Atropine Enhances Neuromuscular Transmission in Humans

Wali, F. A.; Bradshaw, Elizabeth G.; Süer, A. H.; Dark, C.H.

doi:10.1111/j.1472-8206.1987.tb00545.x

Cited by 5 publications

(2 citation statements)

References 13 publications

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“…Infusions of atropine (0.02-0.08 ml.kg À1 .h À1 ) [128] have produced significant reductions in mortality in some centres when compared with conventional intermittent therapy. Atropine has been shown to enhance neuromuscular transmission and transmitter release, possibly by acting on muscarinic presynaptic inhibitory receptors, which are involved in the feedback mechanism of transmitter release [129,130]. This observation is of relevance in OP poisoning, as the pathological basis is the accumulation of acetylcholine at the neuromuscular junction.…”

Section: Atropine or Glycopyrrolatementioning

confidence: 99%

Organophosphorus poisoning and anaesthesia

1999

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SummaryOrganophosphorus compounds, used as insecticides and agents of chemical warfare, are a major global cause of health problems. These irreversible inhibitors of cholinesterase produce three wellrecognised clinical entities: the initial cholinergic phase, which is a medical emergency often requiring management in an intensive care unit; the intermediate syndrome, during which prolonged ventilatory care is necessary; and delayed polyneuropathy. In addition, disturbances of body temperature and endocrine function, electrolyte imbalances, immunological dysfunction and disorders of reproduction have been reported in animals and man. Vocal cord paralysis, pancreatitis, cardiac arrhythmias and a wide range of neuropsychiatric disorders are known to follow acute and chronic exposure to organophosphorus compounds. As a result of the inhibition of plasma cholinesterase, there can be increased sensitivity to drugs hydrolysed by this enzyme, e.g. suxamethonium and mivacurium. The inhibition of acetylcholinesterase causes dysfunction at the neuromuscular junction which can produce altered responses to nondepolarising neuromuscular blockers. Anaesthetists may encounter patients exposed to organophosphorus compounds either following acute poisoning, trauma (warfare) or as patients with a wide range of nonspecific disorders presenting for surgery. The traditional use of oximes and atropine in treatment has failed to reduce the morbidity and mortality associated with poisoning. The roles of agents that have reduced the toxicity of organophosphorus compounds in animal experiments are discussed as potential therapeutic agents. There is an urgent need for accurate information on the problems associated with exposure to organophosphorus compounds. This would best be achieved by collaborative research between technologically advanced countries and developing countries, where organophosphorus compounds are a leading cause of ill health.

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Section: Atropine or Glycopyrrolatementioning

confidence: 99%

Organophosphorus poisoning and anaesthesia

1999

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“…Atropine was shown to enhance neuromuscular transmission and/or transmitter release, possibly by acting on muscarinic presynaptic inhibitory receptors, which are involved in the feedback mechanism of transmitter release. 55 This observation is of relevance in OP poisoning as the pathologic basis is the accumulation of ACh at the NMJ. It has been shown that a lower than traditional dose of atropine used over a shorter duration at a hospital in China was associated with a lower complication and fatality rate.…”

Section: Atropinementioning

confidence: 93%