Standards neuromuscular blockers

A good example for clinical reality of pharmacogenetic methods is the very frequently performed test for pseudocholinesterase. Inherited deficiency in pseudocholinesterase activity results in prolonged respiratory paralysis when deficient patients receive standard doses of the neuromuscular blockers suxamethonium or mivacurium [41]. 

The concurrent use of neuromuscular blockers and lithium is normally safe and uneventful, but four patients taking lithium experienced prolonged blockade and respiratory difficulties after receiving standard doses of pancuronium and/or suxamethonium (succinylcholine). 

Fig. 7. Effect of calcium and acetylcholine on histamine release (means standard errors) by alcuronium in a patient with idiosyncrasy to non-depolarising neuromuscular blockers. Broken /me=control e/re/ej=without Ca " diamondsCa triangles—W ih Ca " and 10 pg/ml acetylcholine...

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