| Popis: |
This chapter outlines an introduction to the neuromuscular junction. It covers anatomy and physiology (including presynaptic physiology and pharmacology, postsynaptic physiology and pharmacology, and margin of safety of neurotransmission), paralytics, reversal agents, the mechanisms of action of muscle relaxants (and their structure-activity relationship, intrinsic activity at the neuromuscular junction, effects on acetylcholine receptors of the CNS/ANS, the carotid body, bronchial smooth muscle, and histamine release and anaphylaxis by relaxants), and the acetylcholinesterase enzyme. The chapter furthermore discusses pre-clinical pharmacology and pharmacological variables of neuromuscular block, pharmacokinetics (models and parameters, factors influencing pharmacokinetics of relaxants, and their elimination and metabolism), clinical pharmacology of succinylcholine and nondepolarizing neuromuscular blocking drugs, factors confounding the clinical pharmacology of relaxants, reversal agents (including the cholinesterase inhibitors Neostigmine and Pyridostigmine) as well as the selective relaxant binding agent sugammadex), and special considerations in neuroanaesthesia and neurocritical care. |
