JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS
AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
A&A International Anesthesia Research Society
QUICK SEARCH:   [advanced]


     

Anesth Analg 1983; 62:160-163
© 1983 International Anesthesia Research Society
This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a colleague
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Jeevendra Martyn, J. A.
Right arrow Articles by Matteo, R. S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Jeevendra Martyn, J. A.
Right arrow Articles by Matteo, R. S.

Competitive Nonspecific Binding Does Not Explain the Potentiating Effects of Muscle Relaxant Combinations

J. A. Jeevendra Martyn, MD, FFARCS, Wayne S. Leibel, PhD, and Richard S. Matteo, MD

Anesthesia Services of Massachusetts General Hospital and Shriners Burns Institute, and the Department of Anesthesiology, Harvard Medical School, Boston, Massachusetts; and from the Anesthesia Services of Presbyterian Hospital and the Department of Anesthesiology of Columbia Univeristy, New York, New York.

Abstract

Combination of pancuronium (Pm) with d-tubocurarine (dTC) or metocurine (mTC) produces potentiation of neuromuscular effects. We tested the hypothesis that this effect is due to decreased plasma protein and/or nonspecific (noncholinergic) tissue binding by one or the other drug such that a greater than expected proportion of unbound drug reaches its neuromuscular site of activity. By varying the concentration of Pm, dTC, and mTC, competitive binding by Pm and dTC or Pm and mTC to plasma constituents was tested in vitro by equilibrium dialysis. Drug interaction and displacement from nonspecific binding sites in tissues was tested in vivo with Pm-mTC combinations. During recovery of mTC-induced neuromuscular paralysis, monitored by evoked twitch tension, 1 mg of Pm was administered intravenously. The twitch height and plasma mTC concentrations before and after Pm administration were noted. The in vitro plasma dTC or mTC binding was not significantly altered by the addition of Pm. Similarly, plasma mTC concentrations in vivo did not increase following the administration of Pm. Thus, there was no displacement of mTC from nonspecific tissue binding sites by Pm. Our in vitro and in vivo experiments both demonstrate that there is no interaction between Pm-dTC and Pm-mTC relative to plasma or tissue binding and thus cannot explain the potentiating effect of the drug combination.

Key Words: INTERACTIONS (DRUG): neuromuscular relaxants • NEUROMUSCULAR RELAXANTS: pancuronium, metocurine, d-tubocurarine • PROTEIN: binding, plasma




This article has been cited by other articles:


Home page
 Anesth. Analg.Home page
D. S. Breslin, K. Jiao, A. S. Habib, J. Schultz, and T. J. Gan
Pharmacodynamic Interactions Between Cisatracurium and Rocuronium
Anesth. Analg., January 1, 2004; 98(1): 107 - 110.
[Abstract] [Full Text] [PDF]


Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 1983 by the International Anesthesia Research Society.