Neuromuscular Nondepolarizing Agents
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.
Pancuronium
Vecuronium Bromide
Monoquaternary homolog of PANCURONIUM. A non-depolarizing neuromuscular blocking agent with shorter duration of action than pancuronium. Its lack of significant cardiovascular effects and lack of dependence on good kidney function for elimination as well as its short duration of action and easy reversibility provide advantages over, or alternatives to, other established neuromuscular blocking agents.
Atracurium
Neuromuscular Blocking Agents
Drugs that interrupt transmission of nerve impulses at the skeletal neuromuscular junction. They can be of two types, competitive, stabilizing blockers (NEUROMUSCULAR NONDEPOLARIZING AGENTS) or noncompetitive, depolarizing agents (NEUROMUSCULAR DEPOLARIZING AGENTS). Both prevent acetylcholine from triggering the muscle contraction and they are used as anesthesia adjuvants, as relaxants during electroshock, in convulsive states, etc.
Androstanols
Succinylcholine
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.
Tubocurarine
Neuromuscular Depolarizing Agents
Neostigmine
Edrophonium
Gallamine Triethiodide
A synthetic nondepolarizing blocking drug. The actions of gallamine triethiodide are similar to those of TUBOCURARINE, but this agent blocks the cardiac vagus and may cause sinus tachycardia and, occasionally, hypertension and increased cardiac output. It should be used cautiously in patients at risk from increased heart rate but may be preferred for patients with bradycardia. (From AMA Drug Evaluations Annual, 1992, p198)
Isoquinolines
Dimethylphenylpiperazinium Iodide
Neuromuscular Blockade
The intentional interruption of transmission at the NEUROMUSCULAR JUNCTION by external agents, usually neuromuscular blocking agents. It is distinguished from NERVE BLOCK in which nerve conduction (NEURAL CONDUCTION) is interrupted rather than neuromuscular transmission. Neuromuscular blockade is commonly used to produce MUSCLE RELAXATION as an adjunct to anesthesia during surgery and other medical procedures. It is also often used as an experimental manipulation in basic research. It is not strictly speaking anesthesia but is grouped here with anesthetic techniques. The failure of neuromuscular transmission as a result of pathological processes is not included here.
Thiopental
Nitrous Oxide
Nicotinic Antagonists
Anesthesia
Muscle Contraction
Acetylcholine
Receptors, Nicotinic
One of the two major classes of cholinergic receptors. Nicotinic receptors were originally distinguished by their preference for NICOTINE over MUSCARINE. They are generally divided into muscle-type and neuronal-type (previously ganglionic) based on pharmacology, and subunit composition of the receptors.
Dose-Response Relationship, Drug
Coronary Artery Bypass
Premedication
Coronary Artery Bypass, Off-Pump
Coronary Artery Disease
Preanesthetic Medication
Influence of atracurium on the diaphragm mean action potential conduction velocity in canines. (1/520)
BACKGROUND: It has been shown that progressive neuromuscular blockade (NMB) affects the electromyogram power spectrum and compound muscle action potential duration in skeletal muscle. These measures are linked to the mean muscle action potential conduction velocity (APCV), but no studies have confirmed a relation between the mean APCV and NMB. The aim of this study was to determine whether diaphragm mean APCV is affected by NMB. METHODS: The effects of NMB on diaphragm mean APCV were evaluated in five mongrel dogs. Progressive NMB was induced by slow intravenous infusion of atracurium. During spontaneous breathing, the diaphragm mean APCV was determined by electromyogram signals, in the time and frequency domains. The magnitude of NMB was quantified by the amplitude of the compound muscle action potential and by changes in muscle shortening during supramaximal stimulation of the phrenic nerve. RESULTS: Progressive NMB was associated with a decrease in diaphragm mean APCV. At approximately 70% reduction in the compound muscle action potential amplitude, diaphragm mean APCV had decreased more than 20%. Recovery after NMB was characterized by a restoration of the mean APCV to control values. CONCLUSION: This study shows that progressive NMB paralyzes motor units within the diaphragm in an orderly manner, and the blockade first affects muscle fibers with high APCV before it affects fibers with lower APCV. (+info)Neostigmine with glycopyrrolate does not increase the incidence or severity of postoperative nausea and vomiting in outpatients undergoing gynaecological laparoscopy. (2/520)
We studied 100 healthy women undergoing outpatient gynaecological laparoscopy in a randomized, double-blind and placebo-controlled study to evaluate the effect of neostigmine on postoperative nausea and vomiting (PONV). After induction of anaesthesia with propofol, anaesthesia was maintained with sevoflurane and 66% nitrous oxide in oxygen. Mivacurium was used for neuromuscular block. At the end of anaesthesia, neostigmine 2.0 mg and glycopyrrolate 0.4 mg, or saline, was given i.v. The incidence of PONV was evaluated in the postanaesthesia care unit, on the ward and at home. The severity of nausea and vomiting, worst pain, antiemetic and analgesic use, times to urinary voiding and home readiness were recorded. During the first 24 h after operation, 44% of patients in the neostigmine group and 43% in the saline group did not have PONV. We conclude that neostigmine with glycopyrrolate did not increase the occurrence of PONV in this patient group. (+info)Effects of an intubating dose of succinylcholine and rocuronium on the larynx and diaphragm: an electromyographic study in humans. (3/520)
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)Factors affecting the pharmacokinetic characteristics of rapacuronium. (4/520)
BACKGROUND: Rapacuronium is a new nondepolarizing muscle relaxant with rapid onset and offset. As part of a study to determine its neuromuscular effects, the authors sampled plasma sparsely to determine the influence of age, gender, and other covariates on its pharmacokinetic characteristics. METHODS: Of 181 patients receiving a single bolus dose of 0.5-2.5 mg/kg rapacuronium, 43 (aged 24-83 yr) had plasma sampled 3 or 4 times to determine plasma concentrations of rapacuronium and its metabolite, ORG9488. Pharmacokinetic analysis was performed using a population approach (mixed-effects modeling) to determine the influence of demographic characteristics and preoperative laboratory values on the pharmacokinetic parameters. RESULTS: Rapacuronium's weight-normalized plasma clearance was 7.03 x (1 - 0.0507 x (HgB - 13)) ml x kg(-1) x min(-1), where HgB is the patient's preoperative value for hemoglobin (g/100 ml); however, rapacuronium's blood clearance (11.4+/-1.4 ml x kg(-1) x min(-1), mean +/- SD) did not vary with hemoglobin. Rapacuronium's weight-normalized pharmacokinetic parameters were not influenced by age, gender, or other covariates examined. Plasma concentrations of ORG9488 were typically less than 14% those of rapacuronium during the initial 30 min after rapacuronium administration. CONCLUSIONS: In this patient population, neither age nor gender influence elimination of rapacuronium. This finding contrasts to an age-related decrease in plasma clearance observed in a study of 10 healthy volunteers and in a pooled analysis of the pharmacokinetic data from 206 adults in multiple clinical studies. Even if ORG9488 has a potency similar to that of rapacuronium, its plasma concentrations after a single bolus dose of rapacuronium are sufficiently small to contribute minimally to neuromuscular blockade. (+info)Antagonism of vecuronium-induced neuromuscular block in patients pretreated with magnesium sulphate: dose-effect relationship of neostigmine. (5/520)
