Patients with traumatic brain injury (TBI) require mechanical ventilation for airway protection, to reduce work of breathing, to reduce cerebral metabolic rate and to optimize intracerebral hemodynamics. Drugs like narcotics, benzodiazepines, propofol and alpha-2 agonists with or without non-depolarizing muscle relaxants are used to facilitate mechanical ventilation. We reviewed literature on s...

Galanthamine hydrobromide (Nivalin), an alkaloid from the bulbs of snowdrops, is widely used in Bulgaria as an antagonist to non-depolarizing muscle relaxants. The pharmacology is reviewed and experiences in the use of galanthamine in 24 patients are described. It is about one-tenth as potent as neostigmine. As changes in pulse rate and blood pressure were slight, it is rarely necessary to inje...

Malignant hyperthermia (MH) is triggered by all inhalative anesthetics as well as depolarizing muscle relaxants in genetically predisposed individuals. Presymptomatic testing is important in this potentially fatal pharmacogenetic disease. In vitro challenging of muscle samples with halothane and caffeine is the basis of contracture testing, which until recently was the only accepted diagnostic ...

Myasthenia gravis is characterized by weakness and easy fatiguability of voluntary muscles. Myasthenic patients are sensitive to non-depolarizing relaxants. Sevoflurane, as an alternative, can be used to achieve good tracheal intubation. In this report, we present our experiences.

The clinical pharmacology of neuromuscular blocking agents is described. During neuromuscular blockade, succinylcholine attaches to receptors in the motor end plate and depolarizes the neuromuscular junction, making the end plate refractory to acetylcholine. The nondepolarizing relaxants have a structure similar to that of succinylcholine and bind to the same receptors. Instead of depolarizing ...

PA~CU~ONrOM B~OMIDE (Organon NA97) is a steroid compound non-depolarizing neuromuscular blocking agent, 1 synthesized by Hewett and Savage in 1964. Following extensive pharmacological studies in animals, Buckett and Bonta 2 suggested that this agent possessed properties similar to those of d-tubocurarine but with certain differences in side effects. Its potency is claimed to be about five times...