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Which of the following statements about neuromuscular blocking agents is false?
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Teaching Points
- The actions of nondepolarizing blocking agents are readily reversed by increasing the concentration of normal transmitters at the receptors.
- Reversal of nondepolarizing drugs is best accomplished by administering choline esterase inhibitors such as neostigmine.
- In contrast, the paralysis produced by depolarizing blockers is increased by cholinesterase inhibitors.
- The drugs block neuromuscular transmission at the neuromuscular junction causing paralysis of the skeletal muscles. This is accomplished either by acting presynaptically via the inhibition of acetylcholine synthesis or release or by acting postsynaptically at the acetylcholine receptors of the motor nerve end-plate. In clinical use, neuromuscular blockade is used adjunctively to anesthesia to paralyze the vocal cords and permit intubation of the trachea as well as to optimize the surgical field by inhibiting spontaneous ventilation to cause relaxation of skeletal muscles. Because the appropriate dose of neuromuscular-blocking drug may paralyze the muscles of the diaphragm, mechanical ventilation should be available. Patients are still aware of pain; hence, general anesthetics or analgesics must also be given.
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PubMed References
| Depolarizing Neuromuscular Blocking Drugs, Gulenay M,Mathai JK,, , 2018 Jan [PubMed PMID: 30422589] | |
| The Advancement of Pediatric Anesthesia Pharmacology: David Ryan Cook (Scions, Serendipity, and Six Degrees of Separation)., Cladis FP,Mai CL,Yaster M,Davis PJ,, Paediatric anaesthesia, 2018 Nov 10 [PubMed PMID: 30414345] | |
| Neuromuscular blocking agents for acute respiratory distress syndrome., Torbic H,Duggal A,, Journal of critical care, 2018 Oct 28 [PubMed PMID: 30396789] | |
| Neuromuscular blocking agents and intubation., Sorbello M,Falcetta S,Di Giacinto I,Cataldo R,, Anaesthesia, 2018 Nov [PubMed PMID: 30298584] | |
| Neuromuscular blocking agents and intubation: a reply., Nakanishi T,Yoshimura M,Sakamoto S,Toriumi T,, Anaesthesia, 2018 Nov [PubMed PMID: 30298582] |