We have investigated the dose-effect relationship of neostigmine in antagonizing vecuronium-induced neuromuscular block with and without magnesium sulphate (MgSO4) pretreatment. Neuromuscular block was assessed by electromyography with train-of-four (TOF) stimulation. First, we determined neostigmine-induced recovery in patients pretreated with MgSO4 (group A) or saline (group B) (n = 12 each). The height of T1, 5 min after neostigmine, was 43 (7)% in group A and 65 (6)% in group B (P < 0.01). Respective values after 10 min were 59 (7)% and 83 (5)% (P < 0.01). TOF ratio, 5 min after neostigmine, was 29 (6)% in group A and 29 (5)% in group B. Respective values after 10 min were 38 (11)% and 51 (7)% (P < 0.01). To gain insight into the mechanisms leading to delayed recovery after MgSO4, we calculated assisted recovery, defined as neostigmine-induced recovery minus mean spontaneous recovery. Spontaneous recovery was assessed in another 24 patients. Patients in group C received MgSO4/vecuronium and patients in group D vecuronium only (n = 12 each). Five minutes after neostigmine, assisted recovery was 22 (7)% in the MgSO4 pretreated patients and 28 (6)% in controls (P < 0.05). Ten minutes after neostigmine, values were 24 (7)% and 22 (6)%. Maximum assisted recovery was not influenced by MgSO4 pretreatment (27 (6)% in group A and 32 (6)% in group B) and time to maximum effect was comparable between groups: 6 (4-10) min and 7 (5-8) min, respectively. We conclude that neostigmine-induced recovery was attenuated in patients treated with MgSO4. This was mainly a result of slower spontaneous recovery and not decreased response to neostigmine. (+info)Augmentation of the rocuronium-induced neuromuscular block by the acutely administered phenytoin. (6/520)
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)Deep sedation and mechanical ventilation without paralysis for 3 weeks in normal beagles: exaggerated resistance to metocurine in gastrocnemius muscle. (7/520)
BACKGROUND: Patients in the intensive care unit may have muscle weakness in the recovery phase, and disuse atrophy may play a role in this weakness. To assess this problem, the authors measured changes in the potency of the nondepolarizing neuromuscular blocking agent metocurine in a canine model that involved 3 weeks of intensive care, nonparalyzing anesthesia with pentobarbital, and positive-pressure ventilation. METHODS: Six dogs were anesthetized with pentobarbital to a sufficient depth that spontaneous and reflex muscle movements were absent. Their tracheas were intubated, their lungs were mechanically ventilated, and they received round-the-clock intensive medical and nursing care for 3 weeks. Transduced gastrocnemius muscle responses to metocurine were determined weekly. A 4- to 15-min infusion of 148-4,300 microg/min (longer durations and greater concentrations on progressive weeks) yielded more than 80% paralysis. Serial metocurine plasma concentrations during the onset of the block and recovery provided data to determine pharmacokinetics using NONMEM. Metocurine plasma concentrations and the degree of paralysis were used to model the effect compartment equilibration constant, and the Hill equation was used to yield the slope factor and potency within the effect compartment. RESULTS: The metocurine effect compartment concentration associated with a 50% diminution of twitch height after 3 weeks was 1,716+/-1,208 ng/ml (mean +/- SD), which was significantly different from 257+/-34 ng/ml, the value on day 0. There were no pharmacokinetic differences. CONCLUSION: The absence of muscle tone and reflex responsiveness for 3 weeks was associated with exaggerated resistance to the neuromuscular blocker metocurine. (+info)Early reversal of rapacuronium with neostigmine. (8/520)
BACKGROUND: Rapacuronium is a rapid-onset, short-acting neuromuscular relaxant. This multiple-center study determined neuromuscular recovery when neostigmine was given 2 or 5 min after rapacuronium. METHODS: One hundred seventeen patients were randomized to receive two different doses of rapacuronium and to receive neostigmine in two different doses and at two different times. During propofol anesthesia with nitrous oxide, oxygen, and fentanyl, 1.5 or 2.5 mg/kg rapacuronium was given 1 min before tracheal intubation. Neuromuscular block was measured by train-of-four ulnar nerve stimulation every 12 s: The adductor pollicis force of contraction was recorded mechanomyographically. Two or five minutes after rapacuronium was administered, 0.05 or 0.07 mg/kg neostigmine was administered and recovery was compared with that of control patients who received no neostigmine. RESULTS: Both doses of rapacuronium produced 100% block in all but one patient, who exhibited 97% block. Neostigmine accelerated recovery in all groups. After 1.5 mg/kg rapacuronium, the time to 25% T1 twitch recovery decreased from a mean of 16 min in control patients to mean values of 8-10 min in the treatment groups: The time to train-of-four ratio of 0.7 decreased from 38 min to 17-19 min. After 2.5 mg/kg rapacuronium, the time to 25% T1 was reduced from 23 min to 11-12 min, and the time to train-of-four ratio of 0.7 decreased from 54 min to 26-32 min. Recovery was not different among the the groups that received different doses and timing of neostigmine. CONCLUSIONS: Recovery of intense rapacuronium block was accelerated by early neostigmine administration. When given 2 min after rapacuronium, neostigmine was as effective as after 5 min, and 0.05 mg/kg neostigmine was comparable to 0.07 mg/kg neostigmine. (+info)
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Dihydrochandonium
... is an aminosteroid non-depolarizing neuromuscular blocking agent. Fitzal, S; Ilias, W; Kalina, K; Schwarz, S ... Foldes, FF; Steinbereithner, K (1982). "Neuromuscular and cardiovascular effects of Duador, a new short-acting nondepolarizing ... Neuromuscular blockers, All stub articles, Steroid stubs, Musculoskeletal system drug stubs). ...
Tubocurarine chloride
In this sense, tubocurarine is the prototypical adjunctive neuromuscular non-depolarizing agent. However, others before ... "d-Tubocurarine (Prototype Nondepolarizing Neuromuscular Blocker)". Tulane University. Retrieved 4 May 2015. Bowman WC, Webb SN ... hypnotic and neuromuscular blocking agents, and tracheal intubation, as well as monitoring techniques that were nonexistent in ... a long-acting neuromuscular blocking agent". The Journal of Pharmacology and Experimental Therapeutics. 118 (4): 395-406. PMID ...
Dantrolene
Nondepolarizing neuromuscular blocking agents, such as vecuronium bromide: Neuromuscular blockade is potentiated. CNS ... or proper neuromuscular balance If the indication is a medical emergency, such as malignant hyperthermia, the only significant ...
Alcuronium chloride
Hughes R, Chapple DJ (1976). "Effects of Non-Depolarizing Neuromuscular Blocking Agents on Peripheral Autonomic Mechanisms in ... Alcuronium chloride (formerly marketed as Alloferin) is a neuromuscular blocking (NMB) agent, alternatively referred to as a ... a very long acting neuromuscular blocking agent For a formal definition of the durations of actions associated with NMB agents ... "The Mode of Action of Quaternary Ammonium Type Neuromuscular Blocking Agents". Br. J. Anaesth. 26 (6): 394-398. doi:10.1093/bja ...
Neuromuscular blocking agents
In small clinical doses, nondepolarizing neuromuscular blocking agent act predominantly at the nicotinic receptor site to ... Neuromuscular blocking agents, or in abbreviation, NMBAs, are chemical agents that paralyse skeletal muscles by blocking the ... Neuromuscular blocking agents exert its effect by modulating the signal transmission in skeletal muscles. An action potential ... "Clinical use of neuromuscular blocking agents in anesthesia". UpToDate. Retrieved 20 April 2020. Katzung, Bertram G. (2011). ...
MRGPRX2
Agonists are gyrase inhibitors like ciprofloxacin and non-depolarizing neuromuscular blocking agents like atracurium as well as ...
