Decamethonium: Difference between revisions

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'''Decamethonium''' is a [[synthetic]] [[alkane bisammonium]] compound used as a [[neuromuscular-blocking drug]] or [[muscle relaxant]] in [[anesthesia]]. It is a [[depolarizing]] [[neuromuscular-blocking drug]], causing persistent depolarization of the motor end plate. It is no longer in clinical use in developed countries due to the risk of [[histamine]] release and [[cardiovascular]] side effects.
== Decamethonium ==


==Etymology==
[[File:Decamethonium.svg|thumb|right|Chemical structure of Decamethonium]]
The name "Decamethonium" is derived from its structure, as it is a decane with two ammonium groups.


==Pharmacology==
'''Decamethonium''' is a [[neuromuscular-blocking drug]] that was historically used in [[anesthesia]] to induce [[muscle relaxation]] during [[surgery]]. It is a [[depolarizing neuromuscular blocker]], which means it works by mimicking the action of [[acetylcholine]] at the [[neuromuscular junction]], leading to sustained [[depolarization]] of the [[muscle]] [[membrane]].
Decamethonium primarily acts by blocking the action of [[acetylcholine]], a neurotransmitter, at the neuromuscular junction. This results in muscle paralysis, which is useful in surgical procedures where muscle relaxation is required. However, its use has been largely discontinued due to the risk of severe side effects.


==Side Effects==
== Mechanism of Action ==
The side effects of Decamethonium include [[hypotension]], [[bradycardia]], and [[arrhythmias]]. These are primarily due to the release of histamine from mast cells. It can also cause an increase in intraocular pressure, which can be problematic in patients with [[glaucoma]].


==History==
Decamethonium acts as an [[agonist]] at the [[nicotinic acetylcholine receptor]]s located on the [[motor end plate]] of the [[skeletal muscle]] fibers. By binding to these receptors, it causes an initial [[depolarization]] of the muscle membrane, which is followed by a prolonged [[refractory period]] during which the muscle cannot respond to further stimulation. This results in [[muscle paralysis]]. Unlike [[non-depolarizing neuromuscular blockers]], decamethonium does not have a competitive antagonistic effect but rather causes a persistent depolarization.
Decamethonium was first synthesized in the 1940s and was used in anesthesia for several decades. However, its use has been largely discontinued due to the development of safer and more effective neuromuscular-blocking drugs.
 
== Clinical Use ==
 
Decamethonium was primarily used to facilitate [[endotracheal intubation]] and to provide muscle relaxation during [[surgical procedures]]. However, its use has largely been replaced by other neuromuscular blockers with more favorable profiles, such as [[succinylcholine]] and [[rocuronium]].
 
== Pharmacokinetics ==
 
Decamethonium is administered [[intravenously]] and has a rapid onset of action. The duration of action is relatively short, which made it suitable for short surgical procedures. It is metabolized by [[plasma cholinesterase]], and its effects are terminated as the drug is broken down and cleared from the body.
 
== Side Effects ==
 
The use of decamethonium can lead to several side effects, including:
 
* [[Hyperkalemia]] due to the release of [[potassium]] from muscle cells.
* [[Bradycardia]] or [[tachycardia]] due to autonomic effects.
* [[Malignant hyperthermia]] in susceptible individuals.
* [[Prolonged apnea]] in patients with atypical [[cholinesterase]].
 
== History ==
 
Decamethonium was one of the first neuromuscular blockers to be used clinically. It was developed in the mid-20th century and was used extensively until the development of newer agents with fewer side effects and more predictable pharmacokinetics.
 
== Related Pages ==


==See Also==
* [[Neuromuscular-blocking drug]]
* [[Neuromuscular-blocking drug]]
* [[Succinylcholine]]
* [[Rocuronium]]
* [[Anesthesia]]
* [[Anesthesia]]
* [[Acetylcholine]]
* [[Acetylcholine]]


[[Category:Neuromuscular blocking agents]]
[[Category:Neuromuscular blockers]]
[[Category:Anesthesia]]
[[Category:Pharmacology]]
 
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Latest revision as of 11:49, 15 February 2025

Decamethonium[edit]

File:Decamethonium.svg
Chemical structure of Decamethonium

Decamethonium is a neuromuscular-blocking drug that was historically used in anesthesia to induce muscle relaxation during surgery. It is a depolarizing neuromuscular blocker, which means it works by mimicking the action of acetylcholine at the neuromuscular junction, leading to sustained depolarization of the muscle membrane.

Mechanism of Action[edit]

Decamethonium acts as an agonist at the nicotinic acetylcholine receptors located on the motor end plate of the skeletal muscle fibers. By binding to these receptors, it causes an initial depolarization of the muscle membrane, which is followed by a prolonged refractory period during which the muscle cannot respond to further stimulation. This results in muscle paralysis. Unlike non-depolarizing neuromuscular blockers, decamethonium does not have a competitive antagonistic effect but rather causes a persistent depolarization.

Clinical Use[edit]

Decamethonium was primarily used to facilitate endotracheal intubation and to provide muscle relaxation during surgical procedures. However, its use has largely been replaced by other neuromuscular blockers with more favorable profiles, such as succinylcholine and rocuronium.

Pharmacokinetics[edit]

Decamethonium is administered intravenously and has a rapid onset of action. The duration of action is relatively short, which made it suitable for short surgical procedures. It is metabolized by plasma cholinesterase, and its effects are terminated as the drug is broken down and cleared from the body.

Side Effects[edit]

The use of decamethonium can lead to several side effects, including:

History[edit]

Decamethonium was one of the first neuromuscular blockers to be used clinically. It was developed in the mid-20th century and was used extensively until the development of newer agents with fewer side effects and more predictable pharmacokinetics.

Related Pages[edit]