Neurology Book

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Paralytic Agent

Aka: Paralytic Agent, Neuromuscular Blockade, Non-depolarizing Neuromuscular Blocking Agent, Depolarizing Neuromuscular Blocking Agent
  1. See Also
    1. Rapid Sequence Intubation
  2. Precautions
    1. Used only in anesthesia, emergency and Intensive Care
    2. Airway and respiratory control is critical after use
    3. Paralytic Agents do not alter Level of Consciousness
      1. Must be used with sedation and analgesia
  3. Mechanism
    1. Interfere with transmission at neuromuscular end plate
    2. Two mechanisms of Neuromuscular Blockade
      1. Non-depolarizing agents (Acetylcholine antagonists)
        1. Prototype: Curare
        2. Agents used clinically
          1. Rocuronium (Rapid Sequence Intubation)
          2. Vecuronium
          3. Pancuronium
        3. Other agents: Tubocurarine, Metocurine, Gallamine
      2. Depolarizing agents (Acetylcholine agonists)
        1. May also occur with Cholinesterase Inhibitors
        2. Prototype: Succinylcholine
        3. Agents used clinically
          1. Succinylcholine (Rapid Sequence Intubation)
  4. References
    1. Miller in Katzung (1989) Pharmacology, p. 323-33
    2. Savarese in Miller (2000) Anesthesia, p. 412-90

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