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The effect of non-depolarizing neuromuscular-blocking drugs may be reversed with acetylcholinesterase inhibitors, neostigmine, and edrophonium, as commonly used examples. Of these, edrophonium has a faster onset of action than neostigmine, but it is unreliable when used to antagonize deep neuromuscular block. [29]
The neuromuscular junction. Neuromuscular drugs are chemical agents that are used to alter the transmission of nerve impulses to muscles, causing effects such as temporary paralysis of targeted skeletal muscles. Most neuromuscular drugs are available as quaternary ammonium compounds which are derived from acetylcholine (ACh). [1]
Antinicotinic agents are classified into ganglionic blockers and neuromuscular blockers. Ganglionic blockers are of little clinical use as they act at all autonomic ganglions. [1] [2] They act by: Interfering acetylcholine release; Prolonged depolarization (depolarisation block), i.e. stimulation then block stimulation
The term "anticholinergic" is typically used to refer to antimuscarinics that competitively inhibit the binding of ACh to muscarinic acetylcholine receptors; such agents do not antagonize the binding at nicotinic acetylcholine receptors at the neuromuscular junction, although the term is sometimes used to refer to agents that do so. [3] [5]
A muscle relaxant is a drug that affects skeletal muscle function and decreases the muscle tone. It may be used to alleviate symptoms such as muscle spasms, pain, and hyperreflexia. The term "muscle relaxant" is used to refer to two major therapeutic groups: neuromuscular blockers and spasmolytics.
Ganglionic blockers are used less frequently now than they were in the past, because antihypertensives with fewer side effects are now available. Hexamethonium has been described as the "first effective antihypertensive drug". [4] However, they are still used in some emergency situations, such as aortic dissection or autonomic dysreflexia.
Pancuronium, the first aminosteroid neuromuscular blocking agent to be introduced. Aminosteroids are a group of steroids with a similar structure based on an amino - substituted steroid nucleus. [ 1 ] [ 2 ] They are neuromuscular blocking agents , acting as competitive antagonists of the nicotinic acetylcholine receptor (nAChR), and block the ...
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