Neuromuscular blockade histamine release

Trimethaphan can produce prolonged neuromuscular blockade in some patients, and therefore, it should be used with caution as a hypotensive agent during surgery. It also has been reported to potentiate the neuromuscular blocking action of tubocurarine, and because of its histamine-releasing properties, trimethaphan should be used with caution in patients with allergies. 

The autonomic margins of safety of the test drugs are calculated as the ratios of cumulative doses producing 50 % block (ED50) of vagal (parasympathetic) and sympathetic transmission and the ED50 for histamine release, each divided by the ED50 of neuromuscular blockade. 

Clutton RE, Boyd C, Flora R et al. (1992) Autonomic and cardiovascular effects of neuromuscular blockade antagonism in the dog. Veterinary Surgery 21 68-75 Paton WDM (1957) Histamine release by compounds of simple chemical structure. Pharmacol Rev 9 269-328 Savarese JJ (1979) The autonomic margins of safety of metocurine and d-tubocurarine in the cat. Anesthesiology 50 40-46... 

DEPOLARIZING, NON-DEPOLARIZING VANCOMYCIN 1. t efficacy of these muscle relaxants 2. Possible risk of hypersensitivity reactions 1. Vancomycin has some neuromuscular blocking activity 2. Animal studies suggest additive effect on histamine release 1. Monitor neuromuscular blockade carefully 2. Be aware... 

Vecuronium is a synthetic steroid derivative that produces full neuromuscular blockade about 3 minutes after a dose of 0.1 mg/kg. After this dose, its diuration of action is 20-30 minutes. It has no cardiovascular side-effects and does not cause histamine release. 

The onset time for complete neuromuscular blockade is similar to that of D-tubocurarine and other non-depolarizing agents, namely 2-4 minutes. However, this is to some extent dose-dependent, and because of the relative lack of cardiovascular effects and histamine release, pancuronium can safely be given in higher dosages, thus producing good intubation conditions within 2 minutes. The dose of D-tubocurarine required to achieve similar... 

Blockade of autonomic ganglia Elevated serum enzymes indicative of muscle damage Histamine release in a genetically determined population Metabolism at the neuromuscular junction by acetylcholinesterase... 

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