Tetanic fade
Non-depolarizing neuromuscular blocking agents (ie Rocuronium, Vecuronium) interact with Ach receptor without activating the ... A some data suggest that this response is due to effect of non-depolarizing neuromuscular blocking agents on the presynaptic ... In tissue under a non-depolarizing neuromuscular blocking agent greatly diminished the levels of Ach that are released into the ... Muscle tissue treated with a non-depolarizing neuromuscular blocking agents will produce an indicative response in the form of ...
Rapid sequence induction
Neostigmine - It can be used to reverse nondepolarizing neuromuscular blocking agents which cannot be reversed with Sugammadex ... Administration of induction agents followed by neuromuscular blockade agents helps to achieve optimal conditions for intubation ... Another possible complication is anaphylaxis in response to a neuromuscular blockade. Neuromuscular blockade agents are ... The neuromuscular blocking agents paralyze all of the skeletal muscles, most notably and importantly in the oropharynx, larynx ...
Lethal injection
... non-depolarizing neuromuscular blocking agents like pancuronium stop this binding from taking place The typical dose for ... The combination of a barbiturate induction agent and a nondepolarizing paralytic agent is used in thousands of anesthetics ... is a non-depolarizing muscle relaxant (a paralytic agent) that blocks the action of acetylcholine at the motor end-plate of the ... a triple intravenous dose of a nondepolarizing neuromuscular muscle relaxant is given, such as 20 mg pancuronium bromide or 20 ...
Laudexium metilsulfate
Neuromuscular+blocking+agents at the US National Library of Medicine Medical Subject Headings (MeSH) (Drugs with non-standard ... As with all clinically established (as well as experimental agents) with a non-depolarizing mechanism of action, its ... Laudexium metilsulfate is a neuromuscular blocking drug or skeletal muscle relaxant in the category of non-depolarizing ... Taylor EP (1952). "Synthetic neuromuscular blocking agents. Part II. Bis(quaternary ammonium salts) derived from laudanosine". ...
Mivacurium chloride
Like other non-depolarizing neuromuscular blocking agents, the pharmacological action of mivacurium is antagonism to nicotinic ... to synthesize potent non-depolarizing agents with pharmacophores derived from cross-combinations of the non-depolarizing agent ... non-depolarizing neuromuscular-blocking drug or skeletal muscle relaxant in the category of non-depolarizing neuromuscular- ... an ultra-short-acting nondepolarizing ester neuromuscular blocking agent". Anesthesiology. 53 (3): S274. doi:10.1097/00000542- ...
Atracurium besilate
Neuromuscular-blocking agents can be classified in accordance to their duration of pharmacological action, defined as follows: ... Atracurium is in the neuromuscular-blocker family of medications and is of the non-depolarizing type. It works by blocking the ... Neuromuscular+blocking+agents at the US National Library of Medicine Medical Subject Headings (MeSH) "Atracurium besilate". ... Stenlake JB, Waigh RD, Urwin J, Dewar GH, Hughes R, Chapple DJ (1981). "Biodegradable neuromuscular blocking agents. Part 3. ...
Pancuronium bromide
"Steroidal monoquaternary ammonium salts with non-depolarizing neuromuscular blocking activity". Journal of Pharmacy and ... "Pancuronium bromide and other steroidal neuromuscular blocking agents containing acetylcholine fragments". Journal of Medicinal ... "Administration and Compounding Of Euthanasic Agents". The Hague: Royal Dutch Society for the Advancement of Pharmacy. Archived ... It competitively inhibits the nicotinic acetylcholine receptor at the neuromuscular junction by blocking the binding of ...
Doxacurium chloride
... and it is classified as a long-duration non-depolarizing neuromuscular blocking agent in a class of compounds commonly and most ... potent non-depolarizing agents with pharmacophoric elements derived from cross-combinations of the non-depolarizing agent, ... is a neuromuscular-blocking drug or skeletal muscle relaxant in the category of non-depolarizing neuromuscular-blocking drugs, ... In the 1950s and 1960s, the present-day concept of a neuromuscular blocking agent with a rapid onset and an ultra-short ...
Rapacuronium bromide
As a non-depolarizing agent it did not cause initial stimulation of muscles before weakening them. Due to risk of fatal ... Rapacuronium bromide (brand name Raplon) is a rapidly acting, non-depolarizing aminosteroid neuromuscular blocker formerly used ... Neuromuscular blockers, All stub articles, Musculoskeletal system drug stubs). ...
Candocuronium iodide
Neuromuscular+blocking+agents at the US National Library of Medicine Medical Subject Headings (MeSH) (CS1 errors: missing title ... The discovery program initiated by Singh initially led to the synthesis of the bis-quaternary non-depolarizing agent HS-342 (4, ... As with other neuromuscular blocking agents, candocuronium preferentially antagonizes competitively the nicotinic subtype of ... The discovery of candocuronium led to numerous related neuromuscular blocking agents with short durations of action but also ...
Malignant hyperthermia
... muscle weakness and prolonged duration of action of nondepolarizing neuromuscular blocking agents), experts no longer recommend ... Exposure to triggering agents (certain volatile anesthetic agents or succinylcholine) can lead to the development of MH in ... they have few or no symptoms unless they are exposed to a triggering agent. The most common triggering agents are volatile ... These signs can develop any time during the administration of the anesthetic triggering agents. Rarely, signs may develop up to ...
Cerebral edema
Pretreatment with a sedative agent and neuromuscular blocking agent to induce unconsciousness and motor paralysis has been ... Additionally, the use of nondepolarizing neuromusclar blocking agents (NMBA), such as doxacurium or atracurium, have been ... Depolarizing neuromuscular blocking agents, most notably succinylcholine, can worsen increased ICP due to induction of muscle ... An ideal osmotic agent produces a favorable osmotic pressure gradient, is nontoxic, and is not filtered out by the blood-brain ...
Muscle relaxant
Nondepolarizing agents, such as tubocurarine, block the agonist, acetylcholine, from binding to nicotinic receptors and ... Neuromuscular blockers act by interfering with transmission at the neuromuscular end plate and have no central nervous system ( ... Most neuromuscular blockers function by blocking transmission at the end plate of the neuromuscular junction. Normally, a nerve ... a nondepolarizing agent). The generation of the neuronal signals in motor neurons that cause muscle contractions is dependent ...
Rocuronium bromide
Of the Neuromuscular-blocking drugs it is considered to be a non-depolarizing neuromuscular junction blocker, because it acts ... Neostigmine can also be used as a reversal agent of rocuronium but is not as effective as sugammadex. Neostigmine is often ... Rocuronium bromide (brand names Zemuron, Esmeron) is an aminosteroid non-depolarizing neuromuscular blocker or muscle relaxant ... non-depolarizing neuromuscular blocking drugs). The γ-cyclodextrin derivative sugammadex (trade name Bridion) has been recently ...
Neuromuscular-blocking drug
A neuromuscular non-depolarizing agent is a form of neuromuscular blocker that does not depolarize the motor end plate. The ... Non-depolarizing blocking agents: These agents constitute the majority of the clinically relevant neuromuscular blockers. They ... Neuromuscular+Nondepolarizing+Agents at the US National Library of Medicine Medical Subject Headings (MeSH) Raghavendra, T. ( ... It is recommended during use of continuous-infusion neuromuscular blocking agents in intensive care. The effect of non- ...
Postoperative residual curarization
Non-depolarizing NMBAs are classified based on their duration of action (short, intermediate, or long-acting agents. The two ... in patients receiving intermediate neuromuscular blocking agents during anaesthesia. It is possible that > 100,000 patients ... It produces a neuromuscular blockade that is the fastest in onset and has the shortest duration of all NMBDs. Due to these ... Today residual neuromuscular blockade is defined as a train of four ratio of less than 0.9 when measuring the response to ulnar ...
