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Clinical Pharmacokinetics

, Volume 43, Issue 2, pp 71–81 | Cite as

Antiepileptic-Induced Resistance to Neuromuscular Blockers

Mechanisms and Clinical Significance
  • Sulpicio G. Soriano
  • J. A. Jeevendra Martyn
Leading Article

Abstract

Abstract Prolonged administration of antiepileptic drugs is associated with several drug interactions. In the field of anaesthesia and critical care, patients exhibit both sensitivity and resistance to non-depolarising neuromuscular blockers (NDNMBs) after acute and long-term administration of antiepileptic drugs, respectively. Although antiepileptic therapy alone has only mild neuromuscular effects, acutely administered antiepileptic drugs can potentiate the neuromuscular effects of NDNMBs as a result of direct pre- and post-junctional effects. Resistance to NDNMBs during long-term antiepileptic therapy is due to multiple factors operating alone or in combination, including induction of hepatic drug metabolism, increased protein binding of the NDNMBs and/or upregulation of acetylcholine receptors.

Keywords

Carbamazepine Antiepileptic Drug Acetylcholine Receptor Vecuronium Atracurium 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgements

This work was supported in part by grants from NIH GM 31569-20, GM 61411-4, and GM55082-6 and Shriners Hospital for Children (to J.A.J.M.). The authors declare no competing financial interest.

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Copyright information

© Adis Data Information BV 2004

Authors and Affiliations

  • Sulpicio G. Soriano
    • 1
  • J. A. Jeevendra Martyn
    • 2
  1. 1.Harvard Medical SchoolChildren’s HospitalBostonUSA
  2. 2.Harvard Medical SchoolMassachusetts General Hospital and Shriners Hospital for ChildrenBostonUSA

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