A quaternary skeletal muscle relaxant usually used in the form of its bromide, chloride, or iodide. It is a depolarizing relaxant, acting in about 30 seconds and with a duration of effect averaging three to five minutes. Succinylcholine is used in surgical, anesthetic, and other procedures in which a brief period of muscle relaxation is called for.
Drugs that interrupt transmission at the skeletal neuromuscular junction by causing sustained depolarization of the motor end plate. These agents are primarily used as adjuvants in surgical anesthesia to cause skeletal muscle relaxation.
Drugs that interrupt transmission 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.
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.
Androstanes and androstane derivatives which are substituted in any position with one or more hydroxyl groups.
Involuntary contraction of the muscle fibers innervated by a motor unit. Fasciculations can often by visualized and take the form of a muscle twitch or dimpling under the skin, but usually do not generate sufficient force to move a limb. They may represent a benign condition or occur as a manifestation of MOTOR NEURON DISEASE or PERIPHERAL NERVOUS SYSTEM DISEASES. (Adams et al., Principles of Neurology, 6th ed, p1294)
A procedure involving placement of a tube into the trachea through the mouth or nose in order to provide a patient with oxygen and anesthesia.
A bis-quaternary steroid that is a competitive nicotinic antagonist. As a neuromuscular blocking agent it is more potent than CURARE but has less effect on the circulatory system and on histamine release.
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.
Cholinesterases are a group of enzymes that catalyze the hydrolysis of acetylcholine and other choline esters, playing crucial roles in the termination of impulse transmission at cholinergic synapses and neuro-muscular junctions, and in the metabolism of certain drugs and toxic substances.
Rapid and excessive rise of temperature accompanied by muscular rigidity following general anesthesia.
A barbiturate that is administered intravenously for the induction of general anesthesia or for the production of complete anesthesia of short duration.
Intratracheal anesthesia is a technique where anesthetic agents are directly instilled into the trachea to induce or maintain general anesthesia, often used in emergency situations, veterinary medicine, or when conventional methods of administration are not feasible.
Anesthesia caused by the breathing of anesthetic gases or vapors or by insufflating anesthetic gases or vapors into the respiratory tract.
A neuromuscular blocker and active ingredient in CURARE; plant based alkaloid of Menispermaceae.
Procedure in which patients are induced into an unconscious state through use of various medications so that they do not feel pain during surgery.
A major nerve of the upper extremity. In humans, the fibers of the ulnar nerve originate in the lower cervical and upper thoracic spinal cord (usually C7 to T1), travel via the medial cord of the brachial plexus, and supply sensory and motor innervation to parts of the hand and forearm.
A masticatory muscle whose action is closing the jaws.
An aspect of cholinesterases.
Continuous involuntary sustained muscle contraction which is often a manifestation of BASAL GANGLIA DISEASES. When an affected muscle is passively stretched, the degree of resistance remains constant regardless of the rate at which the muscle is stretched. This feature helps to distinguish rigidity from MUSCLE SPASTICITY. (From Adams et al., Principles of Neurology, 6th ed, p73)
A transient absence of spontaneous respiration.
Compounds that contain the decamethylenebis(trimethyl)ammonium radical. These compounds frequently act as neuromuscular depolarizing agents.
A non-depolarizing neuromuscular blocking agent with short duration of action. Its lack of significant cardiovascular effects and its lack of dependence on good kidney function for elimination provide clinical advantage over alternate non-depolarizing neuromuscular blocking agents.
Cyclic GLUCANS consisting of eight (8) glucopyranose units linked by 1,4-glycosidic bonds.
A nonflammable, halogenated, hydrocarbon anesthetic that provides relatively rapid induction with little or no excitement. Analgesia may not be adequate. NITROUS OXIDE is often given concomitantly. Because halothane may not produce sufficient muscle relaxation, supplemental neuromuscular blocking agents may be required. (From AMA Drug Evaluations Annual, 1994, p178)
Nitrogen oxide (N2O). A colorless, odorless gas that is used as an anesthetic and analgesic. High concentrations cause a narcotic effect and may replace oxygen, causing death by asphyxia. It is also used as a food aerosol in the preparation of whipping cream.
An aspect of cholinesterase (EC 3.1.1.8).
Drugs administered before an anesthetic to decrease a patient's anxiety and control the effects of that anesthetic.
A sulfur-containing analog of butyrylcholine which is hydrolyzed by butyrylcholinesterase to butyrate and thiocholine. It is used as a reagent in the determination of butyrylcholinesterase activity.
The synapse between a neuron and a muscle.
Ultrashort-acting anesthetics that are used for induction. Loss of consciousness is rapid and induction is pleasant, but there is no muscle relaxation and reflexes frequently are not reduced adequately. Repeated administration results in accumulation and prolongs the recovery time. Since these agents have little if any analgesic activity, they are seldom used alone except in brief minor procedures. (From AMA Drug Evaluations Annual, 1994, p174)
Rapidly decreasing response to a drug or physiologically active agent after administration of a few doses. In immunology, it is the rapid immunization against the effect of toxic doses of an extract or serum by previous injection of small doses. (Dorland, 28th ed)
An intravenous anesthetic agent which has the advantage of a very rapid onset after infusion or bolus injection plus a very short recovery period of a couple of minutes. (From Smith and Reynard, Textbook of Pharmacology, 1992, 1st ed, p206). Propofol has been used as ANTICONVULSANTS and ANTIEMETICS.
A disorder in which the adductor muscles of the VOCAL CORDS exhibit increased activity leading to laryngeal spasm. Laryngismus causes closure of the VOCAL FOLDS and airflow obstruction during inspiration.
A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures.
Muscles arising in the zygomatic arch that close the jaw. Their nerve supply is masseteric from the mandibular division of the trigeminal nerve. (From Stedman, 25th ed)
The period of emergence from general anesthesia, where different elements of consciousness return at different rates.
Methyl, propyl, butyl, and ethyl esters of p-hydroxybenzoic acid. They have been approved by the FDA as antimicrobial agents for foods and pharmaceuticals. (From Hawley's Condensed Chemical Dictionary, 11th ed, p872)
The striated muscle groups which move the LARYNX as a whole or its parts, such as altering tension of the VOCAL CORDS, or size of the slit (RIMA GLOTTIDIS).
A potent narcotic analgesic, abuse of which leads to habituation or addiction. It is primarily a mu-opioid agonist. Fentanyl is also used as an adjunct to general anesthetics, and as an anesthetic for induction and maintenance. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1078)
Substances added to pharmaceutical preparations to protect them from chemical change or microbial action. They include ANTI-BACTERIAL AGENTS and antioxidants.
A local anesthetic of the amide type now generally used for surface anesthesia. It is one of the most potent and toxic of the long-acting local anesthetics and its parenteral use is restricted to spinal anesthesia. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1006)
The musculofibrous partition that separates the THORACIC CAVITY from the ABDOMINAL CAVITY. Contraction of the diaphragm increases the volume of the thoracic cavity aiding INHALATION.
A mercaptocholine used as a reagent for the determination of CHOLINESTERASES. It also serves as a highly selective nerve stain.
Examination, therapy or surgery of the interior of the larynx performed with a specially designed endoscope.
Process of administering an anesthetic through injection directly into the bloodstream.

Effects of an intubating dose of succinylcholine and rocuronium on the larynx and diaphragm: an electromyographic study in humans. (1/306)

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)

Halothane induces calcium release from human skinned masseter muscle fibers. (2/306)

BACKGROUND: An increase in masseter muscle tone in response to halothane or succinylcholine anesthesia (or both) can be observed in healthy persons. Thus the authors compared the fiber-type halothane and succinylcholine sensitivities in human masseter and vastus lateralis muscles. METHODS: Masseter and vastus lateralis muscle segments were obtained from 13 and 9 healthy persons, respectively. After chemical skinning of a single fiber and loading the sarcoplasmic reticulum with Ca++ 0.16 microM solution, halothane (0.5-4 vol% bubbled in the incubating solution), succinylcholine (0.1 microM to 10 mM), or both sensitivities were defined as the concentration inducing more than 10% of the maximum tension obtained by application of 16 microM Ca++ solution. The myofilament response to Ca++ was studied with and without halothane by observing the isometric tension of skinned masseter fibers challenged with increasing concentrations of Ca++. Muscle fiber type was determined by the difference in strontium-induced tension measurements. RESULTS: A significant difference in halothane sensitivity was found between type 1 masseter fibers (0.6+/-0.2 vol%; mean +/- SD) versus type 1 (2.7+/-0.6 vol%) and type 2 vastus lateralis muscle (2.5+/-0.4 vol%). Succinylcholine did not induce Ca++ release by the sarcoplasmic reticulum. In the masseter muscle, 0.75 vol% halothane decreased the maximal activated tension by 40% but did not change the Ca++ concentration that yields 50% of the maximal tension. CONCLUSIONS: The very low halothane threshold for Ca++ release from the masseter muscle usually could be counteracted by a direct negative inotropic effect on contractile proteins. However, halothane may increase the sensitivity of the sarcoplasmic reticulum Ca++ release to succinylcholine-induced depolarization, leading to an increase in masseter muscle tone.  (+info)

Characteristics of recombinant human butyrylcholinesterase. (3/306)

AIM: To study the biochemical-pharmacological properties of the recombinant human butyrylcholinesterase (rhBChE) and thereby to size up the potential possibility of using it as a detoxifying agent in succinylcholine intoxication. METHODS: CHO-dhfr cells were transfected with plasmids by electroporation. BChE activity was determined colorimetrically by 5, 5'-dithiobis-(2-nitrobenzoic acid) (DTNB) method. Antigenicity was estimated by enzyme-linked immunosorbent assay and Western blot. RESULTS: The maximal expression amounted to 25.83 ng.h-1/10(6) cells. The rhBChE was highly similar to the native human BChE (nhBChE) in terms of its catalytic property, substrate affinity, inhibitor sensitivity, reactivation, stability, and immunoreactivity with anti-nhBChE antibodies. Mice challenged with 1.5 lethal dose of succinylcholine preincubated with rhBChE survived without any symptoms of intoxication. CONCLUSION: The rhBChE and nhBChE exhibit similar biochemical-pharmacological features. It is of potential value in practical use.  (+info)

Comparison of intubating conditions after rapacuronium (Org 9487) and succinylcholine following rapid sequence induction in adult patients. (4/306)

We have assessed intubating conditions provided by rapacuronium (Org 9487) and succinylcholine after rapid sequence induction of anaesthesia in adult patients undergoing elective surgery. We studied 335 patients, ASA I and II, in five centres. Two hundred and thirty-four subjects with normal body weight and 101 obese subjects were allocated randomly to one of four treatment groups differing in the neuromuscular blocking drug administered (rapacuronium 1.5 mg kg-1 or succinylcholine 1 mg kg-1) and in the technique used for induction of anaesthesia (fentanyl 2-3 micrograms kg-1 with thiopental 3-6 mg kg-1 or alfentanil 20 micrograms kg-1 with propofol 1.5-2 mg kg-1). Intubation was started at 50 s by an anaesthetist blinded to the drugs used. Intubating conditions were clinically acceptable (excellent or good) in 89.4% of patients after rapacuronium and in 97.4% after succinylcholine (P = 0.004), the estimated difference being 8.1% (95% confidence interval (CI) 2.0-14.1%). Neither anaesthetic technique nor subject group had an influence on intubating conditions. After intubation, the maximum increase in heart rate averaged 23.1 (SD 25.4%) and 9.4 (26.1%) after rapacuronium and succinylcholine, respectively (P < 0.001). Pulmonary side effects (bronchospasm and increased airway pressure) were observed in 10.7% (95% CI 5.8-17%) and 4.1% (95% CI 1.3-8.8%) of patients given rapacuronium and succinylcholine, respectively (P = 0.021). We conclude that after rapid sequence induction of anaesthesia in adults, clinically acceptable intubating conditions were achieved less frequently after rapacuronium 1.5 mg kg-1 than after succinylcholine.  (+info)

