Abstract:
:The aim of this article is to provide an overview on neuromuscular blocking agents and a rational selection of the most appropriate agents, along with pharmacological and pharmacoeconomic considerations on neuromuscular blockers and their antagonists. Neuromuscular blocking agents are used during anesthesia to facilitate endotracheal intubation and provide surgically required paralysis. There is continuing development in the field of neuromuscular blocking agents, with new products appearing at regular intervals. All new agents come at increased costs. The proportion of anesthesia-related drug costs on a per-patient basis are small and vary from country to country, but account for no more than 12% of hospital drug budgets. However, given the large number of anesthetics performed over time, the total cost is significant. Moreover, such costs should be put into the perspective of the operating theater and patient admission costs. Appropriate selection of neuromuscular blocking agents can help not only to reduce biological costs secondary to complications, but also to make operating lists proceed smoothly and without incident. The paucity of outcome studies in relation to anesthetic drugs is not surprising given that anesthesia is used to facilitate the provision of therapy rather than being therapeutic in its own right. Accordingly, the assessment of anesthetic drugs has a different priority to therapeutic drugs. As anesthetic drugs are nontherapeutic, it is also difficult to determine the best choice of agent. However, new neuromuscular blocking agents are marketed on the basis of improvements in the frequency of side effects, safety, reliability, duration, reversibility and undesirable hemodynamic effects.
journal_name
Expert Rev Neurotherjournal_title
Expert review of neurotherapeuticsauthors
Leykin Y,Pellis T,Vincenti Edoi
10.1586/14737175.6.12.1833subject
Has Abstractpub_date
2006-12-01 00:00:00pages
1833-43issue
12eissn
1473-7175issn
1744-8360journal_volume
6pub_type
杂志文章,评审abstract::Hypertension is an important risk factor for stroke. The latter results in disability and premature death and represents a major public health problem. Various studies have established a strong relationship between increasing blood pressure and stroke risk, as well as clear evidence of a reduction in the incidence of ...
journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章
doi:10.1586/14737175.6.2.203
更新日期:2006-02-01 00:00:00
abstract:INTRODUCTION:The underlying etiology of tension type headache (TTH) is not understood. The current paper highlights the etiologic role of muscle trigger points (TrPs) to the development and maintenance of central sensitization in TTH and its clinical repercussion for proper management of these patients. Areas covered: ...
journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章,评审
doi:10.1080/14737175.2017.1359088
更新日期:2017-09-01 00:00:00
abstract::Introduction: Paroxysmal dyskinesias and episodic ataxias are often caused by mutations in genes related to cell membrane and synaptic function. Despite the exponential increase in publications of genetically confirmed cases, management remains largely clinical based on non-systematic evidence. Areas covered: The auth...
journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章,评审
doi:10.1080/14737175.2019.1648211
更新日期:2019-09-01 00:00:00
abstract::Nausea and vomiting continue to present significant problems for cancer patients undergoing chemotherapy. Initial work suggested an important role for central dopamine transmission in the underlying pathophysiology. However, recent evidence has implicated central and peripheral serotonin release. Although the implemen...
journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章
doi:10.1586/14737175.3.1.77
更新日期:2003-01-01 00:00:00
abstract::The most successful approach for treating people with Alzheimer's disease to date has been by improving cholinergic transmission using cholinesterase inhibitors. Many of these drugs selectively inhibit acetylcholinesterase but some agents inhibit both acetylcholinesterase and butyrylcholinesterase. Recent evidence fro...
journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章
doi:10.1586/14737175.5.1.101
更新日期:2005-01-01 00:00:00
abstract::Persistent gait deficits after stroke can cause falls, elevated energy cost and poor endurance. Coordination impairment is an underlying cause of gait deficits. Few efficacious interventions have been described that have targeted and measured restoration of coordinated gait components. Neuromuscular electrical stimula...
journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章,评审
doi:10.1586/14737175.6.10.1511
更新日期:2006-10-01 00:00:00
abstract::Narcolepsy is a life-long neurodegenerative disorder that causes considerable impairment to quality of life. Until the 1970s, the treatment for one of the main symptoms, excessive daytime sleepiness, was restricted to stimulants, whereas the second core symptom, cataplexy, was treated with antidepressants, and the res...
journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章,评审
doi:10.1586/ern.12.42
更新日期:2012-05-01 00:00:00
abstract::Background: Relatively little is known about the use of disease-modifying drugs (DMDs) for multiple sclerosis (MS) in the population-based universal healthcare setting. This study aimed to describe the characteristics of a population-based cohort with MS and their DMD exposure in four Canadian provinces. Methods: We i...
journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章
doi:10.1080/14737175.2021.1847085
更新日期:2021-01-01 00:00:00
abstract::Estrogens fluctuations, particularly their premenstrual fall, are currently regarded as the main triggers of menstrual migraine (MM). MM presents in two clinical forms: pure MM, where attacks are confined to the perimenstrual period (PMP), and menstrually related migraine, where attacks always occur during, but are no...
journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章,评审
doi:10.1586/14737175.7.9.1105
更新日期:2007-09-01 00:00:00
abstract::Guanfacine is an α2A-adrenoreceptor agonist currently indicated for the treatment of attention deficit hyperactivity disorder (ADHD). This article reviews the chemistry, pharmacodynamics and pharmacokinetics of guanfacine, as well as the clinical trial literature on guanfacine for the treatment of ADHD in children and...
journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章,评审
doi:10.1586/14737175.2015.1028370
更新日期:2015-04-01 00:00:00
abstract:INTRODUCTION:Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system (CNS). The modern treatment era for MS witnessed a growing pool of drugs now available for use in clinical practice. These therapies work at different levels, however there is a lack of treatments acting on the neurode...
journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章,评审
doi:10.1080/14737175.2017.1378098
更新日期:2017-11-01 00:00:00
abstract::Seizures are often the presenting symptoms of a cerebral tumor and may precede its diagnosis by many years. The article under evaluation searched two large English registries for patients admitted for new-onset epilepsy. The risk of subsequently being diagnosed with a malignant brain tumor was found to be 26-fold high...
journal_title:Expert review of neurotherapeutics
pub_type: 评论,杂志文章
doi:10.1586/ern.11.80
更新日期:2011-08-01 00:00:00
abstract::Stroke is the third leading cause of mortality in the USA and one of the leading causes of severe morbidity. It is important to provide stroke patients and physicians with the most accurate prognostic information to optimize care and allocation of healthcare resources. Reliable prognostic markers available during the ...
journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章,评审
doi:10.1586/ern.10.200
更新日期:2011-02-01 00:00:00
abstract::Central pain, which follows brain and spinal cord injury remains an ill-treated entity affecting approximately 1-2 million people worldwide. When oral drugs fail, either immediately or in the long run, the only therapeutic option is neuromodulation, via either electrical or chemical means. The whole spectrum of neurom...
journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章
doi:10.1586/14737175.3.5.591
更新日期:2003-09-01 00:00:00
abstract:INTRODUCTION:Patients with multiple sclerosis (MS) may suffer from spasticity and pain during their disease course. Baclofen, dantrolene, diazepam and gabapentin have been used as first-line options to treat these conditions, with modest results. Medical use of marijuana smoking has bypassed traditional clinical trials...
journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章
doi:10.1080/14737175.2020.1776610
更新日期:2020-08-01 00:00:00
abstract::Alzheimer's disease is an age-related dementia and its incidence is rising in developed countries as the population ages. Amyloid plaques and tau-rich neurofibrillary tangles are pathologic hallmarks of the disease. Treatment is symptomatic, consisting of compounds that block enzymatic acetylcholine degradation (acety...
journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章,评审
doi:10.1586/14737175.4.1.97
更新日期:2004-01-01 00:00:00
abstract:INTRODUCTION:Non-convulsive status epilepticus (NCSE) is a complex and diverse condition which is often an under-recognised entity in the intensive care unit. When NCSE is identified the optimal treatment strategy is not always clear. Areas covered: This review is based on a literature review of the key literature in t...
journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章,评审
doi:10.1080/14737175.2017.1369880
更新日期:2017-10-01 00:00:00
abstract::Introduction: Almotriptan (ALT), a serotonin 5-HT1B/1D agonist has been used in the acute treatment of migraine with or without aura for 20 years, accumulating data on more than 15,000 patients in studies and from an estimated >150 million treated migraine attacks in daily clinical practice. The last major review of A...
journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章,评审
doi:10.1080/14737175.2019.1591951
更新日期:2019-08-01 00:00:00
abstract::Introduction: Most preventive migraine treatments modify the brain's excitation/inhibition balance and/or serotonin metabolism, which likely accounts for their unfavorable adverse effect profile. Novel biological therapies blocking CGRP transmission are effective and better tolerated, but they are expensive and may no...
journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章
doi:10.1080/14737175.2020.1729130
更新日期:2020-03-01 00:00:00
abstract:INTRODUCTION:Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease characterized by motor neuron degeneration in the brain and spinal cord. Treatment development for ALS is complicated by complex underlying disease factors. Areas covered: Numerous tested drug compounds have shown no benefits in ALS p...
journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章,评审
doi:10.1080/14737175.2016.1207530
更新日期:2016-12-01 00:00:00
abstract::Bipolar disorder is one of the most serious and prevalent psychiatric disorders. The aim of the present article is to review the efficiency of cognitive-behavioral therapy (CBT) for bipolar patients. Some studies show consistent evidence that cognitive therapy, concomitant to psycho-education and pharmacological treat...
journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章,评审
doi:10.1586/ern.10.75
更新日期:2010-07-01 00:00:00
abstract::Parkinson's disease (PD) is characterized clinically by rest tremor, rigidity, bradykinesia and pathologically by degeneration of nigrostriatal dopamine neurons. Motor fluctuations (wearing off) and motor complications (dyskinesia) are common features of the long-term treatment of PD. Ongoing clinical and preclinical ...
journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章,评审
doi:10.1586/14737175.2014.868306
更新日期:2014-01-01 00:00:00
abstract::The subthalamic nucleus (STN) has been a major target of deep brain stimulation (DBS) for Parkinson's disease (PD) over the past 20 years. The benefits of DBS of the STN include: decreased motor fluctuations and bradykinesia, tremor reduction and a reduction in dopaminergic drug requirements and dyskinesias. Despite t...
journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章,评审
doi:10.1586/14737175.2015.1081815
更新日期:2015-10-01 00:00:00
abstract::Alzheimer's disease (AD) is the most common cause of dementia and is characterized by an insidious onset and slow deterioration in cognition, activities of daily living (ADL), mood stability and social functioning. The cholinesterase inhibitors (ChEIs), developed based on the cholinergic hypothesis, are currently cons...
journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章,评审
doi:10.1586/ern.09.23
更新日期:2009-05-01 00:00:00
abstract::Poor insight or unawareness of illness has been commonly observed in schizophrenia and has been long recognized as a potent barrier to treatment adherence and a risk factor for a range of poorer outcomes. Paradoxically, the achievement of insight often poses a different set of problems including depression and low sel...
journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章,评审
doi:10.1586/14737175.2013.811150
更新日期:2013-07-01 00:00:00
abstract:INTRODUCTION:Antipsychotics have long been the mainstay of treatment for agitation and psychosis in Alzheimer