Paralytic agent

The only way to determine if a comatose patient has SE is by EEG. EEG monitoring should be used for patients who remain unconscious after initial antiepileptic treatment, and for those who received a long-acting paralytic agent or require prolonged therapy for RSE. Treatment should never be delayed while awaiting EEG results. An electrocardiogram (ECG) should be obtained to rule out cardiac dysfunction when hypotension or an abnormal heart rate is observed. 

Saxitoxin is a small tricyclic structure isolated from oceanic red tides it has attracted much interest for its peculiar structure and toxicity as a paralytic agent. The core structure that is related to a l-iminooctahydropyrrolo[l,2-f]-pyrimidine nucleus was prepared by rearrangement after oxidation of a double bond contained in a medium-size guanidine ring. This key intermediate in the synthesis was prepared from azide 376 with a judicious use of Mbs... 

Neuromuscular paralytic agents botulinum toxin type A... 

The ryanodine receptors are calcium release channels found in the endoplasmic reticulum and sarcoplasmic reticulum of muscle cells. One type of receptor can be activated by a depolarization signal (depolarization-induced calcium release). Another receptor type is activated by calcium ions (calcium-induced calcium release). The proteins received their name because they bind ryanodine, a toxin obtained from the stem and roots of the plant Ryania speciosa. Ryanodine inhibits sarcoplasmic reticulum calcium release, and acts as a paralytic agent. It was first used commercially in insecticides. 

The paralytic agent (+)-saxitoxin 283 was obtained from 1,2,3-oxathiazine 282 (Scheme 21) <2006JA3926>. 

Necessary equipment and pharmacologic medication then needs to be made available to ensure smooth intubation. Essential equipment is listed in Table 3.3. Pharmacologic medications consist of hypnotic and paralytic agents and are listed in Table 3.4. All patients should have cardiopulmonary monitoring with cardiac, blood pressure, and pulse oximeter monitors. Intravenous lines should be checked for their patency. The choice of sedative or hypnotic agents will depend on the patient s hemodynamic status, with etomidate and ketamine usually preferred in the hemodynamically unstable patient. The administration of a paralytic agent has... 

In intubated patients, sedation and a short-acting paralytic agent are... 

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