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Related Concept Videos

Allergic Reactions: Anaphylaxis01:30

Allergic Reactions: Anaphylaxis

80
Anaphylaxis is a severe, life-threatening hypersensitivity reaction mediated by Immunoglobulin E (IgE) antibodies. When IgE binds to allergens, it triggers the release of mediators– histamine, leukotrienes, and prostaglandins from mast cells and basophils. These mediators cause vasodilation, edema, and inflammation, leading to various symptoms.The primary allergens causing anaphylaxis include food items (e.g., peanuts, shellfish), drugs (e.g., penicillin, asparaginase, corticotropin,...
80
Allergic Reactions02:06

Allergic Reactions

32.7K
Overview
32.7K
Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions01:27

Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions

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Nondepolarizing neuromuscular blockers prevent the membrane depolarization of muscle cells and inhibit muscle contraction. These are usually administered with anesthetics to achieve complete muscle relaxation. Upon administration, these drugs first block the small, rapidly contracting muscles of the face and hands, followed by the larger muscles of the trunk and the intercostal muscles. The diaphragm is the last muscle to be affected.
Although all competitive neuromuscular blockers are designed...
1.1K
Anticholinesterase Agents: Poisoning and Treatment01:26

Anticholinesterase Agents: Poisoning and Treatment

1.8K
Anticholinesterases, also known as cholinesterase inhibitors, work by blocking the breakdown of acetylcholine, leading to its accumulation in the synaptic cleft. This accumulation indirectly enhances both muscarinic and nicotinic actions. These agents are classified as reversible or irreversible based on their mechanism of action.     
Irreversible agents form a strong bond with the cholinesterase enzyme, making it inactive. The breakdown of the phosphorylated enzyme is...
1.8K
Myasthenia Gravis: Overview and Treatment01:20

Myasthenia Gravis: Overview and Treatment

3.2K
Myasthenia gravis is a neuromuscular transmission disorder characterized by weakness and increased fatigability of skeletal muscles. It is an autoimmune disease affecting approximately one in 2000 people, where antibodies against the α1 subunit of nicotinic acetylcholine receptors are produced.
These antibodies interfere with the function of the nicotinic receptors in three ways: by binding to the receptor and disrupting acetylcholine binding; by causing cross-linking of receptors which...
3.2K
Myasthenia Gravis: Diagnostic Tests01:15

Myasthenia Gravis: Diagnostic Tests

2.9K
Myasthenia gravis is an autoimmune condition affecting neuromuscular transmission, causing generalized weakness in skeletal muscles. Initial diagnoses rely on patients' signs, symptoms, and medical history. The challenge lies in distinguishing myasthenia from other muscular dystrophies. An important diagnostic feature is the significant improvement of symptoms after administering anticholinesterase inhibitors.
The edrophonium test is a diagnostic tool for myasthenia gravis. It involves...
2.9K

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Related Experiment Video

Updated: Mar 2, 2026

Acetylcholine Re-Challenge After Intracoronary Nitroglycerine Administration
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Acetylcholine Re-Challenge After Intracoronary Nitroglycerine Administration

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Anaphylaxis caused by neostigmine.

M J Seed1, P W Ewan

  • 1Clinic 2A, Addenbrooke's Hospital, Cambridge CB2 2QQ, UK.

Anaesthesia
|June 24, 2000
PubMed
Summary

Neostigmine can cause rare anaphylaxis during anesthesia. This drug-induced hypersensitivity reaction was confirmed by elevated mast cell tryptase and positive skin tests for neostigmine-specific IgE.

Area of Science:

  • Anesthesiology
  • Immunology
  • Pharmacology

Background:

  • Anaphylaxis is a severe allergic reaction that can occur during anesthesia.
  • Neostigmine is a medication commonly used to reverse neuromuscular blockade after surgery.

Observation:

  • A patient experienced anaphylaxis 30 seconds after intravenous neostigmine administration at the end of surgery.
  • Symptoms of anaphylaxis included elevated mast cell tryptase levels.

Findings:

  • Skin prick tests confirmed neostigmine-induced anaphylaxis by demonstrating drug-specific IgE antibodies.
  • Normal subjects showed negative skin prick test results to neostigmine, indicating specific sensitization in the patient.

Implications:

  • This case highlights neostigmine as a rare but significant cause of intraoperative anaphylaxis.

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Measuring Local Anaphylaxis in Mice
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  • Awareness of neostigmine hypersensitivity is crucial for anesthesiologists to ensure patient safety.
  • Further investigation into the mechanisms of neostigmine allergy may improve diagnostic and management strategies.