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A Reversal of Misfortune

Neostigmine, glycopryrolate

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A Case Approach to Perioperative Drug-Drug Interactions

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Abstract

This case discusses a pharmacodynamic interaction between glycopyrrolate and acetylcholine. Neostigmine, when given before or out of proportion to glycopyrrolate can cause bradyarrhythmia and sinus arrest.

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References

  1. Stoelting RK, Hillier SC. Anticholinesterase drugs and cholinergic agonists. In: Pharmacology and physiology in anesthetic practice. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2006. p. 251–65.

    Google Scholar 

  2. Stoelting RK, Hillier SC. Anticholinesterase drugs and cholinergic agonists. In: Pharmacology and physiology in anesthetic practice. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2006. p. 266–75.

    Google Scholar 

  3. Bevan DR, Donati F, Kopman AF. Reversal of neuromuscular blockade. Anesthesiology. 1992;77:785–805.

    Article  PubMed  CAS  Google Scholar 

  4. Mirakhur RK, Dundee JW, Jones CJ, et al. Reversal of neuromuscular blockade: dose determination studies with atropine and glycopyrolate given before or in a mixture with neostigmine. Anesth Analg. 1981;60:557–62.

    Article  PubMed  CAS  Google Scholar 

  5. Seidl DC, Martin DE. Prolonged bradycardia after neostigmine administration in a patient taking nadolol. Anesth Analg. 1984;63:365–7.

    Article  PubMed  CAS  Google Scholar 

  6. Wagner DL, Moorthy SS. Stoelting RK Administration of anticholinesterase drugs in the presence of beta-adrenergic blockade. Anesth Analg. 1982;61:153–4.

    Article  PubMed  CAS  Google Scholar 

  7. Owens WD, Waldbaum LS, Stephen CR. Cardiac dysrhythmia following reversal of neuromuscular blocking agents in geriatric patients. Anesth Analg. 1978;57:186–90.

    PubMed  CAS  Google Scholar 

  8. Triantafillou AN, Tsueda K, Berg J, et al. Refractory bradycardia after reversal of muscle relaxant in a diabetic with vagal neuropathy. Anesth Analg. 1986;65:1237–41.

    Article  PubMed  CAS  Google Scholar 

  9. Beebe DS, Shumway SJ, Maddock R. Sinus arrest after intravenous neostigmine in two heart transplant recipients. Anesth Analg. 1994;78:779–82.

    Article  PubMed  CAS  Google Scholar 

  10. Miller RD, Van Nyhuis LS, Eger EI, et al. Comparative times to peak effect and durations of action of neostigmine and pyridostigmine. Anesthesiology. 1974;41:27–33.

    Article  PubMed  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Anesthesiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Thomas N. Talamo MD & Richard J. Kuwik MD

Authors
  1. Thomas N. Talamo MD
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  2. Richard J. Kuwik MD
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Corresponding author

Correspondence to Thomas N. Talamo MD .

Editor information

Editors and Affiliations

  1. Anesthesia Services Department, Philadelphia Veterans Affairs Med Center, Philadelphia, PA, USA

    Catherine Marcucci MD

  2. Department of Anesthesiology, Oregon Health and Science University, Portland, OR, USA

    Michael P. Hutchens MD

  3. Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA

    Erica D. Wittwer MD, PhD , Toby N. Weingarten MD , Juraj Sprung MD, PhD  & Wayne T. Nicholson MD, PharmD, MSc , ,  & 

  4. Department of Anesthesiology and Perioperative Medicine, Oregon Health and Science University, Portland, OR, USA

    Kirk Lalwani MD

  5. Department of Anesthesiology, University of Pittsburgh School of Med Liliane S. Kaufmann Building, Pittsburgh, PA, USA

    David G. Metro MD

  6. Department of Anesthesiology, University of Illinois at Chicago, Chicago, IL, USA

    Randal O. Dull MD, PhD

  7. Department of Anesthesiology, Perioperative Medicine, Oregon Health and Science University, Portland, OR, USA

    Christopher E. Swide MD

  8. Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI, USA

    F. Jacob Seagull PhD

  9. Department of Anesthesiology and Perioperative Medicine, Portland, OR, USA

    Jeffrey R. Kirsch MD (Professor and Chair) (Professor and Chair)

  10. Department of Psychiatry, University of Maryland Medical System VA Maryland Health Care System, Baltimore, MD, USA

    Neil B. Sandson MD

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© 2015 Springer Science+Business Media New York

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Talamo, T.N., Kuwik, R.J. (2015). A Reversal of Misfortune. In: Marcucci, C., et al. A Case Approach to Perioperative Drug-Drug Interactions. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7495-1_92

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  • DOI: https://doi.org/10.1007/978-1-4614-7495-1_92

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-7494-4

  • Online ISBN: 978-1-4614-7495-1

  • eBook Packages: MedicineMedicine (R0)

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