Voluntary euthanasia
Then a triple intravenous dose of a non-depolarizing neuromuscular muscle relaxant is given, such as 20 mg pancuronium bromide ... Only for pancuronium bromide (Pavulon) are there substantial indications that the agent may also be given intramuscularly in a ... "Administration and Compounding of Euthanasic Agents". Archived from the original on 7 June 2008. Lundin, Leigh (April 2009). ...
Gantacurium chloride
... is a new experimental neuromuscular blocking drug or skeletal muscle relaxant in the category of non-depolarizing neuromuscular ... The clinical arena of neuromuscular blocking agents is a minefield of jargonistic language, and some definitions below help to ... In this sense, gantacurium is a first in its class non-depolarizing neuromuscular blocking drug to arguably challenge the ... With the exception of one other clinically tested agent, BW785U77, no other clinically administered neuromuscular blocking drug ...
List of MeSH codes (D27)
... neuromuscular depolarizing agents MeSH D27.505.696.663.700.710.575 - neuromuscular nondepolarizing agents MeSH D27.505.696.663. ... neuromuscular agents MeSH D27.505.696.663.700.600 - muscle relaxants, central MeSH D27.505.696.663.700.710 - neuromuscular ... antiviral agents MeSH D27.505.954.122.388.077 - anti-retroviral agents MeSH D27.505.954.122.388.077.088 - anti-hiv agents MeSH ... tocolytic agents MeSH D27.505.954.016 - anti-allergic agents MeSH D27.505.954.122 - anti-infective agents MeSH D27.505.954.122. ...
Sodium thiopental
... a triple dose of a non-depolarizing neuromuscular blocking drug is given, such as 20 mg pancuronium bromide (Pavulon) or 20 mg ... Its use has been largely replaced with that of propofol, but may retain some popularity as an induction agent for rapid- ... Royal Dutch Society for the Advancement of Pharmacy (1994). "Administration and Compounding of Euthanasic Agents". The Hague. ... Instead, anesthesia is usually maintained with an inhaled anesthetic (gas) agent. Inhaled anesthetics are eliminated relatively ...
Cisatracurium besilate
... is a bisbenzyltetrahydroisoquinolinium that has effect as a neuromuscular-blocking drug non-depolarizing neuromuscular-blocking ... "Biodegradable neuromuscular blocking agents. Part 6. Stereochemical studies on atracurium and related polyalkylene di-esters". ... risk to the use of cisatracurium in patients with liver or renal disease when compared with other neuromuscular-blocking agents ... which stood for excellent Neuromuscular blocker.[citation needed] In vitro studies using human plasma indicated that ...
Piperacillin
... prolonging neuromuscular transmission blockages created by non-depolarizing muscle relaxants, and disruptions in urine tests ... Antimicrobial Agents and Chemotherapy. 40 (4): 829-34. doi:10.1128/AAC.40.4.829. PMC 163214. PMID 8849235. Rice LB, Carias LL, ... Antimicrobial Agents and Chemotherapy. 23 (6): 881-7. doi:10.1128/aac.23.6.881. PMC 184992. PMID 6225390. Wise R, Logan M, ... Antimicrobial Agents and Chemotherapy. 41 (11): 2511-7. doi:10.1128/AAC.41.11.2511. PMC 164153. PMID 9371358. Ong CT, Kuti JL, ...
Anesthetic
... helps reverse the effects of non-depolarizing muscle relaxants Sugammadex, new agent that is designed to bind Rocuronium ... neuromuscular disease and paralyzed (quadriplegic, paraplegic) patients. The mechanism is reported to be through upregulation ... Halothane, an agent introduced in the 1950s, has been almost completely replaced in modern anesthesia practice by newer agents ... This concept refers to the relative solubility of a given agent in blood. Those agents with a lower blood solubility (i.e., a ...
Curare
The use of neuromuscular blocking drugs carries with it the risk of anesthesia awareness. There are dozens of plants from which ... In medicine, curare has been used as a treatment for tetanus or strychnine poisoning and as a paralyzing agent for surgical ... Curare is an example of a non-depolarizing muscle relaxant that blocks the nicotinic acetylcholine receptor (nAChR), one of the ... Used as a paralyzing agent by indigenous peoples in Central and South America for hunting and for therapeutic purposes, curare ...
Suxamethonium chloride
Lee C, Katz RL (March 2009). "Clinical implications of new neuromuscular concepts and agents: so long, neostigmine! So long, ... a non-depolarizing neuromuscular blocking drug, is also metabolized via the same route with a similar clinical effect in ... In people with neuromuscular disease or burns, an injection of suxamethonium can lead to a large release of potassium from ... Dubai authorities deem that the murder of Hamas operative Mahmoud al-Mabhouh was carried out on their soil by Mossad agents ...
Pyridostigmine
It is also used together with atropine to end the effects of neuromuscular blocking medication of the non-depolarizing type. It ... Pyridostigmine bromide has been FDA approved for military use during combat situations as an agent to be given prior to ... exposure to the nerve agent Soman in order to increase survival. Used in particular during the first Gulf War, pyridostigmine ...
Anticholinergic
... antimuscarinic agents, and antinicotinic agents (ganglionic blockers, neuromuscular blockers). The term "anticholinergic" is ... Nondepolarizing skeletal muscular relaxant Plants of the family Solanaceae contain various anticholinergic tropane alkaloids, ... Several are depolarizing agents. Examples of common anticholinergics: Antimuscarinic agents Antipsychotics (clozapine, ... such agents do not antagonize the binding at nicotinic acetylcholine receptors at the neuromuscular junction, although the term ...
Coronary Artery Bypass Grafting Medication: Anxiolytics, Benzodiazepines, Opioid Analgesics, Anesthetic Agents, Neuromuscular...
Neuromuscular Blockers, Nondepolarizing. Class Summary. Nondepolarizing neuromuscular blockers are used in combination with a ... Anesthetic Agents. Class Summary. After standard monitoring equipment is attached and peripheral venous access achieved but ... Like methohexital, it is most commonly used as an induction agent for intubation. To use thiopental as a sedative, titrate in ... It is used to facilitate endotracheal intubation and provide neuromuscular relaxation during intubation and mechanical ...
Coronary Artery Bypass Grafting Medication: Anxiolytics, Benzodiazepines, Opioid Analgesics, Anesthetic Agents, Neuromuscular...
Neuromuscular Blockers, Nondepolarizing. Class Summary. Nondepolarizing neuromuscular blockers are used in combination with a ... Anesthetic Agents. Class Summary. After standard monitoring equipment is attached and peripheral venous access achieved but ... Like methohexital, it is most commonly used as an induction agent for intubation. To use thiopental as a sedative, titrate in ... It is used to facilitate endotracheal intubation and provide neuromuscular relaxation during intubation and mechanical ...
Carbamazepine: Seizure Medication Side Effects & Dosage
Resistance to the neuromuscular blocking action of the nondepolarizing neuromuscular blocking agents. Closely monitor patients ... Neuromuscular blocking agents (e.g., pancuronium, vecuronium, rocuronium, and cisatracurium). ... for more rapid recovery from neuromuscular blockade than expected; infusion rate may need to be higher. ...
Clinical Guidelines for Diagnosis and Treatment of Botulism, 2021 | MMWR
Neuromuscular Blocking Agents. Any agent that can cause paralysis, including NMBAs, should either be avoided or be used after ... The nondepolarizing NMBAs, such as rocuronium, vecuronium, and pancuronium, block acetylcholine from binding to motor endplate ... Aminoglycosides act in vitro as neuromuscular blocking agents (NMBAs) and aggravate botulism anecdotally in several animal ... Neuromuscular paralysis in patients with botulism can result in respiratory failure by affecting the muscles that prevent ...
