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.
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.
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.
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.
Neuromuscular Depolarizing Agents
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)
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.
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.
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Biological Science Disciplines
All of the divisions of the natural sciences dealing with the various aspects of the phenomena of life and vital processes. The concept includes anatomy and physiology, biochemistry and biophysics, and the biology of animals, plants, and microorganisms. It should be differentiated from BIOLOGY, one of its subdivisions, concerned specifically with the origin and life processes of living organisms.
Encyclopedias as Topic
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)
Recovery from Neuromuscular Block after an Intubation Dose of Cisatracurium and Rocuronium in Lumbar Disc Surgery - Hans Pol
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 ...
Mivacurium chloride - Wikipedia
Mivacurium chloride (formerly recognized as BW1090U81, BW B1090U or BW1090U) is a short-duration non-depolarizing neuromuscular-blocking drug or skeletal muscle relaxant in the category of non-depolarizing neuromuscular-blocking drugs, used adjunctively in anesthesia to facilitate endotracheal intubation and to provide skeletal muscle relaxation during surgery or mechanical ventilation. Mivacurium is a symmetrical molecule although it is a mixture of three of the twenty possible isomers: the isomerism stems from chirality at the C-1 carbon position of both the tetrahydroisoquinolinium rings, as well as both the positively charged nitrogen (onium) heads, and the E/Z diastereomerism at the C=C double bond of the oct-4-ene diester bridge. Thus, owing to the symmetry and chirality, the three isomers of mivacurium are (E)-1R,1R,2R,2R, (identified as BW1217U84), (E)-1R,1R,2R,2S, (BW1333U83) and (E)-1R,1R,1S,2S, (BW1309U83). These are also known as cis-cis, cis-trans and trans-trans Mivacurium. ...
Antagonism of Neuromuscular Blockade | Anesthesiology Core Review: Part One Basic Exam | AccessAnesthesiology | McGraw-Hill...
Muscle relaxation caused by a muscle relaxant drug can be terminated spontaneously by diffusion, redistribution, metabolism, and excretion or via pharmacological antagonism using specific reversal agents known as cholinesterase inhibitors. Acetylcholinesterase is an enzyme found at the motor end plate. It functions by breaking down and reducing the amount of acetylcholine (ACh) at the nerve terminal. By inhibiting acetylcholinesterase, cholinesterase inhibitors indirectly increase the amount of ACh molecules that are available to compete with the nondepolarizing muscle relaxant for the binding sites of the ACh receptors. ...
Nondepolarizing block definition at Dictionary.com, a free online dictionary with pronunciation, synonyms and translation. Look it up now!
Pharmacokinetics and Pharmacodynamics of Rapacuronium in Patients with Cirrhosis | Anesthesiology | ASA Publications
The increased volume of distribution of muscle relaxants induced by cirrhosis has now been clearly demonstrated by several studies 12,17-19 and has been proposed as an explanation for the so-called resistance of patients with cirrhosis to muscle relaxants. In the present study, the intubating time and conditions were similar between the two groups. This increase in the volume of distribution of rapacuronium is most probably a result of the enlarged extracellular fluids space, which is a common finding in patients with cirrhosis; however, only one of the patients studied had clinical evidence of ascites. In a previous study of rocuronium, we observed that the volume of the central compartment was increased and associated with a longer onset time in patients with cirrhosis. 18 In the present study, we could not demonstrate such a correlation between onset time and the central volume of distribution. Because the onset time of rapacuronium is particularly short, it may be more complex to show ...
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Rocuronium bromide - Wikipedia
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. 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). The γ-cyclodextrin derivative sugammadex (trade name Bridion) has been recently introduced as a novel agent to reverse the action of rocuronium. 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, but finally approved the medication for use during surgical procedures in the United States on ...
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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. ...
Study of Rocuronium Onset Time According to Remifentanil Infusion - Full Text View - ClinicalTrials.gov
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 ...
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Relationship of the Train-of-four Fade Ratio to Clinical Signs and Symptoms of Residual Paralysis in Awake Volunteers |...
It is widely accepted that the ability to sustain a 5-s head-lift is associated with sufficient strength in otherwise healthy subjects to protect the airway against obstruction and aspiration of oral contents.  There is less agreement on the correlation between a sustained head-lift and the TOF fade ratio at the adductor pollicis muscle. El Mikatti et al.  found that seven of seven subjects were able to sustain a head-lift at a TOF ratio of 0.50 measured on EMG. Dupuis et al.  reported similar results (six of seven) using mechanomyography, but they found that when EMG monitoring was used that the TOF ratio had to attain a value of 0.70 before all subjects had a sustained head-lift. Sharpe et al.  using EMG found that head-lift was uniformly maintained at a TOF ratio greater or equal to 0.60. However, Engbaek et al. (also using EMG) concluded that the TOF ratio had to recover to 0.80 before all patients could sustain head-lift for 5 s, and head-lift could not be sustained for ...
Mivacurium chloride / mivacurium chloride NDA 078562 global drug patent coverage, generic alternatives and manufacturers
Drugs may be covered by multiple patents or regulatory protections. All trademarks and applicant names are the property of their respective owners or licensors. Although great care is taken in the proper and correct provision of this service, thinkBiotech LLC does not accept any responsibility for possible consequences of errors or omissions in the provided data. The data presented herein is for information purposes only. There is no warranty that the data contained herein is error free. thinkBiotech performs no independent verifification of facts as provided by public sources nor are attempts made to provide legal or investing advice. Any reliance on data provided herein is done solely at the discretion of the user. Users of this service are advised to seek professional advice and independent confirmation before considering acting on any of the provided information. thinkBiotech LLC reserves the right to amend, extend or withdraw any part or all of the offered service without notice. ...
Intermediate-Acting Nondepolarizing Neuromuscular Blocking Agents and Risk of Postoperative 30-Day Morbidity and Mortality, and...
AUTHORS: Bronsert, Michael R. PhD, MS et al. Anesthesia & Analgesia: May 2017 - Volume 124 - Issue 5 - p 1476-1483. BACKGROUND: Nondepolarizing neuromuscular blocking drugs (NNMBDs) are commonly used as an adjunct to general anesthesia. Residual blockade is common, but its potential adverse effects are incompletely known. This study was designed to assess the association between NNMBD use with or without neostigmine reversal and postoperative morbidity and mortality.. METHODS: This is a retrospective observational study of 11,355 adult patients undergoing general anesthesia for noncardiac surgery at 5 Veterans Health Administration (VA) hospitals. Of those, 8984 received NNMBDs, and 7047 received reversal with neostigmine. The primary outcome was a composite of respiratory complications (failure to wean from the ventilator, reintubation, or pneumonia), which was yes if a patient had any of the 3 component events and no if they had none. Secondary outcomes were nonrespiratory complications, ...
Preclinical Pharmacology of CW002: A Nondepolarizing Neuromuscular Blocking Drug of Intermediate Duration, Degraded and...
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.
The Impact of Post-tetanic Count on Subsequent Train-of-four During Recovery From Rocuronium - Tabular View - ClinicalTrials.gov
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 ...
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DOSE-RESPONSE OF MIVACURIUM CHLORIDE IN CHILDREN DURING NITROUS OXIDE-OXYGEN-NARCOTIC ANESTHESIA | Anesthesiology | ASA...
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Rocuronium - Healthery
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Mindray Introduces Neuromuscular Transmission Module to Confirm Neuromuscular Blocks | Medgadget
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Anaesthesia UK : Oral case 110
Sudden hypotension occurs during injection of local anesthetic.. 1. What is the etiology?. 2. The mother is immediately unresponsive. What do you do immediately? Do you intubate the trachea, or treat the blood pressure, or are both necessary?. 3. How can you alter intubating drug regimens to accomplish intubation of the trachea with a nondepolarizing relaxant sooner than is usually necessary?. One can use three times the ED95 to overwhelm receptor sites, or one can use a priming technique whereby three minutes before the intubating dose, one-third of the ED95 is given. However, some patients may become apneic.. 4. What is your rationale for drug choice?. ...
Vecuronium - యొక్క ఉపయోగాలు, మోతాదు, దుష్ప్రభావాలు, ప్రయోజనాలు, పరస్పర చర్యలు మరియు హెచ్చరిక - Vecuronium in Telugu
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Effects of Ephedrine on the Onset Time of Neuromuscular Block and Intubating Conditions after Cisatracurium: Preliminary...
en] We studied the effects of intravenous ephedrine on the onset time and the intubating conditions 2 min after a bolus dose of cisatracurium (0.15 mg kg-1). Thirty patients anaesthetized with sufentanil and propofol were randomly divided in 2 groups to receive either ephedrine (70 micrograms.kg-1) or saline, 5 s before propofol. Cisatracurium was administered after loss of consciousness. Neuromuscular block was assessed at the adductor pollicis using accelography. Tracheal intubation was performed 2 min after cisatracurium injection and rated as excellent, good, poor or bad. At intubation, neuromuscular block (% height of control T1) was greater in patients receiving ephedrine (36.1 +/- 25.8% vs 57.9 +/- 25.1%) (mean +/- SD). The frequency of excellent intubating conditions was higher after ephedrine (86.6%) than after saline (40.0%). The onset time of cisatracurium was shorter after ephedrine (167 +/- 64.8 s vs 234.9 +/- 63.1 s). Thus, a low dose of ephedrine given before induction of ...
