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Chapter: Clinical Cases in Anesthesia : Antagonism of Nondepolarizing Neuromuscular Blockade

Describe the mechanism of muscle relaxant antagonism by cyclodextrins

Cyclodextrins are large doughnut-shaped molecules designed to encapsulate rocuronium.

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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Clinical Cases in Anesthesia : Antagonism of Nondepolarizing Neuromuscular Blockade : Describe the mechanism of muscle relaxant antagonism by cyclodextrins |


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