Hemodynamic and metabolic manifestations of acute endotoxin infusion in pigs with and without the malignant hyperthermia mutation. (5/306)

BACKGROUND: The hypermetabolic state induced by acute endotoxemia and malignant hyperthermia (MH) may be indistinguishable. The aims of this study were (1) to investigate the differences between MH and sepsis, (2) to determine whether acute endotoxemia can trigger MH, and (3) to establish the effects of dantrolene in these two disorders. METHODS: Three groups of swine were studied. All pigs were invasively monitored and initially anesthetized with nontriggering agents. A placebo MH-susceptible group (n = 5) received normal saline whereas the endotoxin groups (MH-susceptible, n = 6; MH-negative, n = 4) received intravenous endotoxin (250 microg/kg total) during 2.5 h. Halothane (1.5%) and succinylcholine (2-4 mg/kg) were then administered, followed by two doses of dantrolene (4 mg/kg total). RESULTS: Endotoxin infusion resulted in pulmonary hypertension and systemic hypotension in pigs with and without the MH mutation, but did not trigger MH. Halothane and succinylcholine triggered MH, evidenced by a markedly higher oxygen consumption in the MH-susceptible pigs that received endotoxin (325+/-196 ml/min) and those that did not (374+/-110 ml/min) compared to the MH-negative pigs (69+/-15 ml/min, P<0.0009), as well as muscular rigidity in the susceptible animals. Dantrolene reversed these changes. Three of the six MH-susceptible pigs that received endotoxin died; two died soon after triggering and one after dantrolene administration. In contrast, none of the MH-negative pigs or the MH-susceptible pigs that did not receive endotoxin died (0 of 9 vs. 3 of 6, P = 0.044). CONCLUSION: Endotoxemia does not trigger MH, but may worsen outcome if it occurs.  (+info)

Effect of rocuronium compared with succinylcholine on intraocular pressure during rapid sequence induction of anaesthesia. (6/306)

We have compared the effect of rocuronium and succinylcholine on intraocular pressure (IOP) during rapid sequence induction of anaesthesia using propofol and fentanyl, in a randomized double-blind study. We studied 30 adult patients, allocated to one of two groups. Anaesthesia was induced with fentanyl 2 micrograms kg-1 and propofol until loss of verbal response. This was followed by succinylcholine 1.5 mg kg-1 (group S; n = 15) or rocuronium 0.9 mg kg-1 (group R; n = 15). Laryngoscopy was performed 60 s later. IOP, mean arterial pressure (MAP) and heart rate (HR) were measured before induction, immediately before intubation and every minute after intubation for 5 min. A Keeler Pulsair air impulse tonometer was used to measure IOP and the mean of two readings obtained in the right eye at each measurement time was recorded. Intubating conditions were evaluated according to a simple scoring system. IOP in the succinylcholine group was significantly greater than that in the rocuronium group (mean 21.6 (SEM 1.4) mm Hg vs 13.3 (1.4) mm Hg; P < 0.001). Intubating conditions were equally good in both groups. We conclude that with rapid sequence induction of anaesthesia using propofol and fentanyl, rocuronium did not cause as great an increase in IOP as succinylcholine and may be an alternative in open eye injury cases.  (+info)

Intramuscular rapacuronium in infants and children: dose-ranging and tracheal intubating conditions. (7/306)

BACKGROUND: Intravenous rapacuronium's rapid onset and short duration suggest that intramuscular rapacuronium might facilitate tracheal intubation without prolonged paralysis. Accordingly, the authors injected rapacuronium into the deltoid muscle to determine the optimal dose and time for intubation in pediatric patients. METHODS: Unpremedicated patients (aged, 2 months to 3 yr) were studied. Part I: Spontaneous minute ventilation (V(E)) and twitch tension were measured during N2O/halothane anesthesia. Rapacuronium (2.2-5.5 mg/kg, given intramuscularly, n = 23), succinylcholine (4 mg/kg, given intramuscularly, n = 12), or vecuronium (0.1 mg/kg, given intravenously, n = 15) was given. Time to 50% depression of V(E) and 10% recovery of twitch were measured. Dose for each patient was changed 10-20% according to the previous patient's response. Part II: In 22 patients anesthetized with 0.82-1.0% halothane, the optimal rapacuronium dose determined in part I (infants, 2.8 mg/kg; children, 4.8 mg/kg) was given intramuscularly. Laryngoscopy was scored. Time to laryngoscopy was increased or decreased 0.5 min according to the previous patient's response. RESULTS: Part I: Rapacuronium typically depressed ventilation in < or = 2 min with 10% twitch recovery in 20-60 min. With succinylcholine, median time to ventilatory depression was 1.3 and 1.1 min for infants and children, respectively; for vecuronium, 0.7 and 0.6 min. Part I: Intubating conditions were good-excellent at 3.0 and 2.5 min in infants and children, respectively; time to 10% twitch recovery (mean +/- SD) was 31 +/- 14 and 36 +/- 14 min in the two groups. CONCLUSIONS: This pilot study indicates that deltoid injection of rapacuronium, 2.8 mg/kg in infants and 4.8 mg/kg in children, permits tracheal intubation within 2.5-3.0 min, despite a light plane of anesthesia. Duration of action is intermediate.  (+info)

Comparison of the intubation conditions provided by rapacuronium (ORG 9487) or succinylcholine in humans during anesthesia with fentanyl and propofol. (8/306)

BACKGROUND: Currently, the only approved muscle relaxant with a rapid onset and short duration of action is succinylcholine, a drug with some undesirable effects. Rapacuronium is an investigational nondepolarizing relaxant that also has a rapid onset and short duration and consequently should be compared with succinylcholine in its ability to facilitate rapid tracheal intubation. METHODS: This prospective, randomized clinical trial involved 336 patients. Anesthesia was induced with fentanyl and propofol and either 1.5 mg/kg rapacuronium or 1.0 mg/kg succinylcholine. The goal was to accomplish tracheal intubation by 60 s after administration of the neuromuscular blocking drug. Endotracheal intubation was performed, and conditions were graded by a blinded investigator. Recovery of neuromuscular function was assessed by electromyography. RESULTS: Intubation conditions were evaluated in 236 patients. Intubation by 60 s after drug administration occurred in 100% of patients with rapacuronium and in 98% with succinylcholine. Intubation conditions were excellent or good in 87% of patients with rapacuronium and in 95% with succinylcholine (P < 0.05). The time (median and range) to the first recovery of the train-of-four response was 8.0 (2.8-20.0) min with rapacuronium and 5.7 (1.8-17.7) min with succinylcholine (P < 0.05). The overall incidence of adverse effects was similar with both drugs. CONCLUSIONS: A 1.5-mg/kg dose of rapacuronium effectively facilitates rapid tracheal intubation. It can be considered a valid alternative to 1.0 mg/kg succinylcholine for this purpose.  (+info)

Succinylcholine is a neuromuscular blocking agent, a type of muscle relaxant used in anesthesia during surgical procedures. It works by inhibiting the transmission of nerve impulses at the neuromuscular junction, leading to temporary paralysis of skeletal muscles. This facilitates endotracheal intubation and mechanical ventilation during surgery. Succinylcholine has a rapid onset of action and is metabolized quickly, making it useful for short surgical procedures. However, its use may be associated with certain adverse effects, such as increased heart rate, muscle fasciculations, and potentially life-threatening hyperkalemia in susceptible individuals.

Neuromuscular depolarizing agents are a type of muscle relaxant used in anesthesia and critical care medicine. These drugs work by causing depolarization of the post-synaptic membrane at the neuromuscular junction, which is the site where nerve impulses are transmitted to muscles. This results in the binding of the drug to the receptor and the activation of ion channels, leading to muscle contraction.

The most commonly used depolarizing agent is suxamethonium (also known as succinylcholine), which has a rapid onset and short duration of action. It is often used during rapid sequence intubation, where there is a need for immediate muscle relaxation to facilitate endotracheal intubation.

However, the use of depolarizing agents can also lead to several side effects, including increased potassium levels in the blood (hyperkalemia), muscle fasciculations, and an increase in intracranial and intraocular pressure. Therefore, these drugs should be used with caution and only under the close supervision of a trained healthcare provider.

Neuromuscular blocking agents (NMBAs) are a class of drugs that act on the neuromuscular junction, the site where nerve impulses transmit signals to muscles to cause contraction. NMBAs prevent the transmission of these signals, leading to muscle paralysis. They are used in medical settings during surgical procedures and mechanical ventilation to facilitate intubation, control ventilation, and prevent patient movement. It is important to note that NMBAs do not have any effect on consciousness or pain perception; therefore, they are always used in conjunction with anesthetics and analgesics.

NMBAs can be classified into two main categories based on their mechanism of action:

1. Depolarizing Neuromuscular Blocking Agents: These drugs, such as succinylcholine, cause muscle fasciculations (brief, involuntary contractions) before inducing paralysis. They work by binding to the acetylcholine receptors at the neuromuscular junction and depolarizing the membrane, which results in muscle paralysis. However, the continuous depolarization also causes desensitization of the receptors, leading to a loss of effectiveness over time. Depolarizing NMBAs have a relatively short duration of action.
2. Non-depolarizing Neuromuscular Blocking Agents: These drugs, such as rocuronium, vecuronium, and pancuronium, do not cause muscle fasciculations. They work by binding to the acetylcholine receptors at the neuromuscular junction without depolarizing the membrane, which prevents the transmission of nerve impulses to muscles and leads to paralysis. Non-depolarizing NMBAs have a longer duration of action compared to depolarizing NMBAs.

Close monitoring of neuromuscular function is essential when using NMBAs to ensure adequate reversal of their effects before the patient regains consciousness. This can be achieved through the use of nerve stimulators, which assess the degree of blockade and help guide the administration of reversal agents when necessary.

Neuromuscular non-depolarizing agents are a type of muscle relaxant medication used in anesthesia and critical care settings to facilitate endotracheal intubation, mechanical ventilation, and to prevent muscle contractions during surgery. These agents work by competitively binding to the acetylcholine receptors at the neuromuscular junction, without activating them, thereby preventing the initiation of muscle contraction.

Examples of non-depolarizing neuromuscular blocking agents include:

* Vecuronium
* Rocuronium
* Pancuronium
* Atracurium
* Cisatracurium
* Mivacurium

These medications have a reversible effect and their duration of action can be prolonged in patients with impaired renal or hepatic function, acid-base imbalances, electrolyte abnormalities, or in those who are taking other medications that interact with these agents. Therefore, it is important to monitor the patient's neuromuscular function during and after the administration of non-depolarizing neuromuscular blocking agents.

