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Related Concept Videos

Directly Acting Muscle Relaxants: Dantrolene and Botulinum Toxin01:26

Directly Acting Muscle Relaxants: Dantrolene and Botulinum Toxin

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Directly acting muscle relaxants like dantrolene and botulinum toxin (BoNT) have distinct mechanisms and applications. Dantrolene, a hydantoin derivative, acts on the ryanodine receptor (RYR1) in skeletal muscle cells. RYR1 are calcium channels present at the sarcoplasmic reticulum membrane. In response to excitation, they release calcium ions from the sarcoplasmic reticulum to the cytosol. Calcium promotes actin-myosin-mediated contraction of muscles.
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Myasthenia Gravis: Overview and Treatment01:20

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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...
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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...
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Nondepolarizing (Competitive) Neuromuscular Blockers: Mechanism of Action01:17

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Nondepolarizing neuromuscular blockers induce paralysis by competitively blocking nicotinic acetylcholine receptors at the muscle end plate. Examples include pancuronium, mivacurium, vecuronium, and rocuronium. These quaternary ammonium derivatives are administered intravenously, are poorly absorbed, and are excreted via the kidneys.
Competitive antagonists prevent acetylcholine from binding to its receptor, inhibiting membrane depolarization. Without conformational changes or intrinsic...
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Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacokinetics01:11

Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacokinetics

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All neuromuscular blocking agents are injected intravenously because they are poorly absorbed from the GI tract. Rapid onset is achieved with intravenous administration, although absorption is also adequate from an intramuscular injection. Since these agents are highly ionized, they do not readily penetrate cell membranes or cross the blood-brain barrier.
Instead, they are transported by the blood to different tissues. Muscles with a greater blood supply (arteries) and blood flow receive more...
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Skeletal Muscle Relaxants: Therapeutic Uses01:31

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Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...
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    The Formulary Monograph Service provides monthly drug monographs for Pharmacy & Therapeutics Committees, including new drug reviews and drug utilization evaluations. Subscribers gain online access to customized content and monthly summaries for pharmacy and nursing in-services.

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    Area of Science:

    • Pharmacology
    • Drug Development
    • Health Services Research

    Background:

    • Pharmacy & Therapeutics (P&T) Committees require timely, evidence-based drug information.
    • New drug approvals and late-stage trial data necessitate continuous updates for clinical decision-making.
    • Drug utilization evaluations (DUEs) and medication use evaluations (MUEs) are crucial for optimizing therapeutic outcomes and managing costs.

    Purpose of the Study:

    • To provide a detailed overview of The Formulary Monograph Service.
    • To highlight the service's utility for P&T Committees and healthcare professionals.
    • To inform about the scope of monthly content, including new drug monographs and DUE/MUEs.

    Main Methods:

    • The service delivers 5-6 detailed monographs on newly released or late-phase III trial drugs monthly.
    • One-page summary monographs are provided for pharmacy and nursing in-services.
    • Comprehensive drug utilization evaluation/medication use evaluation (DUE/MUE) is included monthly.

    Main Results:

    • Subscribers receive well-documented monographs accessible online.
    • Content is customizable to meet specific facility needs.
    • March 2017 topics included crisaborole, insulin degludec/liraglutide, insulin glargine/lixisenatide, nusinersen, and rucaparib, with an MUE on insulin GLP-1 combinations.

    Conclusions:

    • The Formulary Monograph Service offers a valuable resource for evidence-based drug information.
    • The service supports informed formulary decisions and medication use optimization.
    • Accessible online content and customizable features enhance its practical application in healthcare settings.