Time course of action and endotracheal intubating conditions of Org 9487, a new short-acting steroidal muscle relaxant; a...
TY - JOUR. T1 - Time course of action and endotracheal intubating conditions of Org 9487, a new short-acting steroidal muscle relaxant; a comparison with succinylcholine. AU - Wierda, JMKH. AU - van den Broek, L. AU - Proost, JH. AU - Verbaan, BW. AU - Hennis, PJ. PY - 1993/9. Y1 - 1993/9. N2 - In a randomized study, we evaluated lag time (time from the end of injection of muscle relaxant until the first depression of the train-of-four response [TOF]), onset time (time from the end of injection of muscle relaxant until the maximum depression of the first twitch of the TOF [T1]), neuromuscular block, and endotracheal intubating conditions at 1 min after 1 mg/kg succinylcholine (n = 15) and 1.5 mg/kg Org 9487 (n = 30). Two minutes after administration of Org 9487, 15 of the 30 patients received neostigmine for reversal. Recovery of neuromuscular block after succinylcholine, Org 9487 without and Org 9487 with neostigmine were compared using the time until T1 was 90% for the succinylcholine group, ...
Clinical pharmacokinetics of the newer neuromuscular blocking drugs. - Semantic Scholar
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
Optimal Dose of Combination of Rocuronium and Cisatracurium: A Randomized Double-blinded Clinical Trial - AdisInsight
This study investigated optimal dose of combination of Rocuronium and Cisatracurium through monitoring neuromuscular relaxation during surgery.
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 ...
The effect of cisatracurium infusion on the energy expenditure of critically ill patients: an observational cohort study |...
Both overfeeding and underfeeding of intensive care unit (ICU) patients are associated with worse outcomes. A reliable estimation of the energy expenditure (EE) of ICU patients may help to avoid these phenomena. Several factors that influence EE have been studied previously. However, the effect of neuromuscular blocking agents on EE, which conceptually would lower EE, has not been extensively investigated. We studied a cohort of adult critically ill patients requiring invasive mechanical ventilation and treatment with continuous infusion of cisatracurium for at least 12 h. The study aimed to quantify the effect of cisatracurium infusion on EE (primary endpoint). EE was estimated based on ventilator-derived VCO2 (EE in kcal/day = VCO2 × 8.19). A subgroup analysis of septic and non-septic patients was performed. Furthermore, the effects of body temperature and sepsis on EE were evaluated. A secondary endpoint was hypercaloric feeding (| 110% of EE) after cisatracurium infusion. In total, 122 patients
Ketamine and Rocuronium...for that critically ill intubation - Emergency Medicine Kenya Foundation
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 ...
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Tracheal intubation with rocuronium bromide using the timing principle - A comparison with succinylcholine for rapid sequence induction ...
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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. ...
Comparison of Kinemyography with Electromyography Neuromuscular Monitoring in Pediatric Patients Receiving Cisatracurium or...
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
Muscle Electromechanical Correlations during Succinylcholine Infusion
The study was designed to compare the electromyographic (EMG) and evoked twitch tension (TT) responses in humans to train-of-four stimulation during neuromuscular blockade induced with a continuous Succinylcholine infusion. Mean values of TT correlated well with EMG (r | 0.97), but several consisten...
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Drug Used for Reversal of Neuromuscular Block Recalled Due to Mislabeling - MPR
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Anaesthesia UK : Primary Viva 12 (Pharmacology)
4. Describe the metabolism of each of the neuromuscular blockers; what are the relative percentages excreted by the liver and the kidney ...
... 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 ...
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 ...
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 ...
... 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 ...
... used to reverse neuromuscular blockade after administration of the aminosteroid non-depolarizing neuromuscular-blocking agents ... Recurarisation', a phenomenon of recurrence of neuromuscular block, may occur where the reversal agents wear off before a ... Sugammadex has been shown to have affinity for two other aminosteroid neuromuscular blocking agents, vecuronium and pancuronium ... be reduced to zero if sugammadex is used as the reversal agent and the correct dosage is selected with the use of neuromuscular ...
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 ... The neuromuscular blocking agents paralyze all of the skeletal muscles, most notably and importantly in the oropharynx, larynx ... Generally the patient will be manually ventilated for a short period of time before a neuromuscular blocking agent is ...
Neostigmine, helps reverse the effects of non-depolarizing muscle relaxants. *Sugammadex, new agent that is designed to bind ... Main article: Neuromuscular blocking drugs. Muscle relaxants do not render patients unconscious or relieve pain. Instead, they ... No anaesthetic agent currently in use meets all these requirements, nor can any anaesthetic agent be considered safe. There are ... Halothane, an agent introduced in the 1950s, has been almost completely replaced in modern anesthesia practice by newer agents ...
Neuromuscular+blocking+agents at the US National Library of Medicine Medical Subject Headings (MeSH). ... 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". ...
... an ultra-short-acting nondepolarizing ester neuromuscular blocking agent". Anesthesiology. 53 (3): S274. doi:10.1097/00000542- ... 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- ... From the 1950s through to the 1970s, the present-day concept of a neuromuscular blocking agent with a rapid onset and an ultra- ...
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 ... Muscle tissue treated with a non-depolarizing neuromuscular blocking agents will produce an indicative response in the form of ... an effect that is similar to the response of muscle to non-depolarizing neuromuscular blocking agents can be observed. This ...
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. ...
Hughes R, Chapple DJ (1976). "Effects of Non-Depolarizing Neuromuscular Blocking Agents on Peripheral Autonomic Mechanisms in ... Alcuronium chloride is a neuromuscular blocking (NMB) agent, alternatively referred to as a skeletal muscle relaxant. It is 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 ...
... is an aminosteroid neuromuscular-blocking drug or skeletal muscle relaxant in the category of non-depolarizing neuromuscular- ... The discovery program initiated by Singh initially led to the synthesis of the bis-quaternary non-depolarizing agent HS-342 (4, ... Neuromuscular+blocking+agents at the US National Library of Medicine Medical Subject Headings (MeSH). ... As with other neuromuscular blocking agents, candocuronium preferentially antagonizes competitively the nicotinic subtype of ...
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 weakness and prolonged duration of action of nondepolarizing neuromuscular blocking agents), experts no longer recommend ... they have few or no symptoms unless they are exposed to a triggering agent. The most common triggering agents are volatile ... The cause of MH is the use of certain volatile anesthetic agents or succinylcholine in those who are susceptible. ... These signs can develop any time during the administration of the anesthetic triggering agents. It is difficult to find ...
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 ...
... 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 ...
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 ...
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 ...
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 ...
Nondepolarizing agents, such as tubocurarine, block the agonist, acetylcholine, from binding to nicotinic receptors and ... Neuromuscular blockers. Detailed view of a neuromuscular junction:. 1. Presynaptic terminal. 2. Sarcolemma. 3. Synaptic ... 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 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- ...
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). ...
... 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 ...
... 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 retains popularity as an induction agent for rapid sequence ... Instead, anesthesia is usually maintained with an inhaled anesthetic (gas) agent. Inhaled anesthetics are eliminated relatively ... depending on local availability and cost of these agents. It was previously the first of three drugs administered during ...
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. ...
... that has effect as a neuromuscular-blocking drug or skeletal muscle relaxant in the category of non-depolarizing neuromuscular- ... "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 ... shortness of breath can also be relieved by the nondepolarizing muscle relaxant, cisatracurium, during total intravenous ...
... 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, ...
... has been recognized as a potential agent for use in bioterrorism. It can be absorbed through the eyes, ... It prevents the release of the neurotransmitter acetylcholine from axon endings at the neuromuscular junction and thus causes ... University-based ophthalmologists in the US and Canada further refined the use of botulinum toxin as a therapeutic agent. By ... The effects of botulinum toxin are different from those of nerve agents involved insofar in that botulism symptoms develop ...
... antimuscarinic agents, ganglionic blockers, and neuromuscular blockers. Anticholinergic drugs are used to treat a variety of ... Nondepolarizing skeletal muscular relaxant Plants of the Solanaceae family contain various anticholinergic tropane alkaloids, ... Several are depolarizing agents. Examples of common anticholinergics: Antimuscarinic agents Atropine Benztropine (Cogentin) ... An anticholinergic agent is a substance that blocks the neurotransmitter acetylcholine in the central and the peripheral ...