Vecuronium Bromide is a neuromuscular blocking agent, which is a type of medication that acts on the muscles to cause paralysis. It is used in anesthesia during surgery to provide skeletal muscle relaxation and to facilitate endotracheal intubation and mechanical ventilation. Vecuronium Bromide works by blocking the transmission of nerve impulses at the neuromuscular junction, the site where nerves meet muscles. This results in temporary paralysis of the muscles, allowing for controlled muscle relaxation during surgical procedures. It is a non-depolarizing muscle relaxant and is considered to have a intermediate duration of action.

Androstanols are a class of steroid compounds that contain a skeleton of 17 carbon atoms arranged in a particular structure. They are derived from androstane, which is a reduced form of testosterone, a male sex hormone. Androstanols have a variety of biological activities and can be found in various tissues and bodily fluids, including sweat, urine, and blood.

In the context of medical research and diagnostics, androstanols are sometimes used as biomarkers to study various physiological processes and diseases. For example, some studies have investigated the use of androstanol metabolites in urine as markers for prostate cancer. However, more research is needed to establish their clinical utility.

It's worth noting that while androstanols are related to steroid hormones, they do not have the same hormonal activity as testosterone or other sex hormones. Instead, they may play a role in cell signaling and other regulatory functions within the body.

A fasciculation is an involuntary muscle contraction and relaxation that occurs randomly and spontaneously, causing a visible twitching of the muscle. Fasciculations can occur in any skeletal muscle of the body and are often described as feeling like a "mini-charley horse." They are generally harmless and can occur in people without any underlying neurological conditions. However, they can also be a symptom of certain neuromuscular disorders, such as amyotrophic lateral sclerosis (ALS) or motor neuron disease. In these cases, fasciculations are often accompanied by other symptoms, such as muscle weakness, atrophy, and cramping. If you are experiencing persistent or frequent fasciculations, it is important to consult with a healthcare professional for further evaluation and diagnosis.

Intubation, intratracheal is a medical procedure in which a flexible plastic or rubber tube called an endotracheal tube (ETT) is inserted through the mouth or nose, passing through the vocal cords and into the trachea (windpipe). This procedure is performed to establish and maintain a patent airway, allowing for the delivery of oxygen and the removal of carbon dioxide during mechanical ventilation in various clinical scenarios, such as:

1. Respiratory failure or arrest
2. Procedural sedation
3. Surgery under general anesthesia
4. Neuromuscular disorders
5. Ingestion of toxic substances
6. Head and neck trauma
7. Critical illness or injury affecting the airway

The process of intubation is typically performed by trained medical professionals, such as anesthesiologists, emergency medicine physicians, or critical care specialists, using direct laryngoscopy or video laryngoscopy to visualize the vocal cords and guide the ETT into the correct position. Once placed, the ETT is secured to prevent dislodgement, and the patient's respiratory status is continuously monitored to ensure proper ventilation and oxygenation.

Pancuronium is defined as a non-depolarizing neuromuscular blocking agent, which is used in anesthesia practice to provide skeletal muscle relaxation during surgery. It works by competitively inhibiting the binding of acetylcholine to nicotinic receptors at the motor endplate, thereby preventing muscle contraction. Pancuronium has a intermediate duration of action and is often used for routine surgical procedures requiring muscle relaxation. It is administered intravenously and is typically reversed with an anticholinesterase agent such as neostigmine at the conclusion of surgery.

Neuromuscular blockade (NMB) is a pharmacological state in which the communication between nerves and muscles is interrupted by blocking the neuromuscular junction, thereby preventing muscle contraction. This condition can be achieved through the use of certain medications called neuromuscular blocking agents (NMBAs). These drugs are commonly used during surgical procedures to facilitate endotracheal intubation, mechanical ventilation, and to prevent patient movement and minimize potential injury during surgery. NMBs are classified into two main categories based on their mechanism of action: depolarizing and non-depolarizing agents.

Depolarizing neuromuscular blocking agents, such as succinylcholine, work by activating the nicotinic acetylcholine receptors at the neuromuscular junction, causing a sustained depolarization and muscle contraction followed by flaccid paralysis. Non-depolarizing neuromuscular blocking agents, such as rocuronium, vecuronium, pancuronium, and atracurium, bind to the receptors without activating them, thereby preventing acetylcholine from binding and transmitting the signal for muscle contraction.

Clinical monitoring of neuromuscular blockade is essential to ensure proper dosing and avoid complications such as residual curarization, which can lead to respiratory compromise in the postoperative period. Monitoring techniques include peripheral nerve stimulation and train-of-four (TOF) assessment to evaluate the depth of neuromuscular blockade and guide the administration of reversal agents when appropriate.

Cholinesterases are a group of enzymes that play an essential role in the nervous system by regulating the transmission of nerve impulses. They work by breaking down a type of chemical messenger called acetylcholine, which is released by nerves to transmit signals to other nerves or muscles.

There are two main types of cholinesterases: acetylcholinesterase (AChE) and butyrylcholinesterase (BChE). AChE is found primarily in the nervous system, where it rapidly breaks down acetylcholine to terminate nerve impulses. BChE, on the other hand, is found in various tissues throughout the body, including the liver and plasma, and plays a less specific role in breaking down various substances, including some drugs and toxins.

Inhibition of cholinesterases can lead to an accumulation of acetylcholine in the synaptic cleft, which can result in excessive stimulation of nerve impulses and muscle contractions. This effect is exploited by certain medications used to treat conditions such as myasthenia gravis, Alzheimer's disease, and glaucoma, but can also be caused by exposure to certain chemicals or toxins, such as organophosphate pesticides and nerve agents.

Malignant hyperthermia (MH) is a rare, but potentially life-threatening genetic disorder that can occur in susceptible individuals as a reaction to certain anesthetic drugs or other triggers. The condition is characterized by a rapid and uncontrolled increase in body temperature (hyperthermia), muscle rigidity, and metabolic rate due to abnormal skeletal muscle calcium regulation.

MH can develop quickly during or after surgery, usually within the first hour of exposure to triggering anesthetics such as succinylcholine or volatile inhalational agents (e.g., halothane, sevoflurane, desflurane). The increased metabolic rate and muscle activity lead to excessive production of heat, carbon dioxide, lactic acid, and potassium, which can cause severe complications such as heart rhythm abnormalities, kidney failure, or multi-organ dysfunction if not promptly recognized and treated.

The primary treatment for MH involves discontinuing triggering anesthetics, providing supportive care (e.g., oxygen, fluid replacement), and administering medications to reduce body temperature, muscle rigidity, and metabolic rate. Dantrolene sodium is the specific antidote for MH, which works by inhibiting calcium release from the sarcoplasmic reticulum in skeletal muscle cells, thereby reducing muscle contractility and metabolism.

Individuals with a family history of MH or who have experienced an episode should undergo genetic testing and counseling to determine their susceptibility and take appropriate precautions when receiving anesthesia.

Thiopental, also known as Thiopentone, is a rapid-onset, ultrashort-acting barbiturate derivative. It is primarily used for the induction of anesthesia due to its ability to cause unconsciousness quickly and its short duration of action. Thiopental can also be used for sedation in critically ill patients, though this use has become less common due to the development of safer alternatives.

The drug works by enhancing the inhibitory effects of gamma-aminobutyric acid (GABA), a neurotransmitter in the brain that produces a calming effect. This results in the depression of the central nervous system, leading to sedation, hypnosis, and ultimately, anesthesia.

It is worth noting that Thiopental has been largely replaced by newer drugs in many clinical settings due to its potential for serious adverse effects, such as cardiovascular and respiratory depression, as well as the risk of anaphylaxis. Additionally, it has been used in controversial procedures like capital punishment in some jurisdictions.

Intratracheal anesthesia refers to the administration of anesthetic agents directly into the trachea. This type of anesthesia is typically used in specific medical procedures, such as bronchoscopy or airway surgery, where it is necessary to achieve adequate anesthesia and analgesia of the airways while avoiding systemic effects.

Intratracheal anesthesia is usually delivered through a specialized device called a laryngoscope, which is used to visualize the vocal cords and introduce a narrow tube (endotracheal tube) into the trachea. Once the endotracheal tube is in place, anesthetic gases or liquids can be administered directly into the airways, providing rapid onset of action and minimal systemic absorption.

It's important to note that intratracheal anesthesia should only be performed by trained medical professionals, as there are potential risks associated with this procedure, including damage to the airway, respiratory compromise, and other complications.

Inhalational anesthesia is a type of general anesthesia that is induced by the inhalation of gases or vapors. It is administered through a breathing system, which delivers the anesthetic agents to the patient via a face mask, laryngeal mask airway, or endotracheal tube.

The most commonly used inhalational anesthetics include nitrous oxide, sevoflurane, isoflurane, and desflurane. These agents work by depressing the central nervous system, causing a reversible loss of consciousness, amnesia, analgesia, and muscle relaxation.

The depth of anesthesia can be easily adjusted during the procedure by changing the concentration of the anesthetic agent. Once the procedure is complete, the anesthetic agents are eliminated from the body through exhalation, allowing for a rapid recovery.

Inhalational anesthesia is commonly used in a wide range of surgical procedures due to its ease of administration, quick onset and offset of action, and ability to rapidly adjust the depth of anesthesia. However, it requires careful monitoring and management by trained anesthesia providers to ensure patient safety and optimize outcomes.

Tubocurarine is a type of neuromuscular blocking agent, specifically a non-depolarizing skeletal muscle relaxant. It works by competitively binding to the nicotinic acetylcholine receptors at the motor endplate, thereby preventing the binding of acetylcholine and inhibiting muscle contraction. Tubocurarine is derived from the South American curare plant and has been used in anesthesia to facilitate intubation and mechanical ventilation during surgery. However, its use has largely been replaced by newer, more selective agents due to its potential for histamine release and cardiovascular effects.

General anesthesia is a state of controlled unconsciousness, induced by administering various medications, that eliminates awareness, movement, and pain sensation during medical procedures. It involves the use of a combination of intravenous and inhaled drugs to produce a reversible loss of consciousness, allowing patients to undergo surgical or diagnostic interventions safely and comfortably. The depth and duration of anesthesia are carefully monitored and adjusted throughout the procedure by an anesthesiologist or certified registered nurse anesthetist (CRNA) to ensure patient safety and optimize recovery. General anesthesia is typically used for more extensive surgical procedures, such as open-heart surgery, major orthopedic surgeries, and neurosurgery.

The Ulnar nerve is one of the major nerves in the forearm and hand, which provides motor function to the majority of the intrinsic muscles of the hand (except for those innervated by the median nerve) and sensory innervation to the little finger and half of the ring finger. It originates from the brachial plexus, passes through the cubital tunnel at the elbow, and continues down the forearm, where it runs close to the ulna bone. The ulnar nerve then passes through the Guyon's canal in the wrist before branching out to innervate the hand muscles and provide sensation to the skin on the little finger and half of the ring finger.