Exam 1 Flashcards
Electroconvulsive Therapy: Overview, Preparation, Technique
However, rocuronium and other nondepolarizing neuromuscular blockade agents can also be considered particularly when followed ... This agent is the most commonly administered neuromuscular blockade during the ECT procedure. ... Neuromuscular Blockade. Neuromuscular blockers are administered to prevent musculoskeletal complications (fractures or ... in which the circulation of the neuromuscular blocking agent is restricted from the hand or foot via a temporary tourniquet. ...
Octopus Envenomation Medication
DailyMed - CARBAMAZEPINE tablet
Resistance to the neuromuscular blocking action of the nondepolarizing neuromuscular blocking agents pancuronium, vecuronium, ... Whether or not carbamazepine has the same effect on other non-depolarizing agents is unknown. Patients should be monitored ... Agents That May Affect Carbamazepine Plasma Levels When carbamazepine is given with drugs that can increase or decrease ... Agents That Decrease Carbamazepine Levels CYP3A4 inducers can increase the rate of carbamazepine metabolism. Drugs that have ...
Clinical review: Critical illness polyneuropathy and myopathy | Critical Care | Full Text
Also, conflicting evidence concerning the neuromuscular effects of corticosteroids exists. A systematic review of the available ... Prolonged paralysis due to nondepolarizing neuromuscular blocking agents and corticosteroids. Muscle Nerve 1994, 17: 647-654. ... Many reports have found CIM to occur in patients treated with a combination of CSs and neuromuscular blocking agents (NMBAs). ... neuromuscular blocking agent; ROS, reactive oxygen species; SR, sarcoplasmatic reticulum. ...
Acetazolamide for Injection (acetazolamide) dose, indications, adverse effects, interactions... from PDR.net
Atracurium: (Moderate) Nondepolarizing neuromuscular blockers when combined with carbonic anhydrase inhibitors may lead to ... Central-acting adrenergic agents: (Moderate) The concomitant administration of diuretics with other antihypertensive agents can ... Cisatracurium: (Moderate) Nondepolarizing neuromuscular blockers when combined with carbonic anhydrase inhibitors may lead to ... Doxacurium: (Moderate) Nondepolarizing neuromuscular blockers when combined with carbonic anhydrase inhibitors may lead to ...
NEW STUDY: Aluminum Adjuvants IN VACCINES REACH BRAIN - Vaccine Liberation Army
... it is the active principle of curare and is a nondepolarizing neuromuscular blocking agent; used in the form of the chloride ... One has to ask…. why would anyone include a neuromuscular blocking agent in a vaccine? What possible use is a muscle relaxant ... to a so-called immunizing agent? I have no doubt that doing a search on the other ingredients would be just as shocking. This ...
MeSH Browser
POLARIZING was see NEUROMUSCULAR NONDEPOLARIZING AGENTS 1989-94; NEUROMUSCULAR NONDEPOLARIZING AGENTS & PACHYCURARES were see ... POLARIZING was see NEUROMUSCULAR NONDEPOLARIZING AGENTS 1989-94; NEUROMUSCULAR NONDEPOLARIZING AGENTS & PACHYCURARES were see ... Neuromuscular Depolarizing Agents [D27.505.696.663.700.710.550] * Neuromuscular Nondepolarizing Agents [D27.505.696.663.700.710 ... Peripheral Nervous System Agents [D27.505.696.663] * Neuromuscular Agents [D27.505.696.663.700] * Neuromuscular Blocking Agents ...
Internet Scientific Publications
0.9 in the preanesthetic period will have increased sensitivity to nondepolarizing neuromuscular blocking agents compared with ... An attempt to estimate neuromuscular blockade after the administration of non depolarizing relaxants to anaesthetized ... Myasthenic patients are sensitive to nondepolarizing relaxants but intermediate-acting nondepolarizing relaxants such as ... Neuro muscular monitoring was done throughout the surgery using Datex Ohmeda Aisys Carestation NMT Module. A train of four ...
Pharmacology - Neurology, Ophthalmology & Otology - Antispasmodic Agents for Medicine
Antispasmodic Agents for Medicine faster and easier with Picmonics unforgettable videos, stories, and quizzes! Picmonic is ... Nondepolarizing Neuromuscular Blocking Drugs. Names Include "Cur". Competitive Antagonists. Acetylcholine Competition. Reversal ... Neuromuscular Blocking Drugs. Motor Nicotinic Receptor. ACh Receptor Agonist. Depolarization. Phases of Action. Phase I ( ...
US Patent for Paralysis monitoring system Patent (Patent # 10,939,867 issued March 9, 2021) - Justia Patents Search
... an anesthesiologist may adjust subsequent doses of a paralytic agent to achieve a desired level of paralysis. ... As paralysis or paralytic agents-such as curare derivative agents or nondepolarizing agents-are administered, a neuromuscular ... A reversal agent or drug is typically a competitive antagonist that competes for a binding site. Thus, reversal agents are ... but within approximately 20-30 minutes the effects of the reversal agent can wear off. If the paralysis agent has not been ...
Practical approach to the patient with acute neuromuscular weakness
Patients treated with high doses of nondepolarizing neuromuscular blocking agents such as vecuronium and pancuronium may have ... and neuromuscular blocking agents have been reported to produce or potentiate neuromuscular weakness[30]. ... Key Words: Neuromuscular weakness, Paralysis, Approach, Nerve, Muscle Core tip: Acute neuromuscular paralysis is a clinical ... Neuromuscular manifestations of critical illness. Muscle Nerve. 2005;32:140-163. [PubMed] [DOI] [Cited in This Article: ] [ ...
NeuromuscularBlockingAgents(Nondepolarizing) - Tracrium, Nimbex | Davis's Drug Guide
Nondepolarizing) - Tracrium, Nimbex in Daviss Drug Guide including dosage, side effects, interactions, nursing implications, ... nondepolarizing_. Vallerand AHA, Sanoski CAC, Quiring CC. NEUROMUSCULAR BLOCKING AGENTS (nondepolarizing). Daviss Drug Guide. ... nondepolarizing_. Vallerand AHA, Sanoski CAC, Quiring CC. NEUROMUSCULAR BLOCKING AGENTS (nondepolarizing) [Internet]. In: ... "NEUROMUSCULAR BLOCKING AGENTS (nondepolarizing)." Daviss Drug Guide, 18th ed., F.A. Davis Company, 2023. Daviss Drug Guide - ...
UMEM Educational Pearls - University of Maryland School of Medicine, Department of Emergency Medicine
DI-fusion An analytical pharmacodynamic model for nondepolarizing...
Publications | Page 19 | Department of Anesthesiology
Fosphenytoin Sodium Injection Side Effects, Uses & Warnings | ClusterMed.info
... resistance to the neuromuscular blocking action of the nondepolarizing neuromuscular blocking agents has occurred in patients ... Whether or not phenytoin has the same effect on other non-depolarizing agents is unknown. Prevention or Management: Patients ... This can lead to loss of virologic response and possible resistance [see CONTRAINDICATIONS]. Neuromuscular blocking agents ... oxcarbazepine Antilipidemic agents Atorvastatin, fluvastatin, simvastatin Antiviral agents Efavirenz, lopinavir/ritonavir, ...
rocuronium bromide injection Clinical Studies
| Pfizer Medical Information - US
Rocuronium bromide injection is a nondepolarizing neuromuscular blocking agent with a rapid to intermediate onset depending on ... Drugs which may enhance the neuromuscular blocking action of nondepolarizing agents such as rocuronium bromide include certain ... Rocuronium bromide is a nondepolarizing neuromuscular blocking agent with a rapid to intermediate onset depending on... ... Overdosage with neuromuscular blocking agents may result in neuromuscular block beyond the time needed for surgery and ...