... non-depolarizing neuromuscular blocking agents like pancuronium stop this binding from taking place. ... The combination of a barbiturate induction agent and a nondepolarizing paralytic agent is used in thousands of anesthetics ... a paralytic agent) that blocks the action of acetylcholine at the motor end-plate of the neuromuscular junction. Binding of ... a triple intravenous dose of a nondepolarizing neuromuscular muscle relaxant is given, such as 20 mg pancuronium bromide or 20 ...
... antimuscarinic agents, and antinicotinic agents (ganglionic blockers, neuromuscular blockers). ... Doxacurium - Nondepolarizing skeletal muscular relaxant. *Hexamethonium - Ganglion blocker. *Mecamylamine - Ganglion blocker ... anticholinergic agents do not antagonize the binding at nicotinic acetylcholine receptors at the neuromuscular junction, for ... Antinicotinic agents *Bupropion - Ganglion blocker. *Dextromethorphan - Cough suppressant and ganglion blocker[ ...
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 ... Suxamethonium is in the neuromuscular blocker family of medications and is of the depolarizing type. It works by blocking the ...
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 ...
The use of neuromuscular blocking drugs carries with it the risk of anesthesia awareness. There are dozens of plants from which ... Historically, curare has been used as an effective treatment for tetanus or strychnine poisoning and as a paralyzing agent for ... 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 for hunting and for therapeutic purposes, Curare only becomes active by a direct wound contamination ...
Carotid Bypass and Reconstruction Medication: Anesthetic Agents, Neuromuscular Blockers, Nondepolarizing
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 ...
Neuromuscular Nondepolarizing Agents Summary Report | CureHunter
Drugs that interrupt transmission at the skeletal neuromuscular junction without causing depolarization of the motor end plate ... Peripheral Nervous System Agents*Neuromuscular Agents: 41*Neuromuscular Blocking Agents: 408*Neuromuscular Nondepolarizing ... Neuromuscular Nondepolarizing Agents. Subscribe to New Research on Neuromuscular Nondepolarizing Agents Drugs that interrupt ... Nondepolarizing Blockers; Agents, Curare-Like; Agents, Neuromuscular Nondepolarizing; Blockers, Nondepolarizing; Curare Like ...
Nondepolarizing Neuromuscular Blocking Agents, Reversal, and Risk of Postoperative Pneumonia | Anesthesiology | ASA Publications
Nondepolarizing Neuromuscular Blocking Agents, Reversal, and Risk of Postoperative Pneumonia Catherine M. Bulka, M.P.H.; Maxim ... The effects of nondepolarizing neuromuscular blocking agents can last beyond the time the patient leaves the operating room ... Nondepolarizing Neuromuscular Blocking Agents, Reversal, and Risk of Postoperative Pneumonia. * "To Reverse or Not To Reverse ... Nondepolarizing Neuromuscular Blocking Agents, Reversal, and Risk of Postoperative Pneumonia You will receive an email whenever ...
Neostigmine: How Much Is Necessary for Patients Who Receive a Nondepolarizing Neuromuscular Blocking Agent? | Anesthesiology |...
Neostigmine: How Much Is Necessary for Patients Who Receive a Nondepolarizing Neuromuscular Blocking Agent?. Anesthesiology 1 ... Cynthia A. Lien; Neostigmine: How Much Is Necessary for Patients Who Receive a Nondepolarizing Neuromuscular Blocking Agent?. ... Neostigmine: How Much Is Necessary for Patients Who Receive a Nondepolarizing Neuromuscular Blocking Agent? ... Neostigmine: How Much Is Necessary for Patients Who Receive a Nondepolarizing Neuromuscular Blocking Agent? ...
Neuromuscular Blocking Agents (Nondepolarizing) - Tracrium, Nimbex | Davis's Drug Guide
Nondepolarizing) - Tracrium, Nimbex in Daviss Drug Guide including dosage, side effects, interactions, nursing implications, ... nondepolarizing_. Quiring C, Sanoski CA, Vallerand AH. NEUROMUSCULAR BLOCKING AGENTS (nondepolarizing). Daviss Drug Guide. F.A ... nondepolarizing_. Quiring C, Sanoski CA, Vallerand AH. NEUROMUSCULAR BLOCKING AGENTS (nondepolarizing) [Internet]. In: Daviss ... "NEUROMUSCULAR BLOCKING AGENTS (nondepolarizing)." Daviss Drug Guide, 16th ed., F.A. Davis Company, 2020. Medicine Central, im. ...
Rocuronium - Neuromuscular Nondepolarizing Agents, Skeletal Muscle Relaxants, ATC:M03AC09
Miowas - Neuromuscular Nondepolarizing Agents, Nicotinic Antagonists, Skeletal Muscle Relaxants, ATC:M03AC02
Although the nondepolarizing neuromuscular blocking drugs do not have the same adverse effects as succinylcholine, their onset ... Gallamine Triethiodide is a nondepolarizing neuromuscular blocking drug (NDMRD) used as an adjunct to anesthesia to induce ... The actions of gallamine triethiodide are similar to those of tubocurarine, but this agent blocks the cardiac vagus and may ... They also have a longer duration of action, making them more suitable for maintaining neuromuscular relaxation during major ...
Neuromuscular-blocking drug - Wikipedia
Non-depolarizing blocking agents. A neuromuscular non-depolarizing agent is a form of neuromuscular blocker that does not ... Comparison of non-depolarizing neuromuscular blocking agents Agent Time to onset (seconds) Duration (minutes) Side effects ... neuromuscular blocking agent".. [permanent dead link] *^ a b c d e f g h W. C. Bowman (2006). "Neuromuscular block". British ... Non-depolarizing blocking agents: These agents constitute the majority of the clinically relevant neuromuscular blockers. They ...
Search | The Merck Index Online
Rocuronium - Drugs and Lactation Database (LactMed) - NCBI Bookshelf
When a combination of anesthetic agents is used for a procedure, follow the recommendations for the most problematic medication ... Neuromuscular Nondepolarizing Agents. Disclaimer: Information presented in this database is not meant as a substitute for ... Spigset O. Anaesthetic agents and excretion in breast milk. Acta Anaesthesiol Scand. 1994;38:94-103. [PubMed: 8171959] ... When a combination of anesthetic agents is used for a procedure, follow the recommendations for the most problematic medication ...
Treatment of Intracranial Hypertension of Severe Tramatic Brain Injured Patients. Physiopathologic Effects of Neuromuscular...
Neuromuscular Agents. Peripheral Nervous System Agents. Physiological Effects of Drugs. Neuromuscular Nondepolarizing Agents. ... Physiopathologic Effects of Neuromuscular Blocking Agents (THIC Cu). The safety and scientific validity of this study is the ... Physiopathologic Effects of Neuromuscular Blocking Agents. A Controlled Randomized Study Versus Placebo. ... In case of intracranial hypertension, french neurocritical care society argue for the use of neuromuscular blocking agents ...
Desflurane Versus Propofol in the Sitting Position - Full Text View - ClinicalTrials.gov
Significant modification of traditional rapid sequence induction improves safety and effectiveness of pre-hospital trauma...
An RSI protocol using fixed ratios of these agents delivers effective pre-hospital tra … ... Neuromuscular Nondepolarizing Agents / administration & dosage * Rocuronium * Succinylcholine / administration & dosage * Young ... A crucial component of developing a standardised protocol is the selection of induction agents. The aim of this study is to ... Apart from the induction agents, the RSI protocol was identical in both groups. Outcomes measured included laryngoscopy view, ...
Low Dose Mivacurium vs. Low Dose Succinylcholine for Rigid Bronchoscopy - Full Text View - ClinicalTrials.gov
Neuromuscular Agents. Peripheral Nervous System Agents. Physiological Effects of Drugs. Neuromuscular Nondepolarizing Agents. ... Neuromuscular Diseases. Nervous System Diseases. Musculoskeletal Pain. Pain. Neurologic Manifestations. Signs and Symptoms. ... Neuromuscular monitoring is performed with accelerometry. the patients receive the muscle relaxant according to the study group ... Neuromuscular monitoring is performed with accelerometry. the patients receive the muscle relaxant according to the study group ...
Acute Pharmacokinetic-pharmacodynamic Change of Rocuronium After Reperfusion of Renal Graft - Full Text View - ClinicalTrials...
Vecuronium (Professional Patient Advice) - Drugs.com
Corticosteroids (Systemic): Neuromuscular-Blocking Agents (Nondepolarizing) may enhance the adverse neuromuscular effect of ... Trimebutine: May enhance the neuromuscular-blocking effect of Neuromuscular-Blocking Agents (Nondepolarizing). Monitor therapy ... Calcium Channel Blockers: May enhance the neuromuscular-blocking effect of Neuromuscular-Blocking Agents (Nondepolarizing). ... Spironolactone: May enhance the neuromuscular-blocking effect of Neuromuscular-Blocking Agents (Nondepolarizing). Monitor ...
