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Neuromuscular blockers

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https://www.readbyqxmd.com/read/28077717/complexin-mutants-reveal-partial-segregation-between-recycling-pathways-that-drive-evoked-and-spontaneous-neurotransmission
#1
Nadezhda Sabeva, Richard W Cho, Alexander Vasin, Agustin Gonzalez, J Troy Littleton, Maria Bykhovskaia
: Synaptic vesicles fuse at morphological specializations in the presynaptic terminal termed active zones (AZs). Vesicle fusion can occur spontaneously or in response to an action potential. Following fusion, vesicles are retrieved and recycled within nerve terminals. It is still unclear whether vesicles that fuse spontaneously or following evoked release share similar recycling mechanisms. Genetic deletion of the SNARE-binding protein complexin dramatically increases spontaneous fusion, with the protein serving as the synaptic vesicle fusion clamp at Drosophila synapses...
January 11, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28057945/ismp-medication-error-report-analysis-aggrastat-argatroban-mix-ups-don-t-expect-radiofrequency-identification-stock-systems-to-be-perfect-paralyzed-by-mistakes-reassess-the-safety-of-neuromuscular-blockers-in-your-facility
#2
Michael R Cohen, Judy L Smetzer
These medication errors have occurred in health care facilities at least once. They will happen again-perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them at your inservice training programs. Your assistance is required to continue this feature. The reports described here were received through the Institute for Safe Medication Practices (ISMP) Medication Errors Reporting Program...
December 2016: Hospital Pharmacy
https://www.readbyqxmd.com/read/28013329/effects-of-neuromuscular-blockers-on-transpulmonary-pressures-in-moderate-to-severe-acute-respiratory-distress-syndrome
#3
Christophe Guervilly, Magali Bisbal, Jean Marie Forel, Malika Mechati, Samuel Lehingue, Jeremy Bourenne, Gilles Perrin, Romain Rambaud, Melanie Adda, Sami Hraiech, Elisa Marchi, Antoine Roch, Marc Gainnier, Laurent Papazian
PURPOSE: To investigate whether neuromuscular blocking agents (NMBA) exert beneficial effects in acute respiratory distress syndrome (ARDS) by reason of their action on respiratory mechanics, particularly transpulmonary pressures (P L). METHODS: A prospective randomised controlled study in patients with moderate to severe ARDS within 48 h of the onset of ARDS. All patients were monitored by means of an oesophageal catheter and followed up for 48 h. Moderate ARDS patients were randomised into two groups according to whether they were given a 48-h continuous infusion of cisatracurium besylate or not (control group)...
December 24, 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/28012426/perceived-safety-and-efficacy-of-neuromuscular-blockers-for-acute-respiratory-distress-syndrome-among-medical-intensive-care-unit-practitioners-a-multicenter-survey
#4
Heather Torbic, Seth R Bauer, Heather A Personett, Amy L Dzierba, Joanna L Stollings, Lindsay P Ryder, Craig E Daniels, Sean M Caples, Erin N Frazee
PURPOSE: Neuromuscular blocking agents (NMBAs) are frequently used in patients with acute respiratory distress syndrome (ARDS). The purpose of this survey is to describe providers' knowledge and perceived efficacy and safety of NMBAs in patients with ARDS. MATERIALS AND METHODS: We performed a prospective, multicenter survey of medical intensive care unit intensivists, fellows, nurse practitioners (NPs), physician's assistants (PAs), and pharmacists at 5 tertiary care centers between July 2012 and May 2013...
December 7, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/28011884/pharmacogenetics-and-pathophysiology-of-cacna1s-mutations-in-malignant-hyperthermia
#5
Teresa Ann Beam, Emily F Loudermilk, David F Kisor
A review of the pharmacogenetics (PGt) and pathophysiology of calcium voltage-gated channel subunit alpha1 S (CACNA1S) mutations in malignant hyperthermia susceptibility type 5 (MHS5; MIM #60188) is presented. Malignant hyperthermia (MH) is a life-threatening hypermetabolic state of skeletal muscle usually induced by volatile, halogenated anesthetics and/or the depolarizing neuromuscular blocker succinylcholine. In addition to ryanodine receptor 1 (RYR1) mutations, several CACNA1S mutations are known to be risk factors for increased susceptibility to MH (MHS)...
December 23, 2016: Physiological Genomics
https://www.readbyqxmd.com/read/28008669/r-type-ca-2-channels-couple-to-inhibitory-neurotransmission-to-the-longitudinal-muscle-in-the-guinea-pig-ileum
#6
Eileen S Rodriguez-Tapia, Vinogran Naidoo, Matthew DeVries, Alberto Perez-Medina, James J Galligan
There is evidence that R-type Ca(2+) channels contribute to synaptic transmission in the myenteric plexus. It is unknown if R-type Ca(2+) channels contribute to neuromuscular transmission. We measured the effects of the nitric oxide synthase (NOS) inhibitor, nitro L-arginine (NLA), Ca(2+) channel blockers and apamin (SK channel blocker) on neurogenic relaxations and contractions of the guinea pig ileum longitudinal muscle-myenteric plexus (LMMP) in vitro. We used intracellular recordings to measure inhibitory junction potentials (IJPs)...