The masseter muscle is a strong chewing muscle in the jaw. It is a broad, thick, quadrilateral muscle that extends from the zygomatic arch (cheekbone) to the lower jaw (mandible). The masseter muscle has two distinct parts: the superficial part and the deep part.

The superficial part of the masseter muscle originates from the lower border of the zygomatic process of the maxilla and the anterior two-thirds of the inferior border of the zygomatic arch. The fibers of this part run almost vertically downward to insert on the lateral surface of the ramus of the mandible and the coronoid process.

The deep part of the masseter muscle originates from the deep surface of the zygomatic arch and inserts on the medial surface of the ramus of the mandible, blending with the temporalis tendon.

The primary function of the masseter muscle is to elevate the mandible, helping to close the mouth and clench the teeth together during mastication (chewing). It also plays a role in stabilizing the jaw during biting and speaking. The masseter muscle is one of the most powerful muscles in the human body relative to its size.

Pseudocholinesterase, also known as butyrylcholinesterase or plasma cholinesterase, is an enzyme found in the blood plasma. It is responsible for breaking down certain types of drugs and muscle relaxants that are used during general anesthesia, such as succinylcholine and mivacurium.

Pseudocholinesterase deficiency can lead to prolonged neuromuscular blockade and difficulty in reversing the effects of these muscle relaxants, which can result in respiratory complications and other adverse effects during or after surgery. This deficiency can be inherited or acquired due to various factors such as liver disease, malnutrition, or exposure to certain chemicals.

It is important to test the patient's pseudocholinesterase levels before administering succinylcholine or mivacurium to ensure that they have adequate enzyme activity to metabolize these drugs properly.

Muscle rigidity is a term used to describe an increased resistance to passive movement or muscle tone that is present at rest, which cannot be overcome by the person. It is a common finding in various neurological conditions such as Parkinson's disease, stiff-person syndrome, and tetanus. In these conditions, muscle rigidity can result from hyperexcitability of the stretch reflex arc or abnormalities in the basal ganglia circuitry.

Muscle rigidity should be distinguished from spasticity, which is a velocity-dependent increase in muscle tone that occurs during voluntary movement or passive stretching. Spasticity is often seen in upper motor neuron lesions such as stroke or spinal cord injury.

It's important to note that the assessment of muscle rigidity requires a careful physical examination and may need to be evaluated in conjunction with other signs and symptoms to determine an underlying cause.

Apnea is a medical condition defined as the cessation of breathing for 10 seconds or more. It can occur during sleep (sleep apnea) or while awake (wakeful apnea). There are different types of sleep apnea, including obstructive sleep apnea, central sleep apnea, and complex sleep apnea syndrome. Obstructive sleep apnea occurs when the airway becomes blocked during sleep, while central sleep apnea occurs when the brain fails to signal the muscles to breathe. Complex sleep apnea syndrome, also known as treatment-emergent central sleep apnea, is a combination of obstructive and central sleep apneas. Sleep apnea can lead to various complications, such as fatigue, difficulty concentrating, high blood pressure, heart disease, and stroke.

Decamethonium compounds are a type of neuromuscular blocking agent used in anesthesia to induce paralysis and relaxation of skeletal muscles. These compounds work by binding to and inhibiting the action of acetylcholine receptors at the neuromuscular junction, which is the site where nerve impulses are transmitted to muscle fibers.

Decamethonium bromide is a commonly used example of a decamethonium compound. It has a rapid onset of action and causes paralysis that lasts for several minutes. This makes it useful for procedures such as endotracheal intubation, where it is important to temporarily paralyze the muscles of the throat to facilitate insertion of a breathing tube.

It's important to note that decamethonium compounds do not have any analgesic or sedative effects, so they are typically used in conjunction with other medications that provide pain relief and sedation during surgical procedures. Additionally, because these compounds can cause respiratory depression, patients must be carefully monitored and provided with mechanical ventilation as needed during their use.

Atracurium is a non-depolarizing neuromuscular blocking agent (NMBDA) that is used in anesthesia practice to provide skeletal muscle relaxation during surgery. It works by competitively inhibiting the binding of acetylcholine to nicotinic receptors at the motor endplate, thereby preventing muscle contraction.

Atracurium has a rapid onset and intermediate duration of action, making it useful for a variety of surgical procedures. It is also known for its unique property of being broken down by Hofmann elimination, a non-enzymatic degradation process that occurs at physiological pH and temperature, which makes it independent of hepatic or renal function. This makes atracurium a useful option in patients with compromised liver or kidney function.

However, atracurium can cause histamine release, which may lead to hypotension, tachycardia, and bronchospasm, especially with rapid bolus administration. Therefore, it is usually administered by continuous infusion or intermittent boluses, titrated to the desired level of muscle relaxation.

It's important to note that atracurium should only be administered under the supervision of anesthesia professionals and used in accordance with the recommended dosages and monitoring guidelines to ensure patient safety.

Gamma-cyclodextrins (γ-CDs) are cyclic oligosaccharides composed of seven α-D-glucopyranose units joined by α-1,4 glycosidic bonds. They have a cone-like structure with a hydrophilic outer surface and a hydrophobic central cavity that can form inclusion complexes with various hydrophobic molecules, making them useful as drug delivery agents or in the removal of toxic substances from the body.

Compared to other cyclodextrins such as α-CDs and β-CDs, γ-CDs have a larger cavity size and can form more stable complexes with larger guest molecules. However, they are less commonly used due to their lower water solubility and higher production cost.

It is important to note that the medical use of cyclodextrins, including γ-CDs, may require approval from regulatory agencies such as the U.S. Food and Drug Administration (FDA) for specific indications and formulations.

Halothane is a general anesthetic agent, which is a volatile liquid that evaporates easily and can be inhaled. It is used to produce and maintain general anesthesia (a state of unconsciousness) during surgical procedures. Halothane is known for its rapid onset and offset of action, making it useful for both induction and maintenance of anesthesia.

The medical definition of Halothane is:

Halothane (2-bromo-2-chloro-1,1,1-trifluoroethane) is a volatile liquid general anesthetic agent with a mild, sweet odor. It is primarily used for the induction and maintenance of general anesthesia in surgical procedures due to its rapid onset and offset of action. Halothane is administered via inhalation and acts by depressing the central nervous system, leading to a reversible loss of consciousness and analgesia.

It's important to note that Halothane has been associated with rare cases of severe liver injury (hepatotoxicity) and anaphylaxis (a severe, life-threatening allergic reaction). These risks have led to the development and use of alternative general anesthetic agents with better safety profiles.

Nitrous oxide, also known as laughing gas, is a colorless and non-flammable gas with a slightly sweet odor and taste. In medicine, it's commonly used for its anesthetic and pain reducing effects. It is often used in dental procedures, surgery, and childbirth to help reduce anxiety and provide mild sedation. Nitrous oxide works by binding to the hemoglobin in red blood cells, which reduces the oxygen-carrying capacity of the blood, but this effect is usually not significant at the low concentrations used for analgesia and anxiolysis. It's also considered relatively safe when administered by a trained medical professional because it does not cause depression of the respiratory system or cardiovascular function.

Butyrylcholinesterase (BChE) is an enzyme that catalyzes the hydrolysis of esters of choline, including butyrylcholine and acetylcholine. It is found in various tissues throughout the body, including the liver, brain, and plasma. BChE plays a role in the metabolism of certain drugs and neurotransmitters, and its activity can be inhibited by certain chemicals, such as organophosphate pesticides and nerve agents. Elevated levels of BChE have been found in some neurological disorders, while decreased levels have been associated with genetic deficiencies and liver disease.

Preanesthetic medication, also known as premedication, refers to the administration of medications before anesthesia to help prepare the patient for the upcoming procedure. These medications can serve various purposes, such as:

1. Anxiolysis: Reducing anxiety and promoting relaxation in patients before surgery.
2. Amnesia: Causing temporary memory loss to help patients forget the events leading up to the surgery.
3. Analgesia: Providing pain relief to minimize discomfort during and after the procedure.
4. Antisialagogue: Decreasing saliva production to reduce the risk of aspiration during intubation.
5. Bronchodilation: Relaxing bronchial smooth muscles, which can help improve respiratory function in patients with obstructive lung diseases.
6. Antiemetic: Preventing or reducing the likelihood of postoperative nausea and vomiting.
7. Sedation: Inducing a state of calmness and drowsiness to facilitate a smooth induction of anesthesia.

Common preanesthetic medications include benzodiazepines (e.g., midazolam), opioids (e.g., fentanyl), anticholinergics (e.g., glycopyrrolate), and H1-antihistamines (e.g., diphenhydramine). The choice of preanesthetic medication depends on the patient's medical history, comorbidities, and the type of anesthesia to be administered.

Butyrylthiocholine is a synthetic chemical compound that is often used in scientific research, particularly in the study of enzymes and neurotransmitters. It is the substrate for the enzyme butyrylcholinesterase, which is found in the blood and helps to break down certain types of drugs and neurotransmitters.

In biochemical terms, butyrylthiocholine is a choline ester of butyric acid, with a thio (sulfur) group replacing one of the oxygen atoms in the ester linkage. This structural feature makes it an excellent substrate for butyrylcholinesterase, as the sulfur atom can form a covalent bond with the enzyme's active site, leading to rapid and specific catalysis.

It is important to note that butyrylthiocholine itself does not have any direct medical relevance, but rather serves as a tool for studying the mechanisms of enzymes and other biological processes.

The neuromuscular junction (NMJ) is the specialized synapse or chemical communication point, where the motor neuron's nerve terminal (presynaptic element) meets the muscle fiber's motor end plate (postsynaptic element). This junction plays a crucial role in controlling muscle contraction and relaxation.

At the NMJ, the neurotransmitter acetylcholine is released from the presynaptic nerve terminal into the synaptic cleft, following an action potential. Acetylcholine then binds to nicotinic acetylcholine receptors on the postsynaptic membrane of the muscle fiber, leading to the generation of an end-plate potential. If sufficient end-plate potentials are generated and summate, they will trigger an action potential in the muscle fiber, ultimately causing muscle contraction.

Dysfunction at the neuromuscular junction can result in various neuromuscular disorders, such as myasthenia gravis, where autoantibodies attack acetylcholine receptors, leading to muscle weakness and fatigue.

Intravenous anesthetics are a type of medication that is administered directly into a vein to cause a loss of consciousness and provide analgesia (pain relief) during medical procedures. They work by depressing the central nervous system, inhibiting nerve impulse transmission and ultimately preventing the patient from feeling pain or discomfort during surgery or other invasive procedures.

There are several different types of intravenous anesthetics, each with its own specific properties and uses. Some common examples include propofol, etomidate, ketamine, and barbiturates. These drugs may be used alone or in combination with other medications to provide a safe and effective level of anesthesia for the patient.

The choice of intravenous anesthetic depends on several factors, including the patient's medical history, the type and duration of the procedure, and the desired depth and duration of anesthesia. Anesthesiologists must carefully consider these factors when selecting an appropriate medication regimen for each individual patient.

While intravenous anesthetics are generally safe and effective, they can have side effects and risks, such as respiratory depression, hypotension, and allergic reactions. Anesthesia providers must closely monitor patients during and after the administration of these medications to ensure their safety and well-being.

