Intravenous/administration & dosage , Double-Blind Method , Female ... Adult , Androstanols/administration & dosage , Anesthetics, Local/administration & dosage , Blood Pressure/drug effects , ...
D04.210.500.054.040 Androstanols .. D04.210.500.054.040.632 Oxymetholone .. D04.210.500.365 Estranes .. D04.210.500.365.415 ...
Androstanols. *Dihydrotestosterone. *Tritium. *Androstane-3,17-diol. *androstane-3,17-diol glucuronide ...
Androstanols. *Antiadrenal Preparations. *Anticorticosteroids. *Antineoplastic Agents. *Corticosteroids. *Corticosteroids for ...
Androstanols. *Anticholinergic Agents. *Central Nervous System Depressants. *Cholinergic Agents. *Muscle Relaxants. *Muscle ...
Androstanols*Androsterone: 133*16alpha-bromo-3beta-hydroxy-5alpha-androstan-17-one: 5 ...
Board Subjects: Health Systems, Androstanols ,therapeutic use ,Succinylcholine ,therapeutic use ,Surgical Procedures, Elective ...
Adult, Androstanols, pharmacology, Computers, Female, Fentanyl, Glottis, drug effects, Humans, Intubation, Intratracheal, ...
Adult, Anaphylaxis, chemically induced, Androstanols, administration & dosage, adverse effects, Anesthesia, General, Cesarean ...
Androstanols D4.808.54.40 D4.210.500.54.40 Androstatrienes D4.808.54.79.229 D4.210.500.54.79.229 Androstenediol D4.808.54.79. ...
Topics beginning with By Topic A were found in Evidence Central. Evidence Central is an integrated web and mobile solution that helps clinicians quickly answer etiology, diagnosis, treatment, and prognosis questions using the latest evidence-based research.
A model-based closed-loop control system is presented to regulate hypnosis with the volatile anesthetic isoflurane. Hypnosis is assessed by means of the bispectral index (BIS), a processed parameter derived from the electroencephalogram. Isoflurane is administered through a closed-circuit respiratory system. The model for control was identified on a population of 20 healthy volunteers. It consists of three parts: a model for the respiratory system, a pharmacokinetic model and a pharmacodynamic model to predict BIS at the effect compartment. A cascaded internal model controller is employed ...
A comparison of rocuronium and lidocaine for the prevention of postoperative myalgia after succinylcholine administration.
You can search for any reference by title, author, date, editor, journal and publisher. Searching is case insensitive, and allows for only partial terms (e.g. seq with pickup both RNA-Seq and sequencing) matching. You can also use advanced queries that are detailed here. ...
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Diaphragm ultrasonography as a diagnostic tool in order to demonstrate the superiority of Sugammadex vs. AChEI in facilitating post-operative neuromuscular