Sugammadex+Sodium - 505(b)(2) development and clinical trial profile - geography, conditions, sponsors
... administration of non-depolarizing neuromuscular blocking agents. The administration of conventional reversal agent neostigmine ... administration of non-depolarizing neuromuscular blocking agents. The administration of conventional reversal agent neostigmine ... A reversal agent is commonly given to improve neuromuscular function after intra-operative ... A reversal agent is commonly given to improve neuromuscular function after intra-operative ...
DeCS
Neuromuscular Nondepolarizing Agents Entry term(s). Agents, Curare-Like Agents, Neuromuscular Nondepolarizing Blockers, ... Agents, Curare-Like. Agents, Neuromuscular Nondepolarizing. Blockers, Nondepolarizing. Curare Like Agents. Curare-Like Agents. ... Neuromuscular Blocking Agents, Competitive Non-Depolarizing Muscle Relaxants Nondepolarizing Agents, Neuromuscular ... Neuromuscular Blocking Agents, Competitive. Non-Depolarizing Muscle Relaxants. Nondepolarizing Agents, Neuromuscular. ...
Vecuronium (Norcuron) | Davis's Drug Guide
Neuromuscular Blockade - Reversal of Neuromuscular Blockade. *NEUROMUSCULAR BLOCKING AGENTS (nondepolarizing). *etomidate. * ... Administration of anticholinesterase agents (neostigmine, pyridostigmine) may be used to antagonize the action of neuromuscular ... High Alert: Unplanned administration of a neuromuscular blocking agent instead of administration of the intended medication or ... Most neuromuscular blocking agents are incompatible with barbiturates and sodium bicarbonate. Do not admix. ...
Atracurium (Tracrium) | Davis's Drug Guide
neuromuscular blocking agents-nondepolarizing. Indications. *Induction of skeletal muscle paralysis and facilitation of ... Adequate anesthesia/analgesia should always be used when neuromuscular blocking agents are used as an adjunct to surgical ... High Alert: Unplanned administration of a neuromuscular blocking agent instead of administration of the intended medication or ... Most neuromuscular blocking agents are incompatible with barbiturates and sodium bicarbonate. Do not admix. ...
Cisatracurium (Nimbex) | Davis's Drug Guide
neuromuscular blocking agents-nondepolarizing. Indications. *Induction of skeletal muscle paralysis and facilitation of ... Adequate anesthesia/analgesia should always be used when neuromuscular blocking agents are used as an adjunct to surgical ... High Alert: Unplanned administration of a neuromuscular blocking agent instead of administration of the intended medication or ... administration of a neuromuscular blocking agent in the absence of ventilatory support has resulted in serious harm and death. ...
Neuromuscular blockers and reversal drugs<...
keywords = "Neostigmine, Neuromuscular blockade, Nondepolarizing neuromuscular blocking agents, Residual neuromuscular blockade ... title = "Neuromuscular blockers and reversal drugs",. abstract = "Nondepolarizing neuromuscular blocking agents were introduced ... long-acting neuromuscular blocking agents are rarely, if ever, used in the clinical setting; new neuromuscular blocking agents ... long-acting neuromuscular blocking agents are rarely, if ever, used in the clinical setting; new neuromuscular blocking agents ...
Updated review of resistance to neuromuscular blocking agents
Resistance to non-depolarizing neuromuscular blocking agents. Br J Anaesth 1991; 67: 511-4. PMID: 10.1093/bja/67.5.511. PMID: ... 1. Tschida SJ, Graupe KJ, Hoey LL, Vance-Bryan K. Resistance to nondepolarizing neuromuscular blocking agents. Pharmacotherapy ... Schematic drawing of the neuromuscular junction (NMJ) and the mechanism of resistance to neuromuscular blocking agents (NMBAs ... Since neuromuscular blocking agents (NMBAs) were introduced to the surgical field, they have become almost mandatory for the ...
BlockadeBlockersJunctionMyasthenia gravisSugammadexNeostigmineBlocking AgentAntagonistPharmacologyNMBAParalysisAcetylcholine receptorsPhysiologyTubocurarineBolusClinicalResidualAnesthesiaNMBAsDrugsRespiratoryPeripheral nerveDurationOxygen saturationAirwayPatientsRocuronium bromideAtropineInhalationalDoseIntubationAdequateAdministrationInfusionMonitoringProducesMuscle relaxant
Blockade23
- An attempt to estimate neuromuscular blockade after the administration of non depolarizing relaxants to anaesthetized myasthenic patients is described. (ispub.com)
- As paralysis or paralytic agents-such as curare derivative agents or nondepolarizing agents-are administered, a neuromuscular blockade of a patient's muscle activity can occur. (justia.com)
- Anesthesia favouring deep/intense neuromuscular blockade during laparoscopy may restore hemodynamics. (drugpatentwatch.com)
- However, no studies has been performed comparing oxygenation parameters during laparoscopy in colorectal surgery in either moderate or intense neuromuscular blockade. (drugpatentwatch.com)
- The investigators aim to investigate whether the intense neuromuscular blockade produces a better oxygenation profile measured by the central venous oxygen saturation than the moderate neuromuscular blockade. (drugpatentwatch.com)
- This is a one centre, prospective clinical trial to compare oxygenation data at different stages of neuromuscular blockade in high-risk patients scheduled for colorectal surgery. (drugpatentwatch.com)
- The investigators hypothesize that oxygenation data will be favourable by applying the intense neuromuscular blockade in comparison with moderate neuromuscular blockade. (drugpatentwatch.com)
- The investigators want to obtain information about influence in the outcome of producing profound neuromuscular blockade during laparoscopy colorectal by comparison of outcome data with matched historical control. (drugpatentwatch.com)
- If overdose occurs, use peripheral nerve stimulator to determine the degree of neuromuscular blockade. (unboundmedicine.com)
- With use, increased recognition of complications, pharmacologic advances, the ability to monitor depth of neuromuscular blockade, and changes in surgical practice, a better understanding of neuromuscular blockade and its reversal is developing. (elsevier.com)
- new neuromuscular blocking agents that can be easily reversed and new reversal agents that can reverse even profound neuromuscular blockade are being developed. (elsevier.com)
- The goal of this work is to ensure that neuromuscular blockade can be easily, quickly, and reliably reversed and that the safety of providing neuromuscular blockade intraoperatively will increase. (elsevier.com)
- Resistance to NMBAs is identified based on increases in the NMBA dosage required to inhibit the muscular twitch response, the time to maximum response, and decreases in the degree of twitch depression or the duration of neuromuscular blockade after a bolus [ 1 ]. (anesth-pain-med.org)
- Animals having abdominal procedures may benefit from neuromuscular blockade through reduction of abdominal muscular tone that allows for easier apposition of the body wall for suturing. (veteriankey.com)
- However, neither pharmacokinetics nor recovery profile of sugammadex for intense neuromuscular blockade reversal in children have been reported. (dataemia.com)
- This prospective study aimed to obtain a pharmacokinetic model of sugammadex and evaluate its efficacy and safety for intense neuromuscular blockade reversal in children. (dataemia.com)
- Forty children (age, 2-17 years) who underwent surgery that required early neuromuscular blockade reversal were enrolled. (dataemia.com)
- After neuromuscular blockade with 1 mg∙kg -1 of rocuronium, sugammadex (2, 4, and 8 mg∙kg -1 ) or a conventional dose of neostigmine (0.03 mg∙kg -1 ) was administered randomly after confirmation of zero post-tetanic count. (dataemia.com)
- We present a pharmacokinetic analysis of sugammadex for rocuronium-induced intense neuromuscular blockade reversal in children with its recovery profile. (dataemia.com)