Tachyphylaxis is a medical term that refers to the rapid and temporary loss of response to a drug after its repeated administration, especially when administered in quick succession. This occurs due to the decreased sensitivity or responsiveness of the body's receptors to the drug, resulting in a reduced therapeutic effect over time.

In simpler terms, tachyphylaxis is when the body becomes quickly desensitized to a medication after taking it multiple times in a short period, causing the drug to become less effective or ineffective at achieving the desired outcome. This phenomenon can occur with various medications, including those used for treating pain, allergies, and psychiatric conditions.

It's important to note that tachyphylaxis should not be confused with tolerance, which is a similar but distinct concept where the body gradually becomes less responsive to a drug after prolonged use over time.

Propofol is a short-acting medication that is primarily used for the induction and maintenance of general anesthesia during procedures such as surgery. It belongs to a class of drugs called hypnotics or sedatives, which work by depressing the central nervous system to produce a calming effect. Propofol can also be used for sedation in mechanically ventilated patients in intensive care units and for procedural sedation in various diagnostic and therapeutic procedures outside the operating room.

The medical definition of Propofol is:
A rapid-onset, short-duration intravenous anesthetic agent that produces a hypnotic effect and is used for induction and maintenance of general anesthesia, sedation in mechanically ventilated patients, and procedural sedation. It acts by enhancing the inhibitory effects of gamma-aminobutyric acid (GABA) in the brain, leading to a decrease in neuronal activity and a reduction in consciousness. Propofol has a rapid clearance and distribution, allowing for quick recovery after discontinuation of its administration.

Laryngospasm, often mistakenly referred to as "laryngismus," is a medical condition characterized by an involuntary and sustained closure of the vocal cords (the structures that form the larynx or voice box). This spasm can occur in response to various stimuli, such as irritation, aspiration, or emotional distress, leading to difficulty breathing, coughing, and stridor (a high-pitched sound during inspiration).

The term "laryngismus" is not a widely accepted medical term; however, it may be used informally to refer to any condition affecting the larynx. The correct term for a prolonged or chronic issue with the larynx would be "laryngeal dyskinesia."

Anesthesia is a medical term that refers to the loss of sensation or awareness, usually induced by the administration of various drugs. It is commonly used during surgical procedures to prevent pain and discomfort. There are several types of anesthesia, including:

1. General anesthesia: This type of anesthesia causes a complete loss of consciousness and is typically used for major surgeries.
2. Regional anesthesia: This type of anesthesia numbs a specific area of the body, such as an arm or leg, while the patient remains conscious.
3. Local anesthesia: This type of anesthesia numbs a small area of the body, such as a cut or wound, and is typically used for minor procedures.

Anesthesia can be administered through various routes, including injection, inhalation, or topical application. The choice of anesthesia depends on several factors, including the type and duration of the procedure, the patient's medical history, and their overall health. Anesthesiologists are medical professionals who specialize in administering anesthesia and monitoring patients during surgical procedures to ensure their safety and comfort.

Masticatory muscles are a group of skeletal muscles responsible for the mastication (chewing) process in humans and other animals. They include:

1. Masseter muscle: This is the primary muscle for chewing and is located on the sides of the face, running from the lower jawbone (mandible) to the cheekbone (zygomatic arch). It helps close the mouth and elevate the mandible during chewing.

2. Temporalis muscle: This muscle is situated in the temporal region of the skull, covering the temple area. It assists in closing the jaw, retracting the mandible, and moving it sideways during chewing.

3. Medial pterygoid muscle: Located deep within the cheek, near the angle of the lower jaw, this muscle helps move the mandible forward and grind food during chewing. It also contributes to closing the mouth.

4. Lateral pterygoid muscle: Found inside the ramus (the vertical part) of the mandible, this muscle has two heads - superior and inferior. The superior head helps open the mouth by pulling the temporomandibular joint (TMJ) downwards, while the inferior head assists in moving the mandible sideways during chewing.

These muscles work together to enable efficient chewing and food breakdown, preparing it for swallowing and digestion.

The anesthesia recovery period, also known as the post-anesthetic care unit (PACU) or recovery room stay, is the time immediately following anesthesia and surgery during which a patient's vital signs are closely monitored as they emerge from the effects of anesthesia.

During this period, the patient is typically observed for adequate ventilation, oxygenation, circulation, level of consciousness, pain control, and any potential complications. The length of stay in the recovery room can vary depending on the type of surgery, the anesthetic used, and the individual patient's needs.

The anesthesia recovery period is a critical time for ensuring patient safety and comfort as they transition from the surgical setting to full recovery. Nurses and other healthcare providers in the recovery room are specially trained to monitor and manage patients during this vulnerable period.

Parabens are a group of synthetic preservatives that have been widely used in the cosmetics and personal care product industry since the 1920s. They are effective at inhibiting the growth of bacteria, yeasts, and molds, which helps to prolong the shelf life of these products. Parabens are commonly found in shampoos, conditioners, lotions, creams, deodorants, and other personal care items.

The most commonly used parabens include methylparaben, ethylparaben, propylparaben, and butylparaben. These compounds are often used in combination to provide broad-spectrum protection against microbial growth. Parabens work by penetrating the cell wall of microorganisms and disrupting their metabolism, which prevents them from multiplying.

Parabens have been approved for use as preservatives in cosmetics and personal care products by regulatory agencies around the world, including the U.S. Food and Drug Administration (FDA) and the European Commission's Scientific Committee on Consumer Safety (SCCS). However, there has been some controversy surrounding their safety, with concerns raised about their potential to mimic the hormone estrogen in the body and disrupt normal endocrine function.

While some studies have suggested that parabens may be associated with health problems such as breast cancer and reproductive toxicity, the evidence is not conclusive, and more research is needed to fully understand their potential risks. In response to these concerns, many manufacturers have begun to remove parabens from their products or offer paraben-free alternatives. It's important to note that while avoiding parabens may be a personal preference for some individuals, there is currently no scientific consensus on the need to avoid them entirely.

The laryngeal muscles are a group of skeletal muscles located in the larynx, also known as the voice box. These muscles play a crucial role in breathing, swallowing, and producing sounds for speech. They include:

1. Cricothyroid muscle: This muscle helps to tense the vocal cords and adjust their pitch during phonation (voice production). It is the only laryngeal muscle that is not innervated by the recurrent laryngeal nerve. Instead, it is supplied by the external branch of the superior laryngeal nerve.
2. Posterior cricoarytenoid muscle: This muscle is primarily responsible for abducting (opening) the vocal cords during breathing and speaking. It is the only muscle that can abduct the vocal cords.
3. Lateral cricoarytenoid muscle: This muscle adducts (closes) the vocal cords during phonation, swallowing, and coughing.
4. Transverse arytenoid muscle: This muscle also contributes to adduction of the vocal cords, working together with the lateral cricoarytenoid muscle. It also helps to relax and lengthen the vocal cords during quiet breathing.
5. Oblique arytenoid muscle: This muscle is involved in adducting, rotating, and shortening the vocal cords. It works together with the transverse arytenoid muscle to provide fine adjustments for voice production.
6. Thyroarytenoid muscle (Vocalis): This muscle forms the main body of the vocal cord and is responsible for its vibration during phonation. The vocalis portion of the muscle helps control pitch and tension in the vocal cords.

These muscles work together to enable various functions of the larynx, such as breathing, swallowing, and speaking.

Fentanyl is a potent synthetic opioid analgesic, which is similar to morphine but is 50 to 100 times more potent. It is a schedule II prescription drug, typically used to treat patients with severe pain or to manage pain after surgery. It works by binding to the body's opioid receptors, which are found in the brain, spinal cord, and other areas of the body.

Fentanyl can be administered in several forms, including transdermal patches, lozenges, injectable solutions, and tablets that dissolve in the mouth. Illegally manufactured and distributed fentanyl has also become a major public health concern, as it is often mixed with other drugs such as heroin, cocaine, and counterfeit pills, leading to an increase in overdose deaths.

Like all opioids, fentanyl carries a risk of dependence, addiction, and overdose, especially when used outside of medical supervision or in combination with other central nervous system depressants such as alcohol or benzodiazepines. It is important to use fentanyl only as directed by a healthcare provider and to be aware of the potential risks associated with its use.

Pharmaceutical preservatives are substances that are added to medications, pharmaceutical products, or biological specimens to prevent degradation, contamination, or spoilage caused by microbial growth, chemical reactions, or environmental factors. These preservatives help extend the shelf life and ensure the stability, safety, and efficacy of the pharmaceutical formulation during storage and use.

Commonly used pharmaceutical preservatives include:

1. Antimicrobials: These are further classified into antifungals (e.g., benzalkonium chloride, chlorhexidine, thimerosal), antibacterials (e.g., parabens, phenol, benzyl alcohol), and antivirals (e.g., phenolic compounds). They work by inhibiting the growth of microorganisms like bacteria, fungi, and viruses.
2. Antioxidants: These substances prevent or slow down oxidation reactions that can degrade pharmaceutical products. Examples include ascorbic acid (vitamin C), tocopherols (vitamin E), sulfites, and butylated hydroxyanisole (BHA) and butylated hydroxytoluene (BHT).
3. Chelating agents: These bind to metal ions that can catalyze degradation reactions in pharmaceutical products. Ethylenediaminetetraacetic acid (EDTA) is an example of a chelating agent used in pharmaceuticals.

The choice of preservative depends on the type of formulation, route of administration, and desired shelf life. The concentration of the preservative should be optimized to maintain product stability while minimizing potential toxicity or adverse effects. It is essential to conduct thorough safety and compatibility studies before incorporating any preservative into a pharmaceutical formulation.

Dibucaine is a local anesthetic drug that is used to numb the skin or mucous membranes before medical procedures. It works by blocking the nerve signals in the area where it is applied, preventing the sensation of pain. Dibucaine is available as a topical cream, ointment, or gel, and it may also be used as an ingredient in lozenges or throat sprays to relieve sore throats.

Dibucaine has been largely replaced by other local anesthetics due to its potential for causing allergic reactions and other side effects. It is important to follow your healthcare provider's instructions carefully when using dibucaine, and to inform them of any medical conditions or medications you are taking that may interact with the drug.

A diaphragm is a thin, dome-shaped muscle that separates the chest cavity from the abdominal cavity. It plays a vital role in the process of breathing as it contracts and flattens to draw air into the lungs (inhalation) and relaxes and returns to its domed shape to expel air out of the lungs (exhalation).

In addition, a diaphragm is also a type of barrier method of birth control. It is a flexible dome-shaped device made of silicone that fits over the cervix inside the vagina. When used correctly and consistently, it prevents sperm from entering the uterus and fertilizing an egg, thereby preventing pregnancy.

Thiocholine is not a medical term per se, but it is a chemical compound that has applications in the medical and biological fields. Thiocholine is the reduced form of thiochrome, which is a derivative of vitamin B1 (thiamine). It is often used as a reagent in biochemical assays to measure the activity of acetylcholinesterase, an enzyme that breaks down the neurotransmitter acetylcholine.

