Aminosteroid neuromuscular blocking drugs

Understanding & Establishing Intraosseous Access
Intraosseous (IO) access is an alternative method to providing venous administration of drugs and fluids. Commonly used by the military and pre-hospital medics, intraosseous access has expanded its use to a variety of settings: in the emergency department, at cardiac arrests, in the paediatric population, and is gaining popularity in adult settings where intravenous access is challenging or time critical.
Length of Study: 50 min
Difficulty:  Easy
   

Aminosteroids are a group of steroids with a similar structure based on an amino - substituted steroid nucleus. [1] [2] They are neuromuscular blocking agents , acting as competitive antagonists of the nicotinic acetylcholine receptor (nAChR), and block the signaling of acetylcholine in the nervous system . [1] [2] [3] These drugs include candocuronium iodide (chandonium iodide), dacuronium bromide , dihydrochandonium , dipyrandium , malouetine , pancuronium bromide , pipecuronium bromide , rapacuronium bromide , rocuronium bromide , stercuronium iodide , and vecuronium bromide . [2] [4]

The γ- cyclodextrin derivative sugammadex (trade name Bridion) has been recently introduced as a novel agent to reverse the action of rocuronium. [4] Sugammadex has been in use since 2009 in many European countries; however, it was turned down for approval twice by the US FDA due to concerns over allergic reactions and bleeding, [5] but finally approved the medication for use during surgical procedures in the United States on December 15, 2015. [6] Neostigmine can also be used as a reversal agent of rocuronium but is not as effective as sugammadex. Neostigmine is often still used due to its low cost compared with sugammadex. [7]

Aminosteroid neuromuscular blocking drugs

aminosteroid neuromuscular blocking drugs

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