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Chapter-08 Anticholinesterases

BOOK TITLE: Drugs in Anaesthesiology

Author
1. Dhama Vipin Kumar
ISBN
9789352701254
DOI
10.5005/jp/books/14209_9
Edition
2/e
Publishing Year
2018
Pages
10
Author Affiliations
1. Lala Lajpat Rai Memorial Medical College, Meerut, Uttar Pradesh, India
Chapter keywords
Anticholinesterase, anticholinesterase drug, physostigmine, neostigmine, edrophonium, pyridostigmine, cholinesterase, acetylcholine, cholinesterase enzyme

Abstract

Cholinesterase refers to a family of enzymes found in the central nervous system, particularly in nervous tissue, muscle and red cells, which catalyze the hydrolysis of the neurotransmitter acetylcholine into choline and acetic acid. There are two types of cholinesterase enzymes, which are related in structure but different in distribution and function—acetylcholinesterase and butyrylcholinesterase. Anticholinesterases are drugs that inhibit both acetylcholinesterase and butyrylcholinesterase. Substrates of these enzymes (acetylcholine) is increased due to inhibition. There are several uses of these drugs—primarily for reversal of non-depolarising muscle blockade, for the treatment of clinical situations like myasthenia gravis, Alzheimer’s disease, paralytic ileus, and glaucoma; and for the reversal of intoxication caused by central anticholinergic drugs. there are few basic considerations to keep in mind before giving reversal: when to give the reversal, which drug to give, how much to give, how to minimise the side effects, and factors affecting reversal. Anticholinesterase Drugs are also listed in the chapter, namely neostigmine, edrophonium and pyridostigmine. The chapter also reviews pharmacodynamics of these drugs and physostigmine.

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