In this context, thiocholine iodide (S-[2-(hydroxyethyl)thio]ethan-1-oniuim iodide) is commonly used as a substrate for acetylcholinesterase. When the enzyme hydrolyzes thiocholine iodide, it produces thiocholine, which can be detected and quantified through its reaction with ferric chloride to form a colored complex. This assay is useful in diagnosing certain neurological conditions or monitoring the effectiveness of treatments that target the cholinergic system.

Laryngoscopy is a medical procedure that involves the examination of the larynx, which is the upper part of the windpipe (trachea), and the vocal cords using a specialized instrument called a laryngoscope. The laryngoscope is inserted through the mouth or nose to provide a clear view of the larynx and surrounding structures. This procedure can be performed for diagnostic purposes, such as identifying abnormalities like growths, inflammation, or injuries, or for therapeutic reasons, such as removing foreign objects or taking tissue samples for biopsy. There are different types of laryngoscopes and techniques used depending on the reason for the examination and the patient's specific needs.

Intravenous anesthesia, also known as IV anesthesia, is a type of anesthesia that involves the administration of one or more drugs into a patient's vein to achieve a state of unconsciousness and analgesia (pain relief) during medical procedures. The drugs used in intravenous anesthesia can include sedatives, hypnotics, analgesics, and muscle relaxants, which are carefully selected and dosed based on the patient's medical history, physical status, and the type and duration of the procedure.

The administration of IV anesthesia is typically performed by a trained anesthesiologist or nurse anesthetist, who monitors the patient's vital signs and adjusts the dosage of the drugs as needed to ensure the patient's safety and comfort throughout the procedure. The onset of action for IV anesthesia is relatively rapid, usually within minutes, and the depth and duration of anesthesia can be easily titrated to meet the needs of the individual patient.

Compared to general anesthesia, which involves the administration of inhaled gases or vapors to achieve a state of unconsciousness, intravenous anesthesia is associated with fewer adverse effects on respiratory and cardiovascular function, and may be preferred for certain types of procedures or patients. However, like all forms of anesthesia, IV anesthesia carries risks and potential complications, including allergic reactions, infection, bleeding, and respiratory depression, and requires careful monitoring and management by trained medical professionals.

