Reversal agents

Andrew Sim; Angela Vick

doi:10.1007/978-1-4614-8948-1_13

Reversal agents

Andrew Sim, Angela Vick

Anesthesiology

Research output: Chapter in Book/Report/Conference proceeding › Chapter

Abstract

One of the clinical indications for administering cholinesterase inhibitors, or anticholinesterases, is to reverse the effect of muscle relaxation by non-depolarizing neuromuscular blocking agents at the conclusion of surgery. The purpose of administering antimuscarinic drugs concomitantly with anticholinesterases is to minimize the muscarinic side effects associated with increased acetylcholine transmission at muscarinic receptors. In this chapter, we review anticholinesterase and anticholinergic pharmacology, including mechanism of action, dosing, and adverse effects. We discuss their clinical significance in both the surgical context and their indications outside the operating room. In addition, we briefly discuss the relaxant binding agent sugammadex and its future role in anesthesia.

Original language	English (US)
Title of host publication	Essentials of Pharmacology for Anesthesia, Pain Medicine, and Critical Care
Publisher	Springer New York
Pages	205-218
Number of pages	14
ISBN (Electronic)	9781461489481
ISBN (Print)	9781461489474
DOIs	https://doi.org/10.1007/978-1-4614-8948-1_13
State	Published - Jan 1 2015

ASJC Scopus subject areas

Medicine(all)

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10.1007/978-1-4614-8948-1_13

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AB - One of the clinical indications for administering cholinesterase inhibitors, or anticholinesterases, is to reverse the effect of muscle relaxation by non-depolarizing neuromuscular blocking agents at the conclusion of surgery. The purpose of administering antimuscarinic drugs concomitantly with anticholinesterases is to minimize the muscarinic side effects associated with increased acetylcholine transmission at muscarinic receptors. In this chapter, we review anticholinesterase and anticholinergic pharmacology, including mechanism of action, dosing, and adverse effects. We discuss their clinical significance in both the surgical context and their indications outside the operating room. In addition, we briefly discuss the relaxant binding agent sugammadex and its future role in anesthesia.

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Reversal agents

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