Intermediate-Acting Nondepolarizing Neuromuscular Blocking Agents and Risk of Postoperative 30-Day Morbidity and Mortality, and...
Effects of non-depolarizing neuromuscular blocking agents on norepinephrine release from human atrial tissue obtained during...
Erratum: Factors that affect the onset of action of non-depolarizing neuromuscular blocking agents | Korean Journal of...
Cisatracurium Besylate Monograph for Professionals - Drugs.com
Neuromuscular blocking agents, nondepolarizing. Potency and duration of nondepolarizing neuromuscular blocking agents may be ... Nondepolarizing neuromuscular blocking agent (benzylisoquinolone); isomer of atracurium.1 3 5 6 7 11 14 15 19 20 ... Resistance to nondepolarizing neuromuscular blocking agents33 34 35 37 38 can develop in burn patients, particularly those with ... Continuous monitoring of neuromuscular transmission recommended during neuromuscular blocking agent therapy in intensive care ...
A pharmacodynamic explanation for the rapid onset/offset of rapacuronium bromide
Unlike the finding for other nondepolarizing muscle relaxants, the laryngeal muscles are not resistant to rapacuronium. ... Neuromuscular Nondepolarizing Agents / administration & dosage * Neuromuscular Nondepolarizing Agents / pharmacokinetics * ... Background: Nondepolarizing muscle relaxants differ in their time course at the laryngeal adductors and the adductor pollicis, ... Unlike the finding for other nondepolarizing muscle relaxants, the laryngeal muscles are not resistant to rapacuronium. ...
Potential Signals of Serious Risks/New Safety Information Identified by the Adverse Event Reporting System (AERS) between...
... and non-depolarizing neuromuscular blocking agents. Drug interactions resulting in decreased effectiveness of the non- ... depolarizing neuromuscular blocking agent. The Precautions / Drug Interactions section of the labeling for Cerebyx was updated ... The Warnings and Precautions section of the labeling for gadolinium-based contrast agents was updated October 2013, to include ...
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. ...
Adachi Y[au] - PubMed - NCBI
Physiology of Muscle Contraction: agents, anatomy, contraction, depolarizing, en, human, muscle, neuromuscular, physiology,...
Case of anaphylaxis induced by rocuronium treated with sugammadex
Keywords: Anaphylaxis; Hypersensitivity; Neuromuscular Nondepolarizing Agents.. INTRODUCTION. Anaphylaxis during anesthesia is ... Once the agent is administered intravenously, it is difficult to prevent the exposure and the reaction may be maintained until ... The patient was monitored with a neuromuscular junction monitor with the use of atracurium for the rest of the procedure ... Among the muscle relaxants, rocuronium has been implicated as the most commonly used agent, although this can be attributed to ...
Tubocurarine chloride - Wikipedia
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. Curare - History, ...
Delayed recovery from rocuronium block in an infant.
We report an unusual case of prolonged neuromuscular blockade with rocuronium in an infant undergoing cleft lip repair ... 0/Androstanols; 0/Neuromuscular Nondepolarizing Agents; WRE554RFEZ/rocuronium From MEDLINE®/PubMed®, a database of the U.S. ... We report an unusual case of prolonged neuromuscular blockade with rocuronium in an infant undergoing cleft lip repair ...
... , Neuromuscular Blockade, Non-depolarizing Neuromuscular Blocking Agent, Depolarizing Neuromuscular Blocking ... Paralytic Agent. Aka: Paralytic Agent, Neuromuscular Blockade, Non-depolarizing Neuromuscular Blocking Agent, Depolarizing ... Interfere with transmission at neuromuscular end plate. *Two Mechanisms of Neuromuscular Blockade. *Non-depolarizing agents ( ... Paralytic Agents do not alter Level of Consciousness. *Must be used with Sedation and analgesia ...
Neuromuscular Blocking Agents | SpringerLink
Neuromuscular blocking agents perhaps have the most fascinating history among the drugs used in anesthesiology and intensive ... Nondepolarizing neuromuscular blocking drugs in the intensive care unit: a clinical review. South Med J 1997; 90: 769-74.PubMed ... Intensive Care Unit Patient Neuromuscular Blockade Neuromuscular Blocking Agent Status Asthmaticus Peripheral Nerve Stimulation ... Neuromuscular blocking agents in the intensive care unit: a two-edged sword. Crit Care Med 1995; 23: 423-8.PubMedCrossRefGoogle ...
Muscle relaxantsPharmacologyBlockersSuccinylcholineAcetylcholineAnesthesiaNMBAsJunctionRecovery of neuromuscular functionIndicationsEffects of nondepolarizing neurParalysisNMBAResidualBlocking AgentNeostigmineSugammadexAdministration of neuromuscularOnsetSkeletal muscle relaxant for intIntravenousAnestheticAtracuriumDepolarizingClinicalDrugsPancuroniumLevel of neuromuscularDuration of neuromuscularSedationDiseasesPost-synapticHypersensitivityPostoperativeProlong neuromuscularPatientsPotencyBlockerAtropineReversal agentIntubation and mechanical ventilationBlockMyastheniaPatientTransmissionPeripheralMivacuriumMechanicalTubocurarineComplicationsInductionRelaxationClinically
- Nondepolarizing muscle relaxants differ in their time course at the laryngeal adductors and the adductor pollicis, a result of differences in equilibration delays between plasma and effect sites, the sensitivity of each muscle to the relaxant, and the steepness of the concentration-effect relation at each muscle (the Hill factor). (nih.gov)
- Unlike the finding for other nondepolarizing muscle relaxants, the laryngeal muscles are not resistant to rapacuronium. (nih.gov)
- Open channel block is produced by depolarizing muscle relaxants but can also be produced by NDBs if a depolarizing agent is given while a high concentration of NDB is present. (anaesthesiauk.com)
- The peripherally acting skeletal muscle relaxants characteristically interfere with the transmission of impulses from motor nerves to skeletal muscle fibers at the neuromuscular junction, thus reducing or abolishing motor activity. (merckvetmanual.com)
- The members of this group of peripherally acting skeletal muscle relaxants are often referred to as curarizing agents because of their relationships with the curare alkaloids that were first used clinically. (merckvetmanual.com)
- Generally, nondepolarizing muscle relaxants are not absorbed from the GI tract and must be administered parenterally, usually intravenously. (merckvetmanual.com)
- Reversal agents reverse the effects of muscle relaxants, enabling patients to regain normal muscle function sooner and breathe on their own again. (emaxhealth.com)
- These neuromuscular blocking agents (muscle relaxants) are competitive reversible antagonists of nACh/nAChR. (flashcardmachine.com)
- These neuromuscular blocking agents (muscle relaxants) work as excessive depolarizing agonists that maintain endplate membrane depolarization. (flashcardmachine.com)
- The pharmacology of NMBAs is well understood, but the use of these agents can be controversial. (uspharmacist.com)
- Nondepolarizing neuromuscular blockers are used in combination with a sedative as part of the rapid-sequence intubation process. (medscape.com)
- These agents constitute the majority of the clinically relevant neuromuscular blockers. (wikipedia.org)
- Some experts recommend that neuromuscular blockers be considered for short-term use (up to 48 hours) only in patients with ARDS and severe gas exchange abnormalities (PaO 2 /FiO 2 ≤120 mmHg) [Siegel 2018] . (drugs.com)
- Whether or not other neuromuscular blockers will yield similar results is unknown. (drugs.com)
- Documentation of allergenic cross-reactivity for neuromuscular blockers is limited. (drugs.com)
- The mechanism by which calcium channel blockers affect neuromuscular transmission is not well established. (ispub.com)
- 3 In patients without known defects of neuromuscular transmission, the calcium channel blockers felodipine and nifedipine have been found to produce features of myasthenia gravis including dysphagia, ptosis, and generalized weakness after long-term use ranging from 18 months to 12 years. (ispub.com)
- Case reports describe a number of beta blockers , including propranolol, practolol, oxprenolol, atenolol, sotalol, nadolol, and ophthalmic timolol which appear to have produced symptoms and signs of myasthenia gravis in patients with no known defects of neuromuscular transmission, or to have exacerbated myasthenic symptoms in patients with known myasthenia gravis. (ispub.com)
- Neuromuscular blockers used and their relation to PORC in the sample studied. (elsevier.es)
- A prospective registry of 102 patients in a period of 4 months was designed to include ASA I-II patients who intraoperatively received nondepolarizing neuromuscular blockers. (elsevier.es)
- Understand the difference between non-depolarizing and depolarizing neuromuscular blockers. (veccs.org)
- In contrast, nondepolarizing neuromuscular blockers such as pancuronium may protect the neuromuscular junction from injury. (nih.gov)
- Even with intermediate acting, nondepolarizing blockers, each patient should be objectively evaluated to see if adequate reversal has occurred. (thedoctors.com)
- Although the nondepolarizing neuromuscular blocking drugs do not have the same adverse effects as succinylcholine, their onset of action is slower. (pharmacycode.com)
- Succinylcholine is commonly used for neuromuscular relaxation for short procedures such as rigid bronchoscopy. (clinicaltrials.gov)
