Describe
the mechanism of muscle relaxant antago-nism by cyclodextrins.
Cyclodextrins are large doughnut-shaped
molecules designed to encapsulate rocuronium. As rocuronium diffuses from the
neuromuscular junction, it forms a guest–host complex with the cyclodextrin
molecule. Neuromuscular recovery occurs rapidly as rocuronium dif-fuses from
the neuromuscular junction. Cyclodextrins also have the potential to reverse
other nondepolarizing muscle relaxants, although further study is indicated.
Since cyclodextrins do not inhibit cholinesterases, they are free of autonomic
side-effects, including cardiovascular and other muscarinic effects.
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