December 23, 2016: Experimental Physiology
https://www.readbyqxmd.com/read/27913592/complexin-mutants-reveal-partial-segregation-between-recycling-pathways-that-drive-evoked-and-spontaneous-neurotransmission
#7
Nadezhda Sabeva, Richard W Cho, Alexander Vasin, Agustin Gonzalez, J Troy Littleton, Maria Bykhovskaia
: Synaptic vesicles fuse at morphological specializations in the presynaptic terminal termed active zones (AZs). Vesicle fusion can occur spontaneously or in response to an action potential. Following fusion, vesicles are retrieved and recycled within nerve terminals. It is still unclear whether vesicles that fuse spontaneously or following evoked release share similar recycling mechanisms. Genetic deletion of the SNARE-binding protein complexin dramatically increases spontaneous fusion, with the protein serving as the synaptic vesicle fusion clamp at Drosophila synapses...
December 2, 2016: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/27908944/use-of-neuromuscular-blockers-during-therapeutic-hypothermia-after-cardiac-arrest-a-nursing-protocol
#8
Coraline Boulila, Samia Ben Abdallah, Aude Marincamp, Vincent Coic, Romuald Lauverjat, Nicole Ericher, Wulfran Bougouin, Jean-Paul Mira, Alain Cariou, Guillaume Geri
BACKGROUND: Neuromuscular blockers used to prevent shivering during therapeutic hypothermia in comatose patients after out-of-hospital cardiac arrest are associated with adverse events. OBJECTIVE: To assess the influence of a nurse-implemented protocol on use of neuromuscular blockers in patients treated with 24-hour therapeutic hypothermia after out-of-hospital cardiac arrest. METHODS: A before and after study was done in a 24-bed cardiac arrest center...
December 2016: Critical Care Nurse
https://www.readbyqxmd.com/read/27871555/anesthetic-implications-for-patients-with-segawa-syndrome
#9
Kathryn E Howze, Nicholas D Will, Bryan T Klassen, Juraj Sprung, Toby N Weingarten
STUDY OBJECTIVE: To characterize the perioperative course of patients with Segawa syndrome undergoing anesthetic management. DESIGN: Retrospective observational case study. SETTING: Large tertiary medical center. PATIENTS: Patients with Segawa syndrome who underwent procedures requiring anesthetic management at our institution from January 1, 2004, through July 31, 2015. MEASUREMENTS: The health records of patients with Segawa syndrome...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27863874/successful-autologous-haematopoietic-stem-cell-transplantation-for-refractory-myasthenia-gravis-a-case-report
#10
Irene Håkansson, Anna Sandstedt, Fredrik Lundin, Håkan Askmark, Ritva Pirskanen, Kristina Carlson, Fredrik Piehl, Hans Hägglund
Myasthenia gravis (MG) is an autoimmune disease, with immune reactivity against the post-synaptic endplate of the neuromuscular junction. Apart from symptomatic treatment with choline esterase blockers, many patients also require immunomodulatory treatment. Despite existing treatment options, some patients are treatment refractory. We describe a patient with severe MG refractory to corticosteroids, four oral immunosuppressants, cyclophosphamide, rituximab and bortezomib who was treated with autologous haematopoietic stem cell transplantation...
September 28, 2016: Neuromuscular Disorders: NMD
https://www.readbyqxmd.com/read/27816131/anesthesia-patients-with-concomitant-cardiac-and-hepatic-dysfunction
#11
REVIEW
Julianne Ahdout, Michael Nurok
Anesthesia and surgery in patients with hepatic and cardiac dysfunction poses a challenge for anesthesiologists. It is imperative to optimize these patients perioperatively. Cirrhosis is associated with a wide range of cardiovascular abnormalities. Cirrhotic cardiomyopathy is characterized by blunted contractile responsiveness or systolic incompetence, and/or diastolic dysfunction. In liver disease, anesthetic drug distribution, metabolism, and elimination may be altered. Among patients with liver disease, propofol is a reasonable anesthetic choice and cisatracurium is the preferred neuromuscular blocker...
December 2016: Anesthesiology Clinics
https://www.readbyqxmd.com/read/27796041/optimal-anesthetic-regimen-for-ambulatory-laser-microlaryngeal-surgery
#12
Hyub Huh, Seol Ju Park, Hyong Hwan Lim, Kwang Yoon Jung, Seung-Kuk Baek, Seung Zhoo Yoon, Hye Won Lee, Hye Ja Lim, Jang Eun Cho
OBJECTIVES/HYPOTHESIS: Laser microlaryngeal surgery (LMS) is a short operation requiring brief and intense paralysis. Adequate muscle relaxation and rapid recovery of neuromuscular function are essential for improving surgical conditions and reducing the incidence of complications during LMS. However, the ideal muscle relaxant with a rapid onset and short duration of action is not yet available. Rocuronium has rapid onset at higher doses, but with a prolonged duration of action. Sugammadex is a selective relaxant-binding agent that allows for rapid reversal of rocuronium-induced neuromuscular blockade...