- however, a neuromuscular blocking agent with a rapid onset of action (e.g., succinylcholine, rocuronium) generally preferred in emergency situations when rapid intubation is required. (drugs.com)
- At present, succinylcholine is the only available agent in this class. (thefreelibrary.com)
- The depolarizing blocking agents, such as succinylcholine, act instead by depolarizing the plasmatic membrane of the muscle. (medscape.com)
- Hoppe JO (1955) Observations on the potency of neuromuscular blocking agents with particular reference to succinylcholine. (springer.com)
- Notify surgeon to halt the procedure ASAP: Discontinue volatile agents and succinylcholine. (mhaus.org)
- If induction of paralysis with muscle relaxing agents is required for intubation, succinylcholine should be avoided because of potential for prolonged duration of paralysis. (nih.gov)
- The increase in intraocular pressure may be attenuated with intravenous or inhalational anesthetic agents prior to administration of succinylcholine. (apsf.org)
- Because of the significant side effects associated with succinylcholine administration, anesthesiologists have been searching for a non-depolarizing muscle relaxant with rapid, reliable onset of complete, neuromuscular blockades, short duration of action, and minimal cardiovascular side effects. (apsf.org)
- Depth of neuromuscular block depends on the balance of the NMBA and acetylcholine at the neuromuscular junction, and recovery depends on increasing acetylcholine concentration relative to the NMBA. (asahq.org)
- Prevents neuromuscular transmission by blocking the effect of acetylcholine at the myoneural junction. (unboundmedicine.com)
- These agents produce this effect at the neuromuscular junction by interfering with the action of the neurotransmitter acetylcholine (Ach). (thefreelibrary.com)
- NMBAs either depolarize the per-and post-synaptic membrane receptors or compete with acetylcholine for binding of the acetylcholine receptors at the neuromuscular junction. (thefreelibrary.com)
- The depolarizing agents bind to acetylcholine receptors and cause a sustained postsynaptic membrane depolarization. (thefreelibrary.com)
- The non-depolarizing agents produce paralysis and muscle weakness by competing with acetylcholine for binding at the acetylcholine receptors. (thefreelibrary.com)
- By preventing the binding of acetylcholine, the nondepolarizing agents block the depolarizing effects of acetylcholine, thereby preventing muscle contraction. (thefreelibrary.com)
- A sustained (tetanic) contraction requires summation of a rapid series of action potentials The pharmacological methods by which neuromuscular transmission is blocked include competitive blockade of the acetylcholine receptor with an antagonist (nondepolarizing block) or non-competitive blockade with an agonist which is not broken down by acetylcholinesterase (depolarizing). (anaesthesiauk.com)
- Competitive nondepolarizing NMBAs are competitive acetylcholine (ACh) antagonists that directly bind to postsynaptic nicotinic receptors. (merckvetmanual.com)
- Nondepolarizing NMBAs are competitive antagonists at nicotinic receptors, blocking acetylcholine at the motor endplate. (uspharmacist.com)
- NIMBEX binds competitively to cholinergic receptors on the motor end-plate to antagonize the action of acetylcholine, resulting in block of neuromuscular transmission. (pdr.net)
- Myasthenia gravis is an autoimmune neuromuscular disease caused by autoantibodies to postsynaptic acetylcholine receptors, blocking their attachment at the postsynaptic junction. (hindawi.com)
- Overdosage with neuromuscular blocking agents may result in neuromuscular block beyond the time needed for surgery and anesthesia. (pharmacycode.com)
- Gallamine Triethiodide is a nondepolarizing neuromuscular blocking drug (NDMRD) used as an adjunct to anesthesia to induce skeletal muscle relaxation. (pharmacycode.com)
- In clinical use, neuromuscular block is used adjunctively to anesthesia to produce paralysis , firstly to paralyze the vocal cords, and permit intubation of the trachea, and secondly to optimize the surgical field by inhibiting spontaneous ventilation, and causing relaxation of skeletal muscles. (wikipedia.org)
- Four mothers who were breastfeeding 3- to 5-month-old infants underwent general anesthesia were given intravenous propofol and remifentanil as induction agents and rocuronium 0.5 mg/kg for intubation. (nih.gov)
- Use lower end of the dosing range when anesthesia is maintained with an inhaled anesthetic agent, with the redosing interval guided by monitoring with a peripheral nerve stimulator. (drugs.com)
- BACKGROUND: Nondepolarizing neuromuscular blocking drugs (NNMBDs) are commonly used as an adjunct to general anesthesia. (anesthesiaexperts.com)
- Regardless, all in all some 30,000 patients had been given tubocurarine by 1941, although it was Griffith and Johnson's 1942 publication that provided the impetus to the standard use of neuromuscular blocking agents in clinical anesthestic practice - a revolution that rapidly metamorphosized into the standard practice of "balanced" anesthesia: the triad of barbiturate hypnosis, light inhalational anesthesia and muscle relaxation. (wikipedia.org)
- Present clinical anesthetic practice still employs the central principle of balanced anesthesia though with some differences to accommodate subsequent technological advances and introductions of new and better gaseous anesthetic, hypnotic and neuromuscular blocking agents, and tracheal intubation, as well as monitoring techniques that were nonexistent in the day of Gray and Halton: pulse oximetry, capnography, peripheral nerve stimulation, noninvasive blood pressure monitoring, etc. (wikipedia.org)
- For those patients with myasthenia gravis undergoing anesthesia, anesthesiologists should be aware of anesthetic agents which warrant special attention. (ispub.com)
- MIVACRON is a short-acting neuromuscular blocking agent indicated for inpatients and outpatients, as an adjunct to general anesthesia, to facilitate tracheal intubation and to provide skeletal muscle relaxation during surgery or mechanical ventilation. (rxlist.com)
- When using MIVACRON or other neuromuscular blocking agents to facilitate tracheal intubation, it is important to recognize that the most important factors affecting intubation are the depth of general anesthesia and the level of neuromuscular block. (rxlist.com)
- Satisfactory intubating conditions can usually be achieved before complete neuromuscular block is attained if there is adequate anesthesia. (rxlist.com)
- Objective: To determine whether use of intermediate acting neuromuscular blocking agents during general anesthesia increases the incidence of postoperative respiratory complications. (harvard.edu)
- Vecuronium is a muscle relaxing agent and is used as an ajunct in general anesthesia. (drugbank.ca)
- A nondepolarizing neuromuscular blocking agent used to relax muscles during anesthesia and surgical procedures. (drugbank.ca)
- Rocuronium, a nondepolarizing neuromuscular blocking agent, is used in general anesthesia to provide conditions for endotracheal intubating. (bioportfolio.com)
- Effects of preoperatively administered carbamazepine and phenytoin on rocuronium-induced neuromuscular block under sevoflurane anesthesia: a retrospective clinical study. (thefreedictionary.com)
- Volatile agents are specially formulated organic liquids that evaporate readily into vapors, and are given by inhalation for induction or maintenance of general anesthesia. (wikipedia.org)
- Because of its low potency, it cannot produce anesthesia on its own but is frequently combined with other agents. (wikipedia.org)
- Halothane, an agent introduced in the 1950s, has been almost completely replaced in modern anesthesia practice by newer agents because of its shortcomings. (wikipedia.org)
- In theory, any inhaled anesthetic agent can be used for induction of general anesthesia. (wikipedia.org)
- All of the volatile agents can be used alone or in combination with other medications to maintain anesthesia (nitrous oxide is not potent enough to be used as a sole agent). (wikipedia.org)
- Neuromuscular blockade plays several critical roles in general anesthesia. (emaxhealth.com)
- This study shows that sugammadex offers advantages over neostigmine and may help improve anesthesia management in the millions of surgeries where muscle relaxation agents are used. (emaxhealth.com)
- Residual postoperative paralysis from nondepolarizing neuromuscular blocking agents (NMBAs) is a known problem. (asahq.org)
- Intraoperative use of intermediate nondepolarizing NMBAs is associated with developing pneumonia after surgery. (asahq.org)
- FORTY-FIVE years after Beecher and Todd 1 first described an increase in mortality associated with the use of d-tubocurarine, anesthesiologists are still learning how best to use neuromuscular blocking agents (NMBAs) and their antagonists. (asahq.org)
- The NMBAs are divided into two types: depolarizing and non-depolarizing agents. (thefreelibrary.com)
- A peripheral nerve stimulator, also known as a train-of-four monitor, is used to assess neuromuscular transmission when neuromuscular blocking agents (NMBAs) are given to block musculoskeletal activity. (medscape.com)
- However, in severe cases when sedation and analgesia have been maximized, NMBAs may still be used in conjunction with other agents for several indications, such as to reduce increased intracranial pressure and to decrease oxygen consumption . (medscape.com)