- NMBs permit a very rapid induction of neuromuscular blockade at the onset of use, and the reversal agent will provide for more rapid reversal of the neuromuscular blockade. (baudaxbio.com)
- In animal models, the proprietary reversal agent acts quickly by chemical reaction to reverse the neuromuscular blockade. (baudaxbio.com)
- Rapid Chemical Antagonism of Neuromuscular Blockade by L-Cysteine Adduction to and Inactivation of the Olefinic (Double-bonded) Isoquinolinium Diester Compounds Gantacurium (AV430A), CW002, and CW011. (baudaxbio.com)
- Even the deepest neuromuscular blockade can be reversed rapidly within one to two minutes. (medtechdevices.in)
Blockers1
- Lien, CA & Eikermann, M 2018, Neuromuscular blockers and reversal drugs . (elsevier.com)
Junction12
- Drugs that interrupt transmission at the skeletal neuromuscular junction without causing depolarization of the motor end plate. (nih.gov)
- MG is caused by a decrease in the numbers of postsynaptic acetylcholine receptors at the neuromuscular junction ( 3 ), which decreases the capacity of the neuromuscular end-plate to transmit the nerve signal. (ispub.com)
- The disorder is classified based on the site of defect in motor unit pathway, i.e ., anterior horn cells, nerve root, peripheral nerve, neuromuscular junction or muscle. (wjgnet.com)
- Prevents neuromuscular transmission by blocking the effect of acetylcholine at the myoneural junction. (unboundmedicine.com)
- During such pathological processes, quantitative and qualitative changes occur in the physiology of acetylcholine and the acetylcholine receptor (AChR) at the neuromuscular junction. (anesth-pain-med.org)
- In addition, quantitative and qualitative changes in the physiology of acetylcholine (ACh) and AChR at the neuromuscular junction (NMJ) develop during pathological processes, which lead to changes in the pharmacokinetics and pharmacodynamics of NMBAs [ 1 , 2 ]. (anesth-pain-med.org)
- Schematic drawing of the neuromuscular junction (NMJ) and the mechanism of resistance to neuromuscular blocking agents (NMBAs). (anesth-pain-med.org)
- The neuromuscular junction is the synapse between a presynaptic motor nerve endplate and the corresponding postsynaptic muscle fiber. (veteriankey.com)
- The neuromuscular junction is the site of action where a motor nerve transmits a signal to muscle to initiate the process of contraction. (veteriankey.com)
- Acetylcholine ( ACh ) is the chemical messenger that traverses the neuromuscular junction to relay information from the nerve to the muscle fiber [1] . (veteriankey.com)
- A clear understanding of the physiologic events occurring at the neuromuscular junction is essential, as it is the site of action for drugs used to prevent muscular contraction. (veteriankey.com)
- The antibodies to the acetylcholine receptor reduce the number of functional receptors by blocking the attachment of acetylcholine molecules, by increasing the rate of degradation of receptors and by complement induced damage to the neuromuscular junction. (wfsahq.org)
Myasthenia gravis3
- Neuromuscular diseases such as myasthenia gravis (small test dose may be used to assess response). (unboundmedicine.com)
- Myasthenia Gravis (MG) is the mostly known autoimmune disease in human, mediated by autoantibodies against the nicotinic receptor of acetylcholine in neuromuscular junctions [ 1 ]. (biomedcentral.com)
- Microelectrode studies indicate that the miniature endplate potential (MEPP) frequency is normal but the MEPP amplitude is reduced in myasthenia gravis, suggesting that the neuromuscular transmission defect is due to a reduction in the postsynaptic response. (wfsahq.org)
Sugammadex4
- Sugammadex works by chelating non-depolarizing neuromuscular blocking agents (NMBA) such as rocuronium and vecuronium to reverse the effects of paralysis. (umem.org)
- For almost a decade, a new novel drug sugammadex has been used to specifically antagonize the effect of aminosteroidal neuromuscular blocking agents. (drugpatentwatch.com)
- Sugammadex, a selective antagonist of steroidal non-depolarizing neuromuscular blocking agents, has been used in children in limited circumstances. (dataemia.com)
- 3. What makes Sugammadex more effective than other reversal agents? (medtechdevices.in)
Neostigmine2
- The administration of conventional reversal agent neostigmine is associated with many undesirable side effects. (drugpatentwatch.com)
- Administration of anticholinesterase agents (neostigmine, pyridostigmine) may be used to antagonize the action of neuromuscular blocking agents once the patient has demonstrated some spontaneous recovery from neuromuscular block. (unboundmedicine.com)
Blocking Agent5
- why would anyone include a neuromuscular blocking agent in a vaccine? (vaccineliberationarmy.com)
- NMBA: neuromuscular blocking agent, AAG: α1-acid glycoprotein, IgG: immunoglobulin G, GFR: glomerular filtration rate. (anesth-pain-med.org)
- 1973. The quest for a short-acting nondepolarizing neuromuscular blocking agent. . (cornell.edu)
- A non-depolarizing neuromuscular blocking agent with shorter duration of action than pancuronium. (newlystar-medtech.com)
- Preclinical Pharmacology in the Rhesus Monkey of CW 1759-50, a New Ultra-short Acting Nondepolarizing Neuromuscular Blocking Agent, Degraded and Antagonized by L-Cysteine. (baudaxbio.com)
Antagonist1
- 4-Aminopyridine (Neurelan) is utilized as an antagonist to nondepolarizing neuromuscular blocking agents (available in the United States as an orphan drug for multiple sclerosis), has been shown to reverse tetrodotoxin toxicity in animal experiments. (medscape.com)
Pharmacology1
- 1973. The pharmacology of new short-acting nondepolarizing ester neuromuscular blocking agents: clinical implications. . (cornell.edu)
NMBA2
- As NMBA resistance may result in problems during anesthesia, it is of utmost importance to understand the mechanisms of NMBA resistance and their associations with pathological status to maintain adequate neuromuscular relaxation. (anesth-pain-med.org)
- Thus, it is of great importance to understand the mechanisms of NMBA resistance associated with different pathological states to maintain adequate neuromuscular relaxation. (anesth-pain-med.org)
Paralysis7
- By monitoring a quantitative response of the muscle activity to nerve stimulation, an anesthesiologist may adjust subsequent doses of a paralytic agent to achieve a desired level of paralysis. (justia.com)
- This type of conventional neuromuscular monitoring is used during the application of general anesthesia with paralysis to determine approximately how well a patient's muscles are able to function. (justia.com)
- During the conventional train-of-four monitoring, the physician looks for gross motor motions of the patient to ascertain that the level of paralysis administered to the patient with a long-acting depolarizing agent is adequate, indicating a loss of muscle activity, as well as for signs that activity has begun to return so that anesthesia may be terminated. (justia.com)
- Thus, train-of-four neuromuscular monitoring can be quite inaccurate in ascertaining whether complete paralysis has occurred or reversed. (justia.com)
- Acute neuromuscular paralysis (ANMP) is a clinical syndrome characterized by rapid onset muscle weakness progressing to maximum severity within several days to weeks (less than 4 wk). (wjgnet.com)
- Neuromuscular blocking agents ( NMBAs ) are a class of drugs used to produce skeletal muscle relaxation and paralysis most commonly to facilitate surgical and diagnostic procedure in anesthetized animals. (veteriankey.com)
- Neuromuscular blocking agents (NMBs) are used to induce total paralysis to permit intubation and muscle relaxation during surgery or in ventilated patients. (baudaxbio.com)
Acetylcholine receptors1
- The reason for this is attributed to the binding of non-depolarizing neuromuscular blocking agents to presynaptic acetylcholine receptors, resulting in inhibition of the recruitment of Ach from the reserve pool. (medtechdevices.in)
