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Related Experiment Videos

Cocaine and succinylcholine sensitivity: a new caution.

P Jatlow, P G Barash, C Van Dyke

    Anesthesia and Analgesia
    |May 1, 1979
    PubMed
    Summary
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    Patients with atypical serum cholinesterase (low dibucaine numbers) metabolize cocaine slower, increasing toxicity risk. Caution is advised when using cocaine for anesthesia in these individuals.

    Area of Science:

    • Biochemistry
    • Pharmacology
    • Anesthesiology

    Background:

    • Serum cholinesterase (or pseudocholinesterase) is crucial for metabolizing various substances, including certain anesthetic drugs.
    • Genetic variations in serum cholinesterase, such as those associated with succinylcholine sensitivity and low dibucaine numbers (atypical variants), affect drug metabolism.
    • Cocaine, a widely used local anesthetic, undergoes hydrolysis, but its metabolic pathway and the influence of atypical serum cholinesterase are not fully elucidated.

    Purpose of the Study:

    • To investigate the in vitro hydrolysis rate of cocaine in plasma from individuals with normal and atypical serum cholinesterase phenotypes.
    • To determine if genetic variations in serum cholinesterase impact cocaine stability and metabolism.
    • To assess the potential risk of cocaine toxicity in patients with atypical serum cholinesterase.

    Related Experiment Videos

    Main Methods:

    • Incubation of cocaine in plasma samples obtained from three groups: normal subjects (phenotype U), patients with succinylcholine sensitivity (phenotype A), and heterozygous offspring.
    • Quantification of remaining cocaine concentration after 120 minutes of incubation using analytical methods.
    • Correlation of cocaine hydrolysis rates with dibucaine numbers, a measure of serum cholinesterase activity.

    Main Results:

    • Cocaine exhibited significant stability in plasma from patients with low dibucaine numbers (93.6% remaining).
    • Cocaine was rapidly hydrolyzed in plasma from normal subjects (40.6% remaining).
    • Plasma from heterozygous individuals showed intermediate cocaine hydrolysis (69.4% remaining).

    Conclusions:

    • Atypical serum cholinesterase significantly reduces the hydrolysis rate of cocaine.
    • Individuals with homozygous atypical serum cholinesterase (low dibucaine numbers) may face an elevated risk of cocaine toxicity.
    • Caution is recommended when administering cocaine for topical anesthesia to patients with a history of succinylcholine sensitivity or low dibucaine numbers.