- Peripheral nerve stimulation is used to assess neuromuscular transmission when NMBAs are given to block musculoskeletal activity. (medscape.com)
- Nondepolarizing NMBAs such as pancuronium, rocuronium, and cisatracurium are most frequently used. (medscape.com)
- NMBAs used to induce neuromuscular blockade must be chosen carefully, taking into account clinical indications, patient factors, and the procedure being performed. (merckvetmanual.com)
- ABSTRACT: Neuromuscular blocking agents (NMBAs) play an important role in the management of a large number of hospital patients. (uspharmacist.com)
- Traditionally, reversal of nondepolarizing neuromuscular blocking agents (NMBAs) such as rocuronium or vecuronium has been achieved by using acetylcholinesterase inhibitors, such as neostigmine. (emaxhealth.com)
- Drugs that interrupt transmission at the skeletal neuromuscular junction without causing depolarization of the motor end plate. (curehunter.com)
- Neuromuscular-blocking drugs block neuromuscular transmission at the neuromuscular junction ,  causing paralysis of the affected skeletal muscles . (wikipedia.org)
- Curare had been used as a source of arrow poison by South American natives to hunt animals, and they were able to eat the animals' contaminated flesh subsequently without any adverse effects because tubocurarine cannot easily cross mucous membranes.Thus, tubocurarine is effective only if given parenterally, as demonstrated by Bernard, who also showed that the site of its action was at the neuromuscular junction. (wikipedia.org)
- Neuromuscular blocking agents and the physiology of the neuromuscular junction. (thefreelibrary.com)
- The area between the axon and the skeletal muscle fiber is also called the neuromuscular junction. (thefreelibrary.com)
- 1 Similarly, oral use of verapamil and amlodipine for at least 3 months in patients with no prior known neuromuscular junction defects has resulted in abnormal jitter on single-fiber EMG study. (ispub.com)
- The mechanism may be at the level of the neuromuscular junction or the muscle membrane. (ispub.com)
- Prior C, Dempster J, Marshall IG (1993) Electrophysiological analysis of transmission at the skeletal neuromuscular junction. (springer.com)
- In: Zaimis E (ed) Neuromuscular junction. (springer.com)
- The neuromuscular junction consists of a nerve terminal (of a motor neurone) adjacent to an end plate on skeletal muscle. (anaesthesiauk.com)
- a compound that causes paralysis of skeletal muscle by blocking neural transmission at the neuromuscular junction. (thefreedictionary.com)
- This non-depolarizing muscle relaxant works by blocking the binding of ACh to nAChR on the post synaptic membrane of the neuromuscular junction. (flashcardmachine.com)
Recovery of neuromuscular function4
- 5 However, satisfactory recovery of neuromuscular function is defined as a TOFR ≥ 0.9. (asahq.org)
- 9-12 No study, however, has looked at the effect of administration of these small doses of neostigmine on the time required for complete recovery of neuromuscular function. (asahq.org)
- 1 21 Time to recovery of neuromuscular function is dependent upon strength of neuromuscular blockade at time of reversal. (drugs.com)
- Objective monitoring (documentation of train-of-four ratio ≥0.90) is the only method of assuring that satisfactory recovery of neuromuscular function has taken place. (medscape.com)
- Neuromuscular blockade: indications, peripheral nerve stimulation, and other concurrent interventions. (springer.com)
- Understand indications for neuromuscular blocking agents in critical care. (veccs.org)
- 4 Although a full discussion of agent selection and dosing for surgical indications is beyond the scope of this article, the clinical reversal of these effects will be addressed. (uspharmacist.com)
Effects of nondepolarizing neur1
- May reverse the effects of nondepolarizing neuromuscular blocking agents. (mims.com)
- 1 Whenever neuromuscular blocking agents are used in the ICU, consider benefits versus risks of such therapy and assess patients frequently to determine need for continued paralysis. (drugs.com)
- Neuromuscular blocking agents (NMBA) are drugs that cause skeletal muscle weakness or paralysis and therefore prevent movement. (thefreelibrary.com)
- It must be noted that any paralysis will need the assistance of a respiratory therapist since the use of these agents will affect breathing. (thefreelibrary.com)
- The authors compared 1,455 surgical cases who received an intermediate-acting nondepolarizing NMBA to 1,455 propensity score-matched cases who did not and 1,320 surgical cases who received an NMBA and reversal with neostigmine to 1,320 propensity score-matched cases who did not receive reversal. (asahq.org)
- Among medical treatments (sedatives), neuromuscular blocking agents (NMBA) are recommended by french but not english speaking societies. (clinicaltrials.gov)
- Peripheral nerve stimulation monitoring during NMBA administration results in use of less medication, which can allow for quicker recovery of spontaneous ventilation and accelerated neuromuscular transmission recovery when the NMBA is discontinued. (medscape.com)
- Residual neuromuscular blockade, which is an important cause of NMBA-associated morbidity in surgical patients, was not reported in any patient in this study. (emaxhealth.com)
- Practices regarding antagonism of residual neuromuscular block vary based on the country of practice, 2 type of anesthetic practice, 3 and individual clinician preference. (asahq.org)
- These disparate practices developed in part because of concern of adverse effects, such as arrhythmias, nausea, and vomiting, resulting from anticholinesterase administration as well as an inability to reliably detect the presence of residual neuromuscular block. (asahq.org)
- Although not administering an anticholinesterase increases the risk of residual neuromuscular blockade, 6 unwarranted administration of neostigmine (at a TOFR ≥ 0.9) can exacerbate weakness. (asahq.org)
- As the function of the diaphragm during sepsis is often severely impaired,[sup] it is of great importance to fully reverse the residual neuromuscular block in septic patients. (thefreedictionary.com)
- the risk of residual neuromuscular is nearly eliminated when this agent is administered intraoperatively. (bireme.br)
- Neostigmine: How Much Is Necessary for Patients Who Receive a Nondepolarizing Neuromuscular Blocking Agent? (asahq.org)
- The primary outcome is the area under the curve of the temporal evolution of intracranial pressure, over a period of 30 minutes after the administration of neuromuscular blocking agent or placebo. (clinicaltrials.gov)
- Dihydrochandonium is an aminosteroid non-depolarizing neuromuscular blocking agent. (wikipedia.org)
- A non-depolarizing neuromuscular blocking agent with shorter duration of action than pancuronium. (drugbank.ca)
- Initially, sugammadex, a reversal agent for a non-depolarizing neuromuscular blocking agent, was suspected as the causat. (bioportfolio.com)
- Impact of high- versus low-dose neuromuscular blocking agent administration on unplanned 30-day readmission rates in retroperitoneal laparoscopic surgery. (bioportfolio.com)
- Rocuronium is a non-depolarising neuromuscular blocking agent. (bioportfolio.com)
- Doses of 40 μg/kg or less of neostigmine have been found effective for reversing 90% neuromuscular block when monitoring for recovery to a TOFR = 0.7. (asahq.org)
- The potential for neostigmine to rapidly restore neuromuscular function is limited. (asahq.org)
- To reverse neuromuscular blockade, administer a cholinesterase inhibitor (e.g., neostigmine, pyridostigmine, edrophonium) in conjunction with an anticholinergic agent such as atropine or glycopyrrolate to block adverse muscarinic effects of the cholinesterase inhibitor. (drugs.com)
- Administration of anticholinesterase agents (neostigmine, pyridostigmine) may be used to antagonize the action of cisatracurium once the patient has demonstrated some spontaneous recovery from neuromuscular block. (unboundmedicine.com)
- Total doses in excess of 2ml are not recommended as this dose of Neostigmine may produce depolarising neuromuscular block. (medicines.org.uk)
- In addition, this product should not be given in conjunction with suxamethonium, as Neostigmine potentiates the depolarising myoneural blocking effects of this agent. (medicines.org.uk)
- Improved postoperative oxygenation after antagonism of moderate neuromuscular block with sugammadex versus neostigmine after extubation in 'blinded' conditions. (thefreedictionary.com)
- Schering-Plough Corp., (NYSE: SGP) today announced that a study published in the November 2008 issue of the medical journal, Anesthesiology (Vol. 109, No. 5)(1) demonstrated that sugammadex produced a significantly more rapid recovery from profound rocuronium-induced muscle relaxation than the conventional reversal agent neostigmine. (emaxhealth.com)
- The study, known as the Signal trial, was a Phase III, multicenter, randomized, parallel-group, safety-assessor blinded study that compared the efficacy and safety of sugammadex versus neostigmine/glycopyrrolate in the reversal of profound rocuronium-induced neuromuscular blockade. (emaxhealth.com)
- In the Signal study, sugammadex or neostigmine was administered at reappearance of 1-2 post-tetanic counts (profound neuromuscular blockade). (emaxhealth.com)
- We chose the use of sugammadex 700 mg intravenously as an adjuvant agent. (scielo.br)
- 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 blocker 4 . (scielo.br)
