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Related Concept Videos

Skeletal Muscle Relaxants: Therapeutic Uses01:31

Skeletal Muscle Relaxants: Therapeutic Uses

761
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...
761
Skeletal Muscle Relaxants: Adverse Effects01:21

Skeletal Muscle Relaxants: Adverse Effects

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Skeletal muscle relaxants are widely used for muscle paralysis and relieving pain following any muscle injury or stiffness. However, depending on the drug type, they can have adverse effects that range from mild to severe. Usually, nondepolarizing neuromuscular blockers have minimal side effects. For example, drugs like d-tubocurarine, cisatracurium, and rocuronium cause hypotension, whereas drugs like baclofen, when stopped abruptly, can lead to the recurrence of spastic conditions.
Unlike...
652
Drugs Used in Lower Respiratory Disorders: Overview01:17

Drugs Used in Lower Respiratory Disorders: Overview

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Lower respiratory tract disorders present challenges that often require skilled and nuanced approaches for effective management. Common ailments, such as asthma and chronic obstructive pulmonary disease (COPD), have prompted the development of intricate treatment strategies involving bronchodilators and anti-inflammatory drugs, each tailored to ease breathing and revitalize the lungs.
Bronchodilators, the first step of respiration enhancement, come in various forms, each with its own mechanism...
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Centrally Acting Muscle Relaxants: Therapeutic Uses01:24

Centrally Acting Muscle Relaxants: Therapeutic Uses

1.0K
Centrally acting muscle relaxants reduce muscle tone and tension by interfering with the postsynaptic reflexes in the central nervous system.
Centrally acting drugs are classified into spasmolytic and antispasmodic drugs. Spasmolytic drugs such as baclofen, diazepam, and tizanidine inhibit spinal motor neurons and decrease muscle tone. Spasmolytic drugs are administered for severe and chronic spasms due to multiple sclerosis, cerebral palsy, stroke, and spinal cord and muscle injuries. However,...
1.0K
Classification of Skeletal Muscle Relaxants01:28

Classification of Skeletal Muscle Relaxants

2.9K
Skeletal muscle relaxants are a group of drugs that can reduce muscle stiffness and induce temporary paralysis to relieve pain. These agents can act centrally to reduce muscle tone or spasms in painful conditions such as multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS), or spinal injuries; they are called antispasmodics or spasmolytics.
Peripherally acting skeletal muscle relaxants interfere with the neurotransmission at the neuromuscular end plate to induce paralysis during...
2.9K
Peripherally and Centrally Acting Muscle Relaxants: A Comparison01:09

Peripherally and Centrally Acting Muscle Relaxants: A Comparison

4.2K
Skeletal muscle relaxants can target the central nervous system [CNS] to reduce muscle tension or act directly at the neuromuscular junction to induce temporary paralysis. These two classes of muscle relaxants are called centrally acting muscle relaxants and peripherally acting muscle relaxants. They differ in their action, mechanism, administration route, and clinical uses.
Centrally acting muscle relaxants can be further divided into spasmolytic and antispasmodic drugs. Spasmolytic...
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In Vitro Method to Control Concentrations of Halogenated Gases in Cultured Alveolar Epithelial Cells
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Myorelaxants in ARDS patients.

Sami Hraiech1,2, Takeshi Yoshida3, Djillali Annane4

  • 1Assistance Publique - Hôpitaux de Marseille, Hôpital Nord, Médecine Intensive Réanimation, 13015, Marseille, France.

Intensive Care Medicine
|November 7, 2020
PubMed
Summary

Neuromuscular blocking agents (NMBAs) can improve outcomes in severe acute respiratory distress syndrome (ARDS) by facilitating lung protective ventilation. Short-term NMBA use shows no harmful muscular effects, supporting their early consideration in ARDS management.

Keywords:
CorticosteroidsECMOMuscle relaxantsPEEPProne positioningProtective ventilationSedation

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Area of Science:

  • Critical Care Medicine
  • Pulmonology
  • Pharmacology

Background:

  • Acute respiratory distress syndrome (ARDS) presents significant ventilation challenges.
  • Patient-ventilator asynchrony and lung injury (VILI) are major concerns in ARDS management.
  • Lung protective ventilation strategies aim to minimize volutrauma and barotrauma.

Purpose of the Study:

  • To evaluate the role of neuromuscular blocking agents (NMBAs) in managing severe ARDS.
  • To assess the impact of NMBAs on patient-ventilator synchrony and lung protection.
  • To review the safety and efficacy of short-term NMBA administration in ARDS.

Main Methods:

  • Review of recent randomized clinical trials on NMBA use in ARDS.
  • Analysis of NMBA effects on tidal volumes, transpulmonary pressures, and oxygenation.
  • Assessment of NMBA impact on inflammatory markers and muscular side effects.

Main Results:

  • NMBAs inhibit spontaneous breathing, reducing tidal volumes and transpulmonary pressure swings.
  • NMBA use minimizes patient-ventilator asynchrony, decreasing VILI and barotrauma.
  • Short-term NMBA administration did not demonstrate significant harmful muscular effects.

Conclusions:

  • NMBAs should be considered in the early phase of severe ARDS to facilitate lung protective ventilation and prone positioning.
  • NMBA integration requires optimization of mechanical ventilation, sedation, and PEEP.
  • A comprehensive strategy including NMBAs, reduced tidal volume, PEEP, prone positioning, and early spontaneous ventilation is recommended.