October 31, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27770577/metabotropic-and-ionotropic-glutamate-receptors-mediate-the-modulation-of-acetylcholine-release-at-the-frog-neuromuscular-junction
#13
Andrei Tsentsevitsky, Leniz Nurullin, Evgeny Nikolsky, Artem Malomouzh
There is some evidence that glutamate (Glu) acts as a signaling molecule at vertebrate neuromuscular junctions where acetylcholine (ACh) serves as a neurotransmitter. In this study, performed on the cutaneous pectoris muscle of the frog Rana ridibunda, Glu receptor mechanisms that modulate ACh release processes were analyzed. Electrophysiological experiments showed that Glu reduces both spontaneous and evoked quantal secretion of ACh and synchronizes its release in response to electrical stimulation. Quisqualate, an agonist of ionotropic α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic receptors and metabotropic Group I mGlu receptors, also exerted Glu-like inhibitory effects on the secretion of ACh but had no effect on the kinetics of quantal release...
October 22, 2016: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/27736708/corticosteroids-and-neuromuscular-blockers-in-development-of-critical-illness-neuromuscular-abnormalities-a-historical-review
#14
REVIEW
Susan R Wilcox
Weakness is common in critically ill patients, associated with prolonged mechanical ventilation and increased mortality. Corticosteroids and neuromuscular blockade (NMB) administration have been implicated as etiologies of acquired weakness in the intensive care unit. Medical literature since the 1970s is replete with case reports and small case series of patients with weakness after receiving high-dose corticosteroids, prolonged NMB, or both. Several risk factors for weakness appear in the early literature, including large doses of steroids, the dose and duration of NMB, hyperglycemia, and the duration of mechanical ventilation...
February 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/27696339/effects-of-sugammadex-vs-pyridostigmine-glycopyrrolate-on-post-operative-nausea-and-vomiting-propensity-score-matching
#15
O H Lee, G J Choi, H Kang, C W Baek, Y H Jung, Y C Woo, J Oh, Y H Park
BACKGROUND: Sugammadex is a new agent that reverses neuromuscular blockade by aminosteroid neuromuscular blocker. This retrospective study compared the effects of sugammadex on post-operative nausea and vomiting (PONV) with those of a pyridostigmine-glycopyrrolate mixture. METHODS: We reviewed the electronic medical records of 7179 patients who had received fentanyl-based, intravenous, patient-controlled analgesia (IV-PCA) at Chung-Ang University Hospital between January 1, 2010 and December 31, 2015...
January 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27687446/interaction-between-magnesium-sulfate-and-neuromuscular-blockers-during-the-perioperative-period-a-systematic-review-and-meta-analysis
#16
REVIEW
Laura Rodríguez-Rubio, Julian Solis Garcia Del Pozo, Eduardo Nava, Joaquín Jordán
No abstract text is available yet for this article.
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27636579/neuromuscular-blockers-and-electroconvulsive-therapy-how-much-is-enough
#17
Aaron F Kopman, Mohamed Naguib
No abstract text is available yet for this article.
October 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27625489/novel-drug-development-for-neuromuscular-blockade
#18
Amit Prabhakar, Alan D Kaye, Melville Q Wyche, Orlando J Salinas, Kenneth Mancuso, Richard D Urman
Pharmacological advances in anesthesia in recent decades have resulted in safer practice and better outcomes. These advances include improvement in anesthesia drugs with regard to efficacy and safety profiles. Although neuromuscular blockers were first introduced over a half century ago, few new neuromuscular blockers and reversal agents have come to market and even fewer have remained as common clinically employed medications. In recent years, newer agents have been studied and are presented in this review...
July 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/27625477/nasal-mask-ventilation-is-better-than-face-mask-ventilation-in-edentulous-patients
#19
Mukul Chandra Kapoor, Sandeep Rana, Arvind Kumar Singh, Vindhya Vishal, Indranil Sikdar
BACKGROUND AND AIMS: Face mask ventilation of the edentulous patient is often difficult as ineffective seating of the standard mask to the face prevents attainment of an adequate air seal. The efficacy of nasal ventilation in edentulous patients has been cited in case reports but has never been investigated. MATERIAL AND METHODS: Consecutive edentulous adult patients scheduled for surgery under general anesthesia with endotracheal intubation, during a 17-month period, were prospectively evaluated...
July 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/27591471/anesthesia-in-a-patient-with-stiff-person-syndrome
#20
Ozgur Yagan, Kadir Özyilmaz, Ahmet Özmaden, Özgür Sayin, Volkan Hanci
Stiff Person Syndrome (SPS), typified by rigidity in muscles of the torso and extremities and painful episodic spasms, is a rare autoimmune-based neurological disease. Here we present the successful endotracheal intubation and application of TIVA without muscle relaxants on an SPS patient. A 46 years old male patient was operated with ASA-II physical status because of lumber vertebral compression fracture. After induction of anesthesia using lidocaine, propofol and remifentanil tracheal intubation was completed easily without neuromuscular blockage...
September 2016: Brazilian Journal of Anesthesiology
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