At the Fifth International Neuromuscular Meeting held in Tokyo in 1994, leading experts in the field came together to discuss the physiology and pharmacology of neuromuscular receptor sites and neuromuscular blocking agents (NBAs). The proceedings of the meeting present a review of the history of muscle relaxants and a comprehensive examination of recent research, with a primary focus on clinical considerations. Among the topics covered by specific chapters are aspects of the neuromuscular junction (NMJ), pharmacokinetics, metabolism and metabolites of neuromuscular blocking agents, and drug…mehr
At the Fifth International Neuromuscular Meeting held in Tokyo in 1994, leading experts in the field came together to discuss the physiology and pharmacology of neuromuscular receptor sites and neuromuscular blocking agents (NBAs). The proceedings of the meeting present a review of the history of muscle relaxants and a comprehensive examination of recent research, with a primary focus on clinical considerations. Among the topics covered by specific chapters are aspects of the neuromuscular junction (NMJ), pharmacokinetics, metabolism and metabolites of neuromuscular blocking agents, and drug interaction. Presenting the most up-to-date knowledge of the physiology and pharmacology of the NMJ and NBAs, this volume will be highly valuable to clinicians and researchers in anesthesiology, physiology, and pharmacology.
'1. History of Muscle Relaxants.- Some Early Approaches to Relaxation in the United Kingdom.- The Final Steps Leading to the Anesthetic Use of Muscle Relaxants 8/TOC.- History of Muscle Relaxants in Japan.- 2. The Neuromuscular Junctions - Update.- Mechanisms of Action of Reversal Agents.- Nicotinic Recentors.- The Neuromuscular Junction - Basic Receptor Pharmacology.- Muscle Contraction and Calcium Ion.- 3. Current Basic Experimental Works Related to Neuromuscular Blockade in Present and Future.- Preiunctional Actions of Neuromuscular Blocking Drugs.- Approaches to Short-Acting Neuromuscular Blocking Agents.- Effects Other than Relaxation of Non-Depolarizing Muscle Relaxants.- Regulation of Innervation-Related Properties of Cultured Skeletal Muscle Cells by Transmitter and Co-Transmitters.- 4. Current Clinical Experimental Works Related to Neuromuscular Blockade in Present and Future.- Where Should Experimental Works Be Conducted?.- Muscle Relaxants in the Intensive Care Unit.- New Relaxants in the Operating Room.- Kinetic-Dynamic Modelling of Neuromuscular Blockade.- 5. Basic Aspects of Neuromuscular Junction.- Physiology of the Neuromuscular Junction.- Properties of ?7-Containing Acetylcholine Receptors and Their Expression in Both Neurons and Muscle.- Molecular Biology of Neuromuscular Transmission.- Presynaptic Neuromuscular Blockade.- The Function of the ACh Receptor Channel.- 6. Onset of Action.- Differences of Onset of Different Muscles in Man and Their Consequences on Monitoring of Neuromuscular Transmission.- Structure-Onset Relationship of Steroidal Neuromuscular Blocking Agents.- A Blueprint for a Fast Acting Non-Depolarizing Drug.- 7. Relaxants in ICU.- Benzylisoquinolinium Compounds in the Critically Ill Patient.- The Long-Term Use of Pipecuronium in Cardiac and Esophageal Surgery Patients.- Mechanisms - Changes Induced by Long-Term High-Dose Muscle Relaxant Administration.- 8. Pharmacokinetics, Metabolism, and Metabolites.- Metabolism and Metabolites of Benzylisoquinolinium Diester Compounds.- Conceptual Building Blocks in Developing a Pharmacodynamic Model for a Muscle Relaxant.- Structure-Pharmacokinetic and Pharmacodynamic Relationships of Steroidal Neuromuscular Blocking Agents.- Pharmacokinetics and Pharmacodynamics of Aminosteroidal Neuromuscular Blocking Agents and Their Metabolites.- 9. Uses in Special Groups.- Pharmacokinetics of Muscle Relaxants in Children.- Muscle Relaxants in Elderly Patients.- Muscle Relaxants in patients with Renal or Hepatic Failure.- The Influence of Temperature on the Adductor Pollicis Twitch Tension in the Presence and Absence of Vecuronium.- 10. Monitoring.- The Iceberg Theory - Fact or Fiction? Implication for Monitoring.- New Aspects of Double Burst Stimulation.- 11. Drug Interactions.- Interactions of Volatile Anesthetics with Non-Depolarizing Neuromuscular Blocking Agents.- Interaction Between Calcium Antagonists and Muscle Relaxants.- Dexamethasone Induces nAChRs Upregulation in C2C12 Mouse Myotubes.- Interaction Between Muscle Relaxants.- 12. Methods of Administration.- The Pharmacokinetics of the Three Isomers of Mivacurium Chloride in Healthy, Renal and Hepatic Patients Given Short or Prolonged Infusions of the Drug.- Methods of Administration of Neuromuscular Blocking Drugs.- Pharmacodynamics and Pharmacokinetics of Different Modes of Rocuronium Administration.- Making the Administration Simple and Safe.- 13. Reversal of Blockade.- Problems with Reversal in Adults.- Ventilation and Neuromuscular Blocking Drugs.- Reversal of Mivacurium: Neostigmine, Edrophonium, or Spontaneous Recovery - Which Makes More Sense?.- Anticholinesterase Agents: An Odyssey.- 14. Future of Muscle Relaxants.- Future Goals of the Benzylisoquinolinium Ester Program.- Is a Non-Depolarising Suxamethonium an Achievable Target?.- The Future of Muscle Relaxants Outside the Operating Room.- 15. Scientif