- Pharmacists in the hospital setting should be familiar with the recently approved novel direct-reversal agent sugammadex (Bridion). (uspharmacist.com)
- Sugammadex, a new reversal agent for neuromuscular block induced by rocuronium in the anaesthetized Rhesus monkey. (semanticscholar.org)
- The present study evaluated the ability of Sugammadex Org 25969, a synthetic gamma-cyclodextrin derivative, to reverse constant neuromuscular block of about 90% induced by rocuronium or the non-steroidal neuromuscular blocking drugs, mivacurium or atracurium, in the anaesthetized Rhesus monkey. (semanticscholar.org)
- Is lower-dose sugammadex a cost-saving strategy for reversal of deep neuromuscular block? (semanticscholar.org)
- Reversal of profound rocuronium or vecuronium-induced neuromuscular block with sugammadex in isoflurane-anaesthetised dogs. (semanticscholar.org)
- Sugammadex (SUG) rapidly reverses steroidal NMB agents after anaesthesia. (medsci.org)
- Sugammadex is a novel selective relaxant binding agent that works in an entirely new and unique way to encapsulate the muscle relaxant molecule and render it inactive. (emaxhealth.com)
- These results demonstrate the efficacy of sugammadex in rapidly reversing profound rocuronium-induced neuromuscular blockade, an option that is not possible with conventional reversal agents," said Robert J. Spiegel, M.D., chief medical officer and senior vice president, Schering-Plough Research Institute. (emaxhealth.com)
Administration of neuromuscular2
- When using a stimulator to monitor onset of neuromuscular block, clinical studies have shown that all four twitches of the train-of-four response may be present, with little or no fade, at the times recommended for intubation. (rxlist.com)
- May decrease time to onset of maximum neuromuscular blockade. (nih.gov)
- This study demonstrated that rocuronium bromide was an effective mydriatic agent in Hispaniolan Amazon parrots with rapid onset and prolonged duration of action. (thefreelibrary.com)
- Compared to other neuromuscular blocking agents, it is intermediate in its onset and duration of action. (pdr.net)
- The time from the end of cisatracurium injection until maximum neuromuscular block (onset time), degree of maximal block, and the time of recovery of the first twitch in TOF to 25% of the control value (recovery time) were recorded (Table 2). (thefreedictionary.com)
Skeletal muscle relaxant for int2
- Reversal of neuromuscular blockade and simultaneous increase in plasma rocuronium concentration after the intravenous infusion of the novel reversal agent Org 25969. (semanticscholar.org)
- 1 , 2 ] When a combination of anesthetic agents is used for a procedure, follow the recommendations for the most problematic medication used during the procedure. (nih.gov)
- This is a particularly important question when such medications are being prescribed for potentially life-threatening conditions such as cardiac arrhythmias, or when anesthetic agents must be chosen for life-saving surgery. (ispub.com)
- We also call attention to special considerations regarding the use of anesthetic agents in these patients. (ispub.com)
- Factors that may warrant dosage adjustment include but may not be limited to: the presence of significant kidney, liver, or cardiovascular disease, obesity (patients weighing greater than or equal to 30% more than ideal body weight for height), asthma, reduction in plasma cholinesterase activity, and the presence of inhalational anesthetic agents. (rxlist.com)
- Animals are fully conscious throughout the period of immobilization unless an anesthetic or hypnotic agent is administered concurrently. (merckvetmanual.com)
- Local anesthetic agents prevent transmission of nerve impulses without causing unconsciousness. (wikipedia.org)
- Only preservative -free local anesthetic agents may be injected intrathecally . (wikipedia.org)
- Anesthetic consideration for neuromuscular diseases. (bireme.br)
- PURPOSE OF REVIEW: The aim of this review is to examine data relating to perioperative management of the patient with neuromuscular disorders RECENT FINDINGS: Patients with pre-existing neuromuscular disorders are at risk for a number of postoperative complications that are related to anesthetic drugs that are administered intraoperatively. (bireme.br)
- This article reviews the anesthetic implications of patients undergoing surgery with neuromuscular disorder. (bireme.br)
- The family required extensive counseling regarding the safety of anesthetic agents in their child, and not all the answers were clear. (apsf.org)
- The neuromuscular blocking potency of NIMBEX is approximately threefold that of atracurium besylate. (pdr.net)
- Most of the agents in this category would also be classified as non-depolarizing. (wikipedia.org)
- These agents act by depolarizing the sarcolemma of the skeletal muscle fiber . (wikipedia.org)
- A neuromuscular non-depolarizing agent is a form of neuromuscular blocker that does not depolarize the motor end plate . (wikipedia.org)
- In this sense, tubocurarine is the prototypical adjunctive neuromuscular non-depolarizing agent. (wikipedia.org)
- Consider cross-reactivity among neuromuscular blocking agents, both depolarizing and non-depolarizing. (nih.gov)
- Zaimis E, Head S (1976) Depolarizing neuromuscular blocking drugs. (springer.com)
- Birmingham AT, Hussain SZ (1980) A comparison of the skeletal neuromuscular and autonomic ganglion-blocking potencies of five non-depolarizing relaxants. (springer.com)
- Bloxiverz is a drug used intravenously in the operating room for the reversal of the effects of non-depolarizing neuromuscular blocking agents after surgery. (reuters.com)
- Rocuronium (ROC) and Vecuronium (VEC) are the most currently used steroidal non-depolarizing neuromuscular blocking (MNB) agents. (medsci.org)
- 015\\012\\015\\012\\015\\012It is a non-depolarizing neuromuscular \\015\\012blocking agent with shorter duration of action than. (tradeindia.com)
- Duration of non-depolarizing neuromuscular blocking agents is longer in isoflurane, compared with halothane-anesthetized animals. (vetstream.com)
- Also, patients may be pretreated with a non-depolarizing neuromuscular blocking drug in the hope of preventing muscle fasciculations and muscle pain. (apsf.org)
- Based on the Society for Critical Care Medicine Clinical Practice Guidelines for Sustained Neuromuscular Blockade in the Adult Critically Ill Patient , a neuromuscular blocker may be used to manage overt shivering in therapeutic hypothermia following cardiac arrest. (drugs.com)
- Nondepolarizing neuromuscular blocking drugs in the intensive care unit: a clinical review. (springer.com)
- The clinical duration of neuromuscular block (time to 25% T1 recovery) was 165 +/- 90 min in Group 1 and 258 +/- 86 in Group 2 (P = 0.03). (curehunter.com)
- Therefore, as with other neuromuscular blocking agents, it is important to use other criteria, such as clinical evaluation of the status of relaxation of jaw muscles and vocal cords, in conjunction with peripheral muscle twitch monitoring, to guide the appropriate time of intubation. (rxlist.com)
- Check for active clinical trials using this agent. (cancer.gov)
- Use peripheral nerve stimulator and monitor clinical signs of neuromuscular blockade. (nih.gov)
- This is a clinical problem if a reversal agent is given while the patient is deeply paralyzed. (anaesthesiauk.com)
- Neuromuscular blocking agents perhaps have the most fascinating history among the drugs used in anesthesiology and intensive care. (springer.com)
- Neuromuscular-blocking drugs. (springer.com)
- The NCI Drug Dictionary contains technical definitions and synonyms for drugs/agents used to treat patients with cancer or conditions related to cancer. (cancer.gov)
- These patients have a normal response to nondepolarizing neuromuscular blocking drugs. (renalandurologynews.com)
- Hunter JM (1995) New neuromuscular blocking drugs. (springer.com)
- Anticholinesterase drugs enhance neuromuscular transmission in voluntary and involuntary muscle in myasthenia gravis. (medicines.org.uk)
- Examples of prejunctional blocking agents include biotoxins, electrolytes, local anesthetics or other drugs, and some antimicrobials. (merckvetmanual.com)
- In addition, the increasing usage of neuromuscular blocking agents in surgeries, and increase in disposable income are also driving the growth of the global muscle relaxant drugs market. (psmarketresearch.com)
- Double-blind, randomized, multicenter study of doxacurium vs. pancuronium in intensive care unit patients who require neuromuscular-blocking agents. (springer.com)
Level of neuromuscular1
- Monitor level of neuromuscular blockade during long-term administration to limit exposure to toxic metabolites. (nih.gov)
Duration of neuromuscular1
- May shorten duration of neuromuscular blockade. (nih.gov)
- Its most useful feature as an induction agent is that it produces deep sedation while causing minimal cardiovascular effects. (medscape.com)
- Neuromuscular blockade does not provide pain control, sedation, or amnestic effects. (drugs.com)
- Pharmacoeconomic issues of sedation, analgesia and neuromuscular blockade in critical care. (springer.com)
- 3-7 The choice of agent and dosing varies widely depending on the surgical procedure and also on the use of alternative agents, including general anesthetics, local anesthetics, and IV sedation medications. (uspharmacist.com)
- Effects of neuromuscular block on systemic and cerebral hemodynamics and bispectral index during moderate or deep sedation in critically ill patients. (thefreedictionary.com)