Succinylcholine chloride injection is indicated, in addition to general anesthesia, to facilitate tracheal intubation and to ... "Succinylcholine Chloride". The American Society of Health-System Pharmacists. Archived from the original on 21 December 2016. ... "Succinylcholine, A Perfect Poison, Makes Appearance in the Dubai Killing". Medgadget. 8 March 2010. Compendium.ch: LYSTHENON 2 ... Tran DT, Newton EK, Mount VA, Lee JS, Wells GA, Perry JJ (October 2015). "Rocuronium versus succinylcholine for rapid sequence ...
Depolarizing drug Succinylcholine: The dosage of succinylcholine is patient-specific and determined based on total body weight ... Depolarizing drug Succinylcholine: Succinylcholine presents several undesirable side effects which affect its application as it ... The use of succinylcholine is therefore also contraindicated in patient with muscle myopathy within 24 to 72 hours post- ... Succinylcholine is currently the only depolarizing neuromuscular blocking drug that has been placed in ongoing clinical use. ...
Cottrell, JE; Hartung, JE; Giffin, JP; Shwiry, B (1983). "Intracranial and Hemodynamic Changes after Succinylcholine ... Cottrell, James E. (2018). "Succinylcholine and Intracranial Pressure". Anesthesiology. 129 (6): 1159-1162. doi:10.1097/ALN. ...
Use of succinylcholine infusion or repeated bolus administration increase the risk of Phase II block and prolonged paralysis. ... Succinylcholine may also trigger malignant hyperthermia in rare cases in patients who may be susceptible. In depolarizing the ... An example is succinylcholine. Depolarizing blocking agents work by depolarizing the plasma membrane of the muscle fiber, ... Options include succinylcholine, rocuronium or vecuronium if sugammadex is available for rapid reversal block. Any short or ...
It can also be used to help with endotracheal intubation but suxamethonium (succinylcholine) is generally preferred if this ... Bele-Binda N, Valeri F (Jan 1971). "A case of bronchospasm induced by succinylcholine". Canadian Anaesthetists' Society Journal ... Cardan E, Deacu E (Jan 1972). "Bronchospasm following succinyl choline". Der Anaesthesist. 21 (1): 27-29. PMID 4111555. Yeung ... tubocurarine and succinylcholine, as well as alcuronium, pancuronium, vecuronium, and gallamine. Seizures rarely occur. Because ...
... prolonged apnoea after administration of succinylcholine". Lancet. 265 (6799): 1291-3. doi:10.1016/S0140-6736(53)91358-0. PMID ...
The depolarizing neuromuscular blocker succinylcholine causes fasciculations. It is a normal side effect of the drug's ... can be prevented with a small dose of a nondepolarizing neuromuscular blocker prior to the administration of succinylcholine, ...
Succinylcholine is the only depolarizing NMBA available for clinical use. It produces a neuromuscular blockade that is the ... When a continuous infusion, repeated doses, or a large dose of succinylcholine (>4 mg/kg) is used, the risk of a Phase II block ... TOF fade is indicative of phase II block that is likely to occur in patients who received succinylcholine and may resemble ... Tran DT, Newton EK, Mount VA, Lee JS, Wells GA, Perry JJ (29 October 2015). "Rocuronium versus succinylcholine for rapid ...
Tran DT, Newton EK, Mount VA, Lee JS, Wells GA, Perry JJ (October 2015). "Rocuronium versus succinylcholine for rapid sequence ... like succinylcholine. It was designed to be a weaker antagonist at the neuromuscular junction than pancuronium; hence its ...
Succinylcholine is a nicotinic agonist. See neuromuscular blocking agents page for details on the mechanism of action. ...
... succinylcholine, and tubocurarine. In 2021, the revelation that he was working at a Western Cape Mediclinic facility caused ...
It may be used alone or followed by succinylcholine. Its use can avoid the need for paralysis and in some instances the ... potential side-effects of succinylcholine. Propofol is safe and effective for gastrointestinal endoscopy procedures. Its use in ...
Death"; killed six people with succinylcholine in the town of Dhom. Raman Raghav: known as "Psycho Raman"; Mumbai man who ...
He was instrumental in introducing the neuropharmacological use of Succinylcholine. Werner became Chairman of the Pharmacology ...
Succinylcholine - This drug has rapid onset of action and fast duration. Its dosages are between 1 and 2 mg/kg body weight with ... Repetitive dosages of succinylcholine are discouraged to prevent vagal stimulation which leads to bradycardia. There are many ... Vecuronium is only used when there is a shortage of drugs such as succinylcholine and rocuronium. Sugammadex - It is used as a ... The patient is given a sedative and paralytic agent, usually midazolam / succinylcholine / Propofol and intubation is quickly ...
"Succinylcholine in the Critically Ill Patient: When Is It Not OK+?" (Chapter 5). In: Canaday, Bruce Robert. ASHP's Clinical ...
The succinylcholine is delivered through a hypodermic needle disguised as a pen. Twisting the nib switches the tip from a ... To carry out the assassinations, the brothers are issued a weapon utilizing succinylcholine, developed by a Columbia University ...
Succinyl choline, phenothiazines and tricyclic antidepressants causes trismus as a secondary effect. Trismus can be seen as an ...
Inheriting abnormal butyrylcholinesterase (pseudocholinesterase) may affect metabolism of drugs such as succinylcholine. ...
Anaesthesia: Cholinesterase inhibitors are likely to exaggerate succinylcholine-type muscle relaxation during anaesthesia. 5. ...
Instead of pancuronium, other drugs in use are succinylcholine chloride and tubocurarine chloride. Lethal injection dosage: 100 ...
... may prolong the effects of neuromuscular-blocking drugs, such as succinylcholine and vecuronium. Its similarity to ...
Drugs to avoid: Succinylcholine, also known as suxamethonium, which is commonly given to paralyse skeletal muscles as part of a ... In case of an atypical PCE or complete absence of PCE, the effect of the injected succinylcholine can last for up to 10 hours. ... Mivacurium, like succinylcholine, is a muscle relaxant and will have prolonged action in those with butyrylcholinesterase ... When succinylcholine is used for anesthesia, its high plasma concentration immediately after intravenous injection decreases ...
Premedication with pentothal and succinylcholine chloride, as is customary in ECT, was tested and found safe. Four random ...
... may have dangerous reactions when used with the paralytic succinylcholine by increasing its neuromuscular effects. ...
The decrease must be greater than 75% before significant prolongation of neuromuscular blockade occurs with succinylcholine. In ... a silent condition that manifests itself only when people that have the deficiency receive the muscle relaxants succinylcholine ...
Al-Mabhouh was injected in his leg with succinylcholine, a quick-acting, depolarizing paralytic muscle relaxant. It causes ...
He was Ng Yui-kwong's friend and was later injected with succinylcholine by him, causing him to die from suffocation. Lam King- ... He was Louis' friend and injected succinylcholine in his body to kill him due to financial disputes. Mak ling-ling as Principal ...
... activity and may result in prolonged neuromuscular blockade when administered concurrently with succinylcholine. Tricyclic ...
... succinylcholine, reserpine, and phenothiazine-type tranquilizers should be avoided in patients with organophosphate poisoning. ...
We report a case of accidental epidural of succinylcholine injection. A prolonged onset and a longer duration of neuromuscular ... Accidental epidural administration of succinylcholine Anesth Analg. 2006 Apr;102(4):1139-40. doi: 10.1213/01.ane. ... We report a case of accidental epidural of succinylcholine injection. A prolonged onset and a longer duration of neuromuscular ...
... succinylcholine has been used to assist difficult intubations since March 1, 1979. In this report, the first 48 cases are ... Succinylcholine for endotracheal intubation Ann Emerg Med. 1982 Oct;11(10):526-9. doi: 10.1016/s0196-0644(82)80423-x. ... When properly administered, succinylcholine can be used to facilitate difficult intubations in the emergency department with an ... In the emergency department at Hennepin County Medical Center, succinylcholine has been used to assist difficult intubations ...
Succinylcholine Chloride (UNII: I9L0DDD30I) (Succinylcholine - UNII:J2R869A8YF) Succinylcholine Chloride. 20 mg in 1 mL. ... Succinylcholine chloride injection contains succinylcholine chloride as the active pharmaceutical ingredient.. Succinylcholine ... Succinylcholine chloride injection is for intravenous or intramuscular use only.. * Succinylcholine chloride injection must be ... Diluted succinylcholine chloride injection solutions containing from 1 mg/mL to 2 mg/mL succinylcholine have commonly been used ...
A literature search was undertaken for evidence of the effect of succinylcholine (SCH) on the intracranial pressure (ICP) of ... In patients with head injuries who undergo rapid sequence intubation using succinylcholine, does pretreatment with a ... In patients with head injuries who undergo rapid sequence intubation using succinylcholine, does pretreatment with a ...
Management of Patients in Whom Trismus Occurs Following Succinylcholine GERALD A. GRONERT, M.D. GERALD A. GRONERT, M.D. ... GERALD A. GRONERT; Management of Patients in Whom Trismus Occurs Following Succinylcholine. Anesthesiology 1988; 68:653 doi: ... Comparison of the Intubation Conditions Provided by Rapacuronium (ORG 9487) or Succinylcholine in Humans during Anesthesia with ... Management of Patients in Whom Trismus Occurs Following Succinylcholine Anesthesiology (April 1988) ...
Succinylcholine Chloride published on Jun 2018 by American Society of Health-System Pharmacists. ...
... get best Succinylcholine Chloride for Injection USP third party manufacturers. ... Succinylcholine Chloride for Injection USP Manufacturers - Visit Protech Telelinks now & ...
Learn Succinylcholine - Cholinergic Receptor Pharmacology - Pharmacology - Picmonic for Medicine faster and easier with ... The cells are kept in a depolarized state (as succinylcholine is bound to the receptor), as succinylcholine is not broken down ... Succinylcholine is a paralytic agent used for surgeries or short procedures, such as intubation. It works by binding at motor ... Succinylcholine, on the other hand, is bound for much longer time. This can be observed immediately after IV administration of ...
Succinylcholine Chloride) Injection, 20 mg/mL, approved by the US Food and Drug Administration (USFDA). The Quelicin® brand and ... Dr Reddys Laboratories announced the launch of Succinylcholine Chloride Injection USP, 200 mg/10 mL (20 mg/mL), Multiple-Dose ... Dr Reddys Succinylcholine Chloride Injection USP, 200 mg/10 mL (20 mg/mL), is available in multi-dose vials. ... Dr Reddys Laboratories announced the launch of Succinylcholine Chloride Injection USP, 200 mg/10 mL (20 mg/mL), Multiple-Dose ...
Anest Access to Succinylcholine PLEASE NOTE: Posts made to this forum should not be considered as the expressed opinions of, ... Anest Access to Succinylcholine We utilize Pyxis Anesthesia for medication storage in the OR suite. We have received a request ... from Anesthesia to allow them to store succinylcholine outside of the Pyxis for the purposes being prepared to treat ...
The risk of arrhythmias led us to choose a non-depolarizing NMBD over succinylcholine in the initial two settings. However, due ... Based on the existing literature and our experience, the use of succinylcholine or a non-depolarizing NMBD in such patients ... In her first ECT session, succinylcholine was avoided because of the reported risk of life-threatening hyperkalemia as a result ... In the third ECT session, it was decided to use succinylcholine instead of atracurium with complete preparation for monitoring ...
Prolonged Asystole after Succinylcholine Administration CHARLES H. MCLESKEY, LCDR MC USNR; CHARLES H. MCLESKEY, LCDR MC USNR ... CHARLES H. MCLESKEY, DONALD S. MCLEOD, TERRANCE L. HOUGH, JAMES M. STALLWORTH; Prolonged Asystole after Succinylcholine ...
Succinylcholine and the Risk of Pediatric Hyperkalemic Arrest needs to be consider when performing Rapid Sequence Intubation ( ... Can I Use Succinylcholine in Pediatric Patients?. *Yes, the FDA still approves of succinylcholine for emergent endotracheal ... Succinylcholine Efficacy and Usage: [Alvarellos 2015]*Succinylcholine exhibits many pharmacologic advantages:*Rapid onset of ... Succinylcholine: Problems. *Adverse reactions can occur with Succinylcholine (just like any medication) ...
Succinylcholine Use and Dantrolene Availability: Comment. / Joshi, Girish P.; Desai, Meena; Valedon, Arnaldo et al. In: ... Joshi GP, Desai M, Valedon A, Gayer S. Succinylcholine Use and Dantrolene Availability: Comment. Anesthesiology. 2019 Oct 1;131 ... title = "Succinylcholine Use and Dantrolene Availability: Comment",. author = "Joshi, {Girish P.} and Meena Desai and Arnaldo ... Joshi, GP, Desai, M, Valedon, A & Gayer, S 2019, Succinylcholine Use and Dantrolene Availability: Comment, Anesthesiology, ...
Succinylcholine chloride injection is indicated, in addition to general anesthesia, to facilitate tracheal intubation and to ... "Succinylcholine Chloride". The American Society of Health-System Pharmacists. Archived from the original on 21 December 2016. ... "Succinylcholine, A Perfect Poison, Makes Appearance in the Dubai Killing". Medgadget. 8 March 2010. Compendium.ch: LYSTHENON 2 ... Tran DT, Newton EK, Mount VA, Lee JS, Wells GA, Perry JJ (October 2015). "Rocuronium versus succinylcholine for rapid sequence ...
20180711-62AE54_Succinylcholine_20mg_per_mL_in_5mL_Room_Temp-signed. Posted July 31, 2018. by Certificate Manager ...
Issues with perioperative management, including collapsible airway and susceptibility to succinylcholine, have also been ...
No, but seriously, |i|Riverdale|/i| was a rollercoaster I wish I never got on.
Succinylcholine. *Tacrolimus. *Tenofovir Alafenamide. *Tubocurarine. *Vecuronium. Using this medicine with any of the following ...
Succinylcholine. *Verapamil. *Yohimbine. Interactions with Food/Tobacco/Alcohol. Certain medicines should not be used at or ...
Succinylcholine sensitivity, see Pseudocholinesterase deficiency. *Succinylpurinemic autism, see Adenylosuccinate lyase ...
Succinylcholine (Clark 2002). *Use of gray-top blood collection tubes or those containing fluoride (Clark 2002) ...
Table 1: Empiric corrective http://www.health-canada-pharmacy.com/antifungals.html factors of the body weight in context of thermally indifferent ground under body (other ground types: Tab.2) and applied to a body weight of 70 kg; ...
Hydrolysis of acetylcholine catalyzed by acetylcholinesterase (AChE), one of the most efficient enzymes in nature, occurs at the base of a deep and narrow active center gorge. At the entrance of the gorge, the peripheral anionic site provides a binding locus for allosteric ligands, including substrates. To date, no structural information on substrate entry to the active center from the peripheral site of AChE or its subsequent egress has been reported. Complementary crystal structures of mouse AChE and an inactive mouse AChE mutant with a substituted catalytic serine (S203A), in various complexes with four substrates (acetylcholine, acetylthiocholine, succinyldicholine, and butyrylthiocholine), two non-hydrolyzable substrate analogues (m-(N,N,N-trimethylammonio)-trifluoroacetophenone and 4-ketoamyltrimethylammonium), and one reaction product (choline) were solved in the 2.05-2.65-A resolution range. These structures, supported by binding and inhibition data obtained on the same complexes, reveal ...
Concomitant use of succinylcholine has been associated with most, but not all, of these cases. These patients also experienced ... The risk of developing malignant hyperthermia increases with the concomitant administration of succinylcholine and volatile ... For endotracheal intubation, do not reduce the dose of nondepolarizing muscle relaxants or succinylcholine. ... 95 of succinylcholine by approximately 30% and that of atracurium and pancuronium by approximately 50% compared to N 2O/opioid ...
Succinylcholine, is a fast-acting depolarising muscle relaxant and is widely used in clinical settings. Succinylcholine is an ... are at risk of prolonged apnea if administered succinylcholine. The US FDA-approved label contraindicates succinylcholine for ... Apart from succinylcholine containing drugs Quelicin & Anectine, the gene also is involved in metabolism of mivacurium, ester ... Pharmacogenetic testing for Suxamethonium (Succinylcholine) posted May 28, 2017, 1:22 AM by Vinod Scaria [ updated May 28, 2017 ...