'1. History of Muscle Relaxants.- Some Early Approaches to Relaxation in the United Kingdom.- The Final Steps Leading to the Anesthetic Use of Muscle Relaxants 8/TOC.- History of Muscle Relaxants in Japan.- 2. The Neuromuscular Junctions - Update.- Mechanisms of Action of Reversal Agents.- Nicotinic Recentors.- The Neuromuscular Junction - Basic Receptor Pharmacology.- Muscle Contraction and Calcium Ion.- 3. Current Basic Experimental Works Related to Neuromuscular Blockade in Present and Future.- Preiunctional Actions of Neuromuscular Blocking Drugs.- Approaches to Short-Acting Neuromuscular Blocking Agents.- Effects Other than Relaxation of Non-Depolarizing Muscle Relaxants.- Regulation of Innervation-Related Properties of Cultured Skeletal Muscle Cells by Transmitter and Co-Transmitters.- 4. Current Clinical Experimental Works Related to Neuromuscular Blockade in Present and Future.- Where Should Experimental Works Be Conducted?.- Muscle Relaxants in the Intensive Care Unit.- New Relaxants in the Operating Room.- Kinetic-Dynamic Modelling of Neuromuscular Blockade.- 5. Basic Aspects of Neuromuscular Junction.- Physiology of the Neuromuscular Junction.- Properties of ?7-Containing Acetylcholine Receptors and Their Expression in Both Neurons and Muscle.- Molecular Biology of Neuromuscular Transmission.- Presynaptic Neuromuscular Blockade.- The Function of the ACh Receptor Channel.- 6. Onset of Action.- Differences of Onset of Different Muscles in Man and Their Consequences on Monitoring of Neuromuscular Transmission.- Structure-Onset Relationship of Steroidal Neuromuscular Blocking Agents.- A Blueprint for a Fast Acting Non-Depolarizing Drug.- 7. Relaxants in ICU.- Benzylisoquinolinium Compounds in the Critically Ill Patient.- The Long-Term Use of Pipecuronium in Cardiac and Esophageal Surgery Patients.- Mechanisms - Changes Induced by Long-Term High-Dose Muscle Relaxant Administration.- 8. Pharmacokinetics, Metabolism, and Metabolites.- Metabolism and Metabolites of Benzylisoquinolinium Diester Compounds.- Conceptual Building Blocks in Developing a Pharmacodynamic Model for a Muscle Relaxant.- Structure-Pharmacokinetic and Pharmacodynamic Relationships of Steroidal Neuromuscular Blocking Agents.- Pharmacokinetics and Pharmacodynamics of Aminosteroidal Neuromuscular Blocking Agents and Their Metabolites.- 9. Uses in Special Groups.- Pharmacokinetics of Muscle Relaxants in Children.- Muscle Relaxants in Elderly Patients.- Muscle Relaxants in patients with Renal or Hepatic Failure.- The Influence of Temperature on the Adductor Pollicis Twitch Tension in the Presence and Absence of Vecuronium.- 10. Monitoring.- The Iceberg Theory - Fact or Fiction? Implication for Monitoring.- New Aspects of Double Burst Stimulation.- 11. Drug Interactions.- Interactions of Volatile Anesthetics with Non-Depolarizing Neuromuscular Blocking Agents.- Interaction Between Calcium Antagonists and Muscle Relaxants.- Dexamethasone Induces nAChRs Upregulation in C2C12 Mouse Myotubes.- Interaction Between Muscle Relaxants.- 12. Methods of Administration.- The Pharmacokinetics of the Three Isomers of Mivacurium Chloride in Healthy, Renal and Hepatic Patients Given Short or Prolonged Infusions of the Drug.- Methods of Administration of Neuromuscular Blocking Drugs.- Pharmacodynamics and Pharmacokinetics of Different Modes of Rocuronium Administration.- Making the Administration Simple and Safe.- 13. Reversal of Blockade.- Problems with Reversal in Adults.- Ventilation and Neuromuscular Blocking Drugs.- Reversal of Mivacurium: Neostigmine, Edrophonium, or Spontaneous Recovery - Which Makes More Sense?.- Anticholinesterase Agents: An Odyssey.- 14. Future of Muscle Relaxants.- Future Goals of the Benzylisoquinolinium Ester Program.- Is a Non-Depolarising Suxamethonium an Achievable Target?.- The Future of Muscle Relaxants Outside the Operating Room.- 15. Scientif
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