- Neuromuscular diseases such as myasthenia gravis (small test dose may be used to assess response). (unboundmedicine.com)
- Patients with neuromuscular diseases are at higher risk. (nih.gov)
- Journal of Neuromuscular Diseases. (mhaus.org)
- SUMMARY: Careful assessment and management of patients with underlying neuromuscular diseases is required to reduce postoperative complications. (bireme.br)
- Myasthenia gravis is an immune-mediated post-synaptic disorder of neuromuscular transmission, most commonly presenting as oculobulbar and proximal muscle weakness associated with easy fatigability. (ispub.com)
- There may be either hypersensitivity or resistance to nondepolarizing neuromuscular blocking agents. (soap.org)
- Among patients who receive these agents, nonreversal is associated with an increased risk of postoperative pneumonia. (asahq.org)
- monitor patients closely until adequate recovery of normal neuromuscular function is assured (i.e., ability to maintain satisfactory ventilation and a patent airway). (drugs.com)
- Sedative and neuromuscular blocking drug use in critically ill patients with head injuries. (springer.com)
- Because a variety of pharmacologic agents may affect neuromuscular transmission, physicians caring for these patients often must determine whether the medications needed by these patients are likely to adversely affect their myasthenia gravis. (ispub.com)
- In addition, many patients with myasthenia gravis are treated with immunosuppressive agents, leading to more frequent and serious infections than are seen in the general population, and requiring judicious choices of antibiotics. (ispub.com)
- The purpose of this review is to provide a clinician's guide to medications which may exacerbate myasthenia gravis, or which may produce signs and symptoms of myasthenia gravis in patients without a known defect of neuromuscular transmission. (ispub.com)
- To determine the characteristics of neuromuscular block produced by two and three times the 95% effective dose (ED95) of doxacurium in patients undergoing coronary artery surgery with hypothermic cardiopulmonary bypass . (curehunter.com)
- These patients have increased sensitivity to nondepolarizing neuromuscular blocking agents. (renalandurologynews.com)
- Use a lower initial bolus dose and consider using a reversal agent in these patients. (nih.gov)
- Administration of anticholinesterase agents to patients with intestinal anastomoses may produce rupture of the anastomosis or leakage of intestinal contents. (medicines.org.uk)
- This session will focus on the use of NMB agents in critically ill dogs and cats with emphasis on mechanically ventilated patients. (veccs.org)
- MELAS patients have nonetheless successfully undergone surgery using neuromuscular blockade and inhaled anesthetics without incident. (soap.org)
- Cautious use should be exercised when administering these agents to those patients with hyperthyroidism, low heart rate (bradycardia), peptic ulcer disease or asthma. (pharmacology2000.com)
- An antifungal agent used for the treatment of various fungal infections in immunocompromised and non-immunocompromised patients, such as pulmonary and extrapulmonary blastomycosis, histoplasmosis, and onychomycosis. (drugbank.ca)
- The cis-cis diester has been estimated from studies in cats to have one-tenth the neuromuscular blocking potency of the other two stereoisomers. (rxlist.com)
- Volatile agents are frequently compared in terms of potency, which is inversely proportional to the minimum alveolar concentration . (wikipedia.org)
- Aminosteroid, competitive neuromuscular blocker. (drugfuture.com)
- Atropine is usually administered prior to or concurrently with anticholinesterase agents to counteract the muscarinic effects. (unboundmedicine.com)
- Consequently, topical or intraocular parasympatholytic (atropine) and sympathomimetic (phenylephrine) mydriatic agents used to dilate mammalian pupils are not effective in a variety of avian species because of the high proportion of striated sphincter muscle fibers. (thefreelibrary.com)
- Ocular symptoms caused by local absorption of nerve agents do not respond to systemic administration of atropine. (nih.gov)
- A reversal agent should be readily available in the event of a failed intubation or to accelerate neuromuscular recovery after surgery. (drugs.com)
Intubation and mechanical ventilation1
- It is used to facilitate endotracheal intubation and provide neuromuscular relaxation during intubation and mechanical ventilation. (medscape.com)
- It will not effectively antagonize 100% neuromuscular block, and requiring 10 min to peak effect, it cannot instantaneously restore neuromuscular function. (asahq.org)
- neuromuscular block induced by aminoglycoside antibiotics and antiarrhythmic agents. (medicines.org.uk)
- BACKGROUND Binding of the steroidal molecule of rocuronium by a cyclodextrin is a new concept for reversal of neuromuscular block. (semanticscholar.org)
- A novel concept of reversing neuromuscular block: chemical encapsulation of rocuronium bromide by a cyclodextrin-based synthetic host. (semanticscholar.org)
- Recent data shows that a neuromuscular block (NMB) induced by administration of high doses of rocuronium improves surgical conditions in certain procedures. (bioportfolio.com)
- Robertson, "Determinants of the reversal time of competitive neuromuscular block by anticholinesterases," British Journal of Anaesthesia, vol. (thefreedictionary.com)
- Intubating conditions and time course of rocuronium-induced neuromuscular block in children. (thefreedictionary.com)
- Stimulus frequency in the detection of neuromuscular block in humans. (thefreedictionary.com)
- In the case of myasthenia gravis, typically fast-acting reversible acetylcholinesterase inhibitors help with assessing the extent of neuromuscular dysfunction of the disease. (pharmacology2000.com)
- Although a patient with four equal responses to train-of-four (TOF) stimulation, on either visual or tactile assessment, might be completely recovered from neuromuscular blockade, the TOF ratio (TOFR) could be as low as 0.4. (asahq.org)
- We report an unusual case of prolonged neuromuscular blockade with rocuronium in an infant undergoing cleft lip repair anesthetized with sevoflurane and management of the patient. (biomedsearch.com)
- Fortunately, there is a remarkable amount of redundancy built into the anatomic and physiologic processes of neuromuscular transmission. (asahq.org)
- Viby-Mogensen J. Neuromuscular transmission and neuromuscular disease. (springer.com)
- One such cause is the prescription of one or more medications which may worsen neuromuscular transmission. (ispub.com)
- Explain the physiology of neuromuscular transmission and how this may be interfered with to produce muscle relaxation. (anaesthesiauk.com)
- Neuromuscular transmission can be modified either at the axonal membrane (prejunctional blockade) or at the cholinergic receptors in the sarcolemma (postjunctional blockade). (merckvetmanual.com)
- FRCA examinations require an extensive knowledge of neuromuscular transmission blocking agents. (anaesthesiauk.com)
- Assess neuromuscular blockade and recovery with a peripheral nerve stimulator to accurately monitor the degree of muscle relaxation, determine need for additional doses, and minimize possibility of overdosage. (drugs.com)
- Monitor neuromuscular response with a peripheral nerve stimulator intraoperatively. (unboundmedicine.com)
- If overdose occurs, use peripheral nerve stimulator to determine the degree of neuromuscular blockade. (unboundmedicine.com)
- By assessing the depth of neuromuscular blockade, peripheral nerve stimulation can ensure proper medication dosing and thus decrease the incidence of side effects. (medscape.com)
- A consensus statment recommends that neuromuscular function must be monitored by observing the evoked muscular response to peripheral nerve stimulation. (medscape.com)
- The trans- trans and cis-trans stereoisomers comprise 92% to 96% of mivacurium chloride and their neuromuscular blocking potencies are not significantly different from each other or from mivacurium chloride. (rxlist.com)
- Because the appropriate dose of neuromuscular-blocking drug may paralyze muscles required for breathing (i.e., the diaphragm), mechanical ventilation should be available to maintain adequate respiration . (wikipedia.org)
- 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. (pharmacycode.com)
- Like methohexital, it is most commonly used as an induction agent for intubation. (medscape.com)
- A crucial component of developing a standardised protocol is the selection of induction agents. (nih.gov)
- Apart from the induction agents, the RSI protocol was identical in both groups. (nih.gov)
- For this reason, the most frequently used agent for inhalational induction is sevoflurane [ citation needed ] . (wikipedia.org)
- They also have a longer duration of action, making them more suitable for maintaining neuromuscular relaxation during major surgical procedures. (pharmacycode.com)
- Maintenance for continued surgical relaxation (only after return of neuromuscular function): Intermittent dosing: 0.01 to 0.015 mg/kg or continuous infusion of 0.8 to 1.2 mcg /kg/ minute (0.048 to 0.072 mg /kg/ hour ). (drugs.com)
- Examples of 'reversible' acetylcholinesterase inhibitors that may be used clinically include both carbamylating agents and those that associate only with the choline binding domain. (pharmacology2000.com)