Drugs affecting the autonomic nervous system( Neuromuscular blocker )
Drugs:
- Atracurium
- Cisatracurium
- Doxocurium
- Metocurine
- Mivacurium
- Tubocurarine
- Pancuronium
- Rocuronium
- Vecuronium
Structure:
1- Atracurium: benzylisoquinolinium
2- Cisatracurium: benzylisoquinolinium
3- Doxocurium: benzylisoquinolinium
4- Metocurine: benzylisoquinolinium
5- Mivacurium: benzylisoquinolinium
6- Tubocurarine: benzylisoquinolinium
7- Pancuronium: aminosteroid
8- Rocuronium: aminosteroid
9- Vecuronium: aminosteroid
Pharmacological action:
1- At low doses: In the low dose, all of these drugs work to prevent the binding of acetylcholine to the nicotine receptor, and therefore these drugs will lead to preventing skeletal muscles from contracting.
2- At high doses: They can block the ion channels of the end plate. So, they reduce the ability of acetylcholinesterase inhibitors to reverse their action.
Uses:
These drugs are used in surgical operations as an anesthetic in low doses, not high, because high doses, if used in surgical operations, lead to respiratory paralysis and cardiac depression, and also lead to an increase in recovery time after surgery. Therefore, these drugs should be used in low doses in surgeries.
Side effect:
One of the common side effects of these medications is postoperative muscle pain. However, these medications are considered safe because they are used in low doses.