Physiology1
- A detailed review of neuromuscular physiology is beyond the scope of this chapter. (veteriankey.com)
Tubocurarine2
- and to reverse the effects of nondepolarizing muscle relaxants (e.g., tubocurarine). (medpill.info)
- Monitor respiration, maintain airway or assisted ventilation, and give oxygen as indicated when used as antidote for tubocurarine or other nondepolarizing neuromuscular blocking agents (usually preceded by atropine). (medpill.info)
Bolus1
- Neuromuscular block was maintained during surgery with bolus maintenance doses of 0.3 mg/kg. (pfizermedicalinformation.com)
Clinical3
- Nondepolarizing neuromuscular blocking agents were introduced into clinical practice more than 60 years ago. (elsevier.com)
- Does Clinical Anesthesia Need New Neuromuscular Blocking Agents? (silverchair.com)
- Clinical factors such as site and severity of infection, suspected or confirmed infectious agent, underlying disease and concomitant therapies 7 , and the fact that the drug has a narrow therapeutic range all increase the risk of side effects, such as nephritic syndrome and ototoxicity, skin reactions (e.g., erythema), and flushing histamine-like and other anaphylactic reactions, when anaesthetics are given. (bvsalud.org)
Residual1
- The ratio of the height of the fourth response of the train to that of the first (T4/T1) gave a good indication of the degree of residual neuromuscular block. (ispub.com)
Anesthesia4
- Since neuromuscular blocking agents (NMBAs) were introduced to the surgical field, they have become almost mandatory for the induction and maintenance of anesthesia. (anesth-pain-med.org)
- Vecuronium is a muscle relaxing agent and is used as an ajunct in general anesthesia. (newlystar-medtech.com)
- This potentiation however, becomes clinically relevant in the course of anesthesia, when the volatile agents have reached the tissue concentrations required for this interaction. (bernofarm.com)
- We believe that the NMBs can reduce the time required for induction of anesthesia and the reversal agent can reduce the time needed to recover from NMB dosing post-procedure, while potentially enhancing patient safety and resulting in cost savings for the hospital or another provider. (baudaxbio.com)
NMBAs2
- Since neuromuscular blocking agents (NMBAs) were introduced into the surgical field, they have become indispensable for surgery. (anesth-pain-med.org)
- NMBAs can be broadly classified into two categories based on their mechanism of action: depolarizing NMBAs and nondepolarizing NMBAs. (veteriankey.com)
Drugs2
- The duration of action of rocuronium bromide 0.6 mg/kg is longer than succinylcholine and at this dose is approximately equivalent to the duration of other intermediate-acting neuromuscular blocking drugs. (pfizermedicalinformation.com)
- Therefore, anesthetic and analgesic agents must be used in conjunction with these drugs. (veteriankey.com)
Respiratory4
- Respiratory failure caused by neuromuscular weakness is considered as more critical than lung disease because its development may be insidious or subtle until sudden decompensation leads to life threatening hypoxia. (wjgnet.com)
- Hence, the requirement for respiratory assistance should also be intensively and promptly investigated in all patients with neuromuscular disease. (wjgnet.com)
- Myasthenic crisis refers to a rapid deterioration in neuromuscular function with respiratory compromise due to ventilatory muscle insufficiency or weakness of upper airway musculature or both [ 1 ]. (biomedcentral.com)
- Respiratory assistance is continued until recovery of respiration and neuromuscular transmission is assured. (medpill.info)
Peripheral nerve1
- Neuromuscular response should be monitored with a peripheral nerve stimulator intraoperatively. (unboundmedicine.com)
Duration2
- The administration of rocuronium bromide in the 47 of 330 (14%) patients who were at least 30% or more above their ideal body weight (IBW) was not associated with clinically significant differences in the onset, duration, recovery, or reversal of rocuronium bromide-induced neuromuscular block. (pfizermedicalinformation.com)
- Its lack of significant cardiovascular effects and lack of dependence on good kidney function for elimination as well as its short duration of action and easy reversibility provide advantages over, or alternatives to, other established neuromuscular blocking agents. (newlystar-medtech.com)
Oxygen saturation1
- He was monitored with peripheral oxygen saturation, electrocardiogram, cutaneous temperature, noninvasive blood pressure and neuromuscular transmitter. (ispub.com)
Airway1
- Patients with severe obesity or neuromuscular disease may have airway and/or breathing problems requiring special care before, during, and after the use of neuromuscular blocking agents such as vecuronium. (newlystar-medtech.com)
Patients5
- Further, prior to a surgical procedure, patients are typically preloaded with a heavy dose of a paralytic agent, which is allowed to wear off over time. (justia.com)
- Throughout the world, millions of patients receive neuromuscular blocking agents as part of their general anesthetic each year. (elsevier.com)
- Buck ML and Reed MD. Use of nondepolarizing neuromuscular blocking agents in mechanically ventilated patients. (cmcedmasters.com)
- Based on the 2012 American College of Cardiology Foundation/American Heart Association (ACCF/AHA) guideline for the diagnosis and management of patients with stable ischemic heart disease , a dihydropyridine calcium channel blocker (eg, felodipine) is an effective and recommended agent in the management of chronic stable angina. (medicine.com)
- For initial treatment in patients with blood pressure ≥20/10 mm Hg above goal, may be used in combination with another appropriate agent (eg, ACE inhibitor, ARB, or thiazide diuretic). (medicine.com)
Rocuronium bromide2
- As with other neuromuscular blocking agents, the dosage of Rocuronium Bromide should be individualized in each patient. (bernofarm.com)
- If Rocuronium Bromide is administered by continuous infusion, it is recommended to give a loading dose of 0.6 mg Rocuronium Bromide per kg body weight and when neuromuscular block starts to recover, to start administration by infusion. (bernofarm.com)
Atropine1
- Atropine is usually administered prior to or concurrently with anticholinesterase agents to counteract the muscarinic effects. (unboundmedicine.com)
Inhalational1
- Atracurium 15mg and inhalational anesthetic agent-Isoflurane. (ispub.com)
Dose1
- Dose-response and cardiopulmonary side effects of the novel neuromuscular blocking drug CW 002 in man. (baudaxbio.com)
Intubation1
- Like methohexital, it is most commonly used as an induction agent for intubation. (medscape.com)
Adequate1
- Although acetazolamide appears to be a more potent ocular hypotensive agent than topical therapy, the authors of the available studies recommend its use when adequate reductions in IOP are not achieved with topical therapy due to the potential for serious adverse reactions. (pdr.net)
Administration2
- Administration of nondepolarizing neuromuscular blocking antagonists may be beneficial. (medscape.com)
- A reversal agent is commonly given to improve neuromuscular function after intra-operative administration of non-depolarizing neuromuscular blocking agents. (drugpatentwatch.com)
Infusion1
- Continuous monitoring of neuromuscular block is recommended since infusion rate requirements vary from patient to patient and with the anesthetic method used. (bernofarm.com)
Monitoring1
- The use of an appropriate neuromuscular monitoring technique is recommended for the evaluation of neuromuscular block and recovery. (bernofarm.com)
Produces1
- Its most useful feature as an induction agent is that it produces deep sedation while causing minimal cardiovascular effects. (medscape.com)
Muscle relaxant1
- What possible use is a muscle relaxant to a so-called immunizing agent? (vaccineliberationarmy.com)