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Sugammadex

Neues pharmakologisches Konzept zur Antagonisierung von Rocuronium und Vecuronium

Sugammadex

New pharmacological concept for antagonizing rocuronium and vecuronium

  • Klinische Pharmakologie
  • Published:
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Zusammenfassung

Bisher standen lediglich Acetylcholinesterasehemmer wie z. B. Neostigmin zur Antagonisierung neuromuskulärer Restblockaden zur Verfügung. Mit dem modifizierten γ-Zyklodextrin Sugammadex gibt es zumindest für aminosteroidale Muskelrelaxanzien zukünftig eine Alternative. Es handelt sich bei dieser Substanz um eine ringförmige Zuckerverbindung, die eine stabile Einschlussverbindung mit aminosteroidalen Muskelrelaxanzien, insbesondere Rocuronium und Vecuronium, bildet. Dieser Wirkmechanismus unterscheidet sich somit grundsätzlich von dem der Acetylcholinesterasehemmer. Die nachfolgende Übersichtsarbeit fasst die bisherigen Untersuchungen im Rahmen des Zulassungsverfahrens zusammen. Insbesondere wird auf die Wirksamkeit, Nebenwirkungen und neue anästhesiologische Konzepte, die durch Sugammadex möglich sind, eingegangen.

Abstract

Up to now only acetylcholine esterase inhibitors, such as neostigmine, were available as antagonists of residual neuromuscular blocks. Sugammadex is a modified γ-cyclodextrin that binds rocuronium and chemically similar aminosteroidal muscle relaxants, such as vecuronium. The underlying mechanism of action is new and differs completely from that of acetylcholine esterase inhibitors. This review summarizes data published so far within the framework of the licensing procedure about the efficacy, safety and side-effects of sugammadex and presents potential new anesthesiological concepts using this compound.

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Interessenkonflikt

Doz. Sparr und Prof. Booij waren als Prüfärzte bei einigen der beschriebenen Zulassungsstudien von Sugammadex involviert. Doz. Sparr und Prof. Fuchs-Buder erhielten in der Vergangenheit Vortragshonorare von der Fa. Organon. Die Autoren versichern, dass die Präsentation des Themas unabhängig und die Darstellung der Inhalte neutral ist.

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Authors and Affiliations

  1. Abteilung für Anästhesie und Intensivmedizin, Krankenhaus Dornbirn, Lustenaustr. 4, 6850, Dornbirn, Österreich

    H.J. Sparr

  2. Abteilung für Anästhesiologie, Radbound Universität Nijmegen, Nijmegen, Niederlande

    L.H. Booij

  3. Département d’Anesthésie-Réanimation, Universitätsklinik Nancy/Brabois, Nancy, France

    T. Fuchs-Buder

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  1. H.J. Sparr
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  2. L.H. Booij
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  3. T. Fuchs-Buder
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Correspondence to H.J. Sparr.

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Sparr, H., Booij, L. & Fuchs-Buder, T. Sugammadex. Anaesthesist 58, 66–80 (2009). https://doi.org/10.1007/s00101-008-1455-2

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