Non-depolarizing neuromuscular

Driessen JJ, Vree TB, van Egmond J, Booij LH, Crul JF. Interaction of midazolam with two non-depolarizing neuromuscular blocking drugs in the rat in vivo sciatic nerve-tibialis anterior muscle preparation. Br J Anaesth 1985 57(ll) 1089-94. 

Hughes R, Chappie DJ. Effects on non-depolarizing neuromuscular blocking agents on peripheral autonomic mechanisms in cats. Br J Anaesth 1976 48(2) 59-68. 

Burns are associated with resistance to atracurium (43), as for several other non-depolarizing neuromuscular blocking agents. The EC50 is increased and dose requirements may be increased by up to 2-3 times. The resistance varies with the burn area and the time from injury (SEDA-12, 116), being maximal at 15 0 days in patients repeatedly anesthetized. 

In contrast to reports on other non-depolarizing neuromuscular blocking agents, resistance to atracurium has not been found in patients taking long-term carbamazepine (SEDA-13, 104) (58). 

From animal experiments (8) it seems hkely that drug interactions with atracurium will be similar to those for other non-depolarizing neuromuscular blocking agents. Laudanosine has been reported to increase the MAC for halothane in animals (61). 

Hughes R, Payne JP, Sngai N. Stndies on fazadinium bromide (AH 8165) a new non-depolarizing neuromuscular blocking agent. Can Anaesth Soc J 1976 23(l) 36-47. 

The effects of non-depolarizing neuromuscular blocking drugs can be potentiated and their actions prolonged by large doses of local anesthetics, because of depression of nerve conduction, inhibition of acetylcholine formation, mobilization, and release, reduced postsynaptic receptor channel opening times, and reduced muscle contraction (370). 

The umbilical/maternal vein concentration ratio of non-depolarizing neuromuscular relaxants varies... 

Wierda JM, Kleef UW, Lambalk LM, Kloppenburg WD, Agoston S. The pharmacodynamics and pharmacokinetics of Org 9426, a new non-depolarizing neuromuscular blocking agent, in patients anaesthetized with nitrous oxide, halothane and fentanyl. Can J Anaesth 1991 38(4 Pt l) 430-5. 

Patients with burns require more D-tubocurarine (and higher plasma concentrations) for the same degree of blockade compared with non-burned patients (6). The mechanism is not known, but it appears not to be altered pharmacokinetics (7). The resistance to non-depolarizing neuromuscular blocking agents (SEDA-8,136) appears to be influenced by the size of the body surface area burned and by the time which has elapsed since the injury (see Atracurium). In extensive burns dose requirements are increased approximately by a factor of 2-3. 

Acute administration of phenytoin (10 mg/kg intravenously) has been reported to enhance slightly, but statistically significantly, steady blockade maintained by an infusion of vecuronium (SEDA-15, 124) (46). This is in contrast to reports of resistance to non-depolarizing neuromuscular blocking agents, including vecuronium, associated with long-term phen)4 oin (SEDA-13,104) (47). 

Marshall RJ, McGrath JC, Miller RD, Docherty JR, Lamar JC. Comparison of the cardiovascular actions of ORG NC 45 with those produced by other non-depolarizing neuromuscular blocking agents in experimental animals. Br J Anaesth 1980 52(Suppl l) S21-32. 

Neuromuscular blocking agents are structurally related to acetylcholine. They either block transmission by simulating an excess of acetylcholine (depolarizing neuromuscular blockers) or prevent depolarization by preventing acetylcholine from binding to its receptor on the motor end plate (non-depolarizing neuromuscular blockers). 

Pancuronium, vecuronium and atracurium are synthetic non-depolarizing neuromuscular... 

Indications Neuromuscular blockade, endotracheal intubation Category Non-depolarizing neuromuscular blocker Half-life initial 2 minutes terminal 20 minutes Clinically important, potentially hazardous interactions with amikacin, aminoglycosides, anesthetics, antibiotics, gentamicin, halothane, kanamycin, neomycin, piperacillin, streptomycin, tobramycin... 

Clinically important, potentially hazardous interactions with aminoglycosides, non-depolarizing neuromuscular blocking agents... 

Category Non-depolarizing neuromuscular blocker Half-life 22 minutes... 

Trade names Norcuron Vecuron Indications Adjunct to general anesthesia Category Non-depolarizing neuromuscular blocker Half-life 65-75 minutes... 

Gutteck-Amsler, U. and Rentsch, K. M. Quantification of the aminosteroidal non-depolarizing neuromuscular blocking agents rocuronium and vecuronium in plasma with liquid chromatography-tandem mass spectroscopy. Clin. Chem., 46, 1413-1414 (2000). 

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