  • These highlights do not include all the information needed to use SUCCINYLCHOLINE CHLORIDE INJECTION safely and effectively. (nih.gov)
  • Reserve use of succinylcholine chloride injection in pediatric patients for emergency intubation or instances where immediate securing of the airway is necessary, or for intramuscular use when a suitable vein is inaccessible. (nih.gov)
  • Store succinylcholine chloride injection with the cap and ferrule intact and in a manner that minimizes the possibility of selecting the wrong product. (nih.gov)
  • Unintended administration of succinylcholine chloride injection may result in paralysis, respiratory arrest and death. (nih.gov)
  • Succinylcholine chloride injection may induce serious cardiac arrhythmias or cardiac arrest due to hyperkalemia. (nih.gov)
  • Dr Reddy's Laboratories announced the launch of Succinylcholine Chloride Injection USP, 200 mg/10 mL (20 mg/mL), Multiple-Dose Vials a therapeutic equivalent generic version of Quelicin® (Succinylcholine Chloride) Injection, 20 mg/mL, approved by the US Food and Drug Administration (USFDA). (nct-cbnw.com)
  • Dr Reddy's Succinylcholine Chloride Injection USP, 200 mg/10 mL (20 mg/mL), is available in multi-dose vials. (nct-cbnw.com)
  • Succinylcholine chloride injection is indicated, in addition to general anesthesia, to facilitate tracheal intubation and to provide skeletal muscle relaxation during surgery or mechanical ventilation. (wikipedia.org)
  • Succinylcholine is a paralytic agent used for surgeries or short procedures, such as intubation. (picmonic.com)
  • We have received a request from Anesthesia to allow them to store succinylcholine outside of the Pyxis for the purposes being prepared to treat laryngospasm citing the reason that they cannot take the time to type in the drug name to access when a patient is crashing. (medsafetyofficer.org)
  • Suxamethonium chloride, also known as suxamethonium or succinylcholine, or simply sux by medical abbreviation, is a medication used to cause short-term paralysis as part of general anesthesia. (wikipedia.org)
  • When properly administered, succinylcholine can be used to facilitate difficult intubations in the emergency department with an acceptable incidence of adverse effects or failures. (nih.gov)
  • The US FDA-approved label contraindicates succinylcholine for individuals carrying one of many genetic variants known to increase the risk of adverse side effect. (meragenome.com)
  • Indications for treatment of malignant hyperthermia (MH) with dantrolene include signs of hypermetabolism, a rapid rise in carbon dioxide in the face of an increase in the minute ventilation, tachycardia, muscle and or jaw rigidity (after succinylcholine), and fever (a late sign). (medscape.com)
  • Apart from succinylcholine containing drugs Quelicin & Anectine, the gene also is involved in metabolism of mivacurium, ester local anesthetics particularly chloroprocaine. (meragenome.com)
  • In patients with head injuries who undergo rapid sequence intubation using succinylcholine, does pretreatment with a competitive neuromuscular blocking agent improve outcome? (bmj.com)
  • A literature search was undertaken for evidence of the effect of succinylcholine (SCH) on the intracranial pressure (ICP) of patients with acute brain injury and whether pretreatment with a defasciculating dose of competitive neuromuscular blocker is beneficial in this patient group. (bmj.com)
  • In her first ECT session, succinylcholine was avoided because of the reported risk of life-threatening hyperkalemia as a result of upregulation of nicotinic cholinergic receptors secondary to long-term immobilization (as the patient was immobilized for the past 6 months). (anesth-pain-med.org)
  • In the third ECT session, it was decided to use succinylcholine instead of atracurium with complete preparation for monitoring, diagnosis, and management of hyperkalemia, in case such an event occurred. (anesth-pain-med.org)
  • Hudcova and Schumann [ 3 ] reported ventricular tachycardia and ECG changes suggestive of hyperkalemia (with a rise in serum potassium level from 4.3 mEq/L to 6.4 mEq/L) after administering succinylcholine in a patient with catatonia scheduled to undergo ECT. (anesth-pain-med.org)
  • Rosenberg et al (1992) described four males under 8 years who received halothane and succinylcholine with subsequent massive rhabdomyolysis and hyperkalemia leading to arrest and death. (pedemmorsels.com)
  • The mechanism of life-threatening arrhythmias and arrest was proposed by Rosenberg et al to be massive rhabdomyolysis (from depolarizing effects of succinylcholine) leading to acute hyperkalemia , which precipitates wide complex tachyarrhythmias, bradyarrhythmias, and arrest . (pedemmorsels.com)
  • Succinylcholine is a short-acting depolarizing neuromuscular blocking agent. (turkjemergmed.org)
  • The incidence is higher following a second dose of succinylcholine. (nih.gov)
  • Further clinical examination and laboratory investigations led the treating physicians to suspect deliberate intravenous injection of succinylcholine. (turkjemergmed.org)
  • This is the first report describing the survival of a patient with intentional intravenous (IV) succinylcholine administration. (turkjemergmed.org)
  • Succinylcholine, is a fast-acting depolarising muscle relaxant and is widely used in clinical settings. (meragenome.com)
  • Succinylcholine keeps cells in sustained depolarization and prevents muscle contraction. (picmonic.com)
  • However, due to improvement in muscle rigidity, succinylcholine was administered in the next three sessions with all preparations in place. (anesth-pain-med.org)
  • Our experience suggests that succinylcholine may be safe when muscle rigidity is improved. (anesth-pain-med.org)
  • Succinylcholine Chloride is the chloride salt form of succinylcholine, a quaternary ammonium compound and depolarizing agent with short-term muscle relaxant properties. (cartkoo.com)
  • Severe anaphylactic reactions to neuromuscular blocking agents, including succinylcholine, have been reported. (nih.gov)
  • 4 ] reported arrhythmias and asystoles after succinylcholine administration in a patient with catatonia undergoing ECT. (anesth-pain-med.org)
  • The risk of arrhythmias led us to choose a non-depolarizing NMBD over succinylcholine in the initial two settings. (anesth-pain-med.org)
  • Zisselman and Jaffe [ 5 ] also reported ventricular tachycardia with succinylcholine administration in these patients. (anesth-pain-med.org)
  • Succinylcholine is an analog of the neurotransmitter acetylcholine. (meragenome.com)
  • Succinylcholine chloride binds to nicotinic receptors at the neuromuscular junction and opening the ligand-gated channels in the same way as acetylcholine, resulting in depolarization and inhibition of neuromuscular transmission. (cartkoo.com)
  • It is often used to overcome the desensitization experience by paralyzed patients in Phase II block of succinylcholine. (picmonic.com)
  • Based on the existing literature and our experience, the use of succinylcholine or a non-depolarizing NMBD in such patients remains controversial. (anesth-pain-med.org)
  • Before you reflexively say "Sux," we should consider some risks in the pediatric population that come with succinylcholine administration. (pedemmorsels.com)
  • The US FDA-approved label warns that individuals who are carriers of the atypical variant of the plasma cholinesterase gene (BCHE) are at risk of prolonged apnea if administered succinylcholine. (meragenome.com)
  • In the emergency department at Hennepin County Medical Center, succinylcholine has been used to assist difficult intubations since March 1, 1979. (nih.gov)
  • As routine blood investigations were normal, our main concern was serum potassium (4.45 mEq/L), which was expected to rise further with succinylcholine, a commonly used neuromuscular blocking drug (NMBD) in ECT procedures [ 2 ]. (anesth-pain-med.org)
  • Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline for the use of potent volatile anesthetic agents and succinylcholine in the context of RYR1 or CACNA1S genotypes. (cdc.gov)
  • Succinylcholine, on the other hand, is bound for much longer time. (picmonic.com)
  • we will focus on considerations in predicted difficult airways (RSI vs. awake intubation), Rocuronium vs. Succinylcholine, and the indications. (emottawablog.com)
  • Rocuronium versus succinylcholine in air medical rapid-sequence intubation. (wakehealth.edu)
  • With the decline in the use of succinylcholine and the availability of safer alternatives such as rocuronium and sugammadex, less and less is being written in textbooks about PChE deficiency. (jicajournal.in)
  • A formulation for preparing Succinylcholine Chloride 50-mg/mL Injection. (ijpc.com)
  • Succinylcholine or Suxamethonium is a muscle-relaxant agent with a peripheric depolarizing action that is used for rapid endotracheal intubation procedures, mechanical ventilation, and surgical procedures. (e-lactancia.org)
  • Suxamethonium chloride, also known as suxamethonium or succinylcholine, or simply sux by medical abbreviation, is a medication used to cause short-term paralysis as part of general anesthesia. (wikipedia.org)
  • As routine blood investigations were normal, our main concern was serum potassium (4.45 mEq/L), which was expected to rise further with succinylcholine, a commonly used neuromuscular blocking drug (NMBD) in ECT procedures [ 2 ]. (anesth-pain-med.org)
  • with prolonged duration of action of mivacurium or succinylcholine during anaesthesia. (nih.gov)
  • PChE (BuChE, EC 3.1.1.8): Also known as plasma cholinesterase, butyrylcholinesterase, or acylcholine acylhydrolase: Found primarily in the liver and is responsible for the metabolism of succinylcholine, mivacurium, and local anesthetics chloroprocaine, tetracaine, procaine, and benzocaine. (jicajournal.in)
  • PChE or butyrylcholinesterase deficiency is a rare, acquired, or inherited condition where the PChE levels are absent or lower than normal with a reduced ability to metabolize succinylcholine and mivacurium leading to prolonged muscular paralysis from standard doses. (jicajournal.in)
  • In her first ECT session, succinylcholine was avoided because of the reported risk of life-threatening hyperkalemia as a result of upregulation of nicotinic cholinergic receptors secondary to long-term immobilization (as the patient was immobilized for the past 6 months). (anesth-pain-med.org)
  • In the third ECT session, it was decided to use succinylcholine instead of atracurium with complete preparation for monitoring, diagnosis, and management of hyperkalemia, in case such an event occurred. (anesth-pain-med.org)
  • Hudcova and Schumann [ 3 ] reported ventricular tachycardia and ECG changes suggestive of hyperkalemia (with a rise in serum potassium level from 4.3 mEq/L to 6.4 mEq/L) after administering succinylcholine in a patient with catatonia scheduled to undergo ECT. (anesth-pain-med.org)
  • [2] , [3] The Food and Drug Administration issued a black box warning in 1993 for succinylcholine after a series of cardiac arrests occurred related to hyperkalemia in children with undiagnosed muscular dystrophy. (jicajournal.in)
  • Avoid succinylcholine as a paralytic in any patient with possible rhabdomyolysis to prevent the development of hyperkalemia. (medscape.com)
  • Succinylcholine is a commonly used depolarizing neuromuscular blocking agent in anesthesia for relaxation of the skeletal muscles during endotracheal intubation. (providence.org)
  • Because of multiple complications related to succinylcholine, many anesthesiologists now avoid its use for emergency and elective intubation. (jicajournal.in)
  • [6] Since the mutation is recessive, heterozygotes will present with an approximately 30% increase in the duration of action of succinylcholine. (jicajournal.in)
  • PharmGKB summary: succinylcholine pathway, pharmacokinetics/pharmacodynamics. (cdc.gov)
  • One documented side effects of succinylcholine is postoperative myalgia, which was first described in the literature in 1952. (providence.org)
  • Given recent surgery, succinylcholine-induced postoperative myalgia was considered the likely culprit. (providence.org)
  • Although succinylcholine-induced postoperative myalgia is generally mild and self-limited, certain cases can be severe. (providence.org)
  • The mechanism behind postoperative myalgias is not definitively elucidated, but is thought to be related to the fasciculations that occur soon after succinylcholine is administered. (providence.org)
  • Succinylcholine should not prevent a mother from breast feeding her baby shortly after recovering from an anesthesia if she is in a good condition. (e-lactancia.org)
  • Clinical Cases in Anesthesia : Depolarizing Neuromuscular Blockade : What are the contraindications to succinylcholine administration? (brainkart.com)
  • Since the 1950s, cardiac arrest has been observed in burn patients receiving succinylcholine. (medscape.com)
  • What are the contraindications to succinylcholine administration? (brainkart.com)
  • Contraindications to succinylcholine administration follow logically from its known side-effects. (brainkart.com)
  • [1] The delayed reversal from neuromuscular blockade after administration of succinylcholine, was unlike the classic complete prolonged neuromuscular block seen in a patient with PChE deficiency. (jicajournal.in)
  • It is thus important to revisit PChE deficiency, and start a conversation on this life-threatening but relatively easy-to-manage complication following succinylcholine administration. (jicajournal.in)
  • echothiophate iodide increases levels of succinylcholine by decreasing metabolism. (medscape.com)
  • When large muscle groups are involved, a massive efflux of potassium ions from the muscle cells into the serum occurs after succinylcholine administration. (medscape.com)
  • Administration of succinylcholine to patients without neuromuscular disease results in a small, transient increase in a serum potassium concentration of about 0.55 meq/L. [ 7 ] Potassium increases greater than 5 meq/ L are extremely rare. (medscape.com)
  • Succinylcholine administration has been associated with acute onset of malignant hyperthermia. (nih.gov)
  • Uncommon neuro-muscular diseases, such as myotonia and dermatomyositis, react with sustained muscular contraction following succinylcholine administration. (brainkart.com)
  • 4 ] reported arrhythmias and asystoles after succinylcholine administration in a patient with catatonia undergoing ECT. (anesth-pain-med.org)
  • Zisselman and Jaffe [ 5 ] also reported ventricular tachycardia with succinylcholine administration in these patients. (anesth-pain-med.org)
  • Partial, weak respiratory efforts were observed initially, but complete recovery from neuromuscular block occurred 6 h after administration of succinylcholine. (jicajournal.in)
  • Following the administration of succinylcholine chloride, a one-hour waiting period is advisable before initiation of dexpanthenol therapy. (drugs.com)
  • The rapid onset and ultra-short duration of succinylcholine provide excellent intubating conditions and can theoretically facilitate an earlier reversal of NM blockade making it highly desirable in emergent situations. (jicajournal.in)
  • Garcia DF, Oliveira TG, Molfetta GA, Garcia LV, Ferreira CA, Marques AA, Silva WA Jr. Biochemical and genetic analysis of butyrylcholinesterase (BChE) in a family, due to prolonged neuromuscular blockade after the use of succinylcholine. (medlineplus.gov)
  • Structurally, succinylcholine consists of two acetylcholine molecules arranged back-to-back and mimics the pharmacologic action of acetylcholine at the acetylcholine receptor. (medscape.com)
  • amikacin increases effects of succinylcholine by pharmacodynamic synergism. (medscape.com)
  • amphotericin B deoxycholate increases effects of succinylcholine by pharmacodynamic synergism. (medscape.com)
  • 1,2] A general anesthetic regimen that included succinylcholine for cesarean section caused a delay in the time to the first breastfeeding, but the part that succinylcholine played in this difference in outcome in unknown. (nih.gov)
  • Electroconvulsive therapy in a catatonia patient: succinylcholine or no succinylcholine? (anesth-pain-med.org)