Reversal agents

Andrew Sim, Angela Vick

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 languageEnglish (US)
Title of host publicationEssentials of Pharmacology for Anesthesia, Pain Medicine, and Critical Care
PublisherSpringer New York
Pages205-218
Number of pages14
ISBN (Print)9781461489481, 9781461489474
DOIs
Publication statusPublished - Jan 1 2015

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ASJC Scopus subject areas

  • Medicine(all)

Cite this

Sim, A., & Vick, A. (2015). Reversal agents. In Essentials of Pharmacology for Anesthesia, Pain Medicine, and Critical Care (pp. 205-218). Springer New York. https://doi.org/10.1007/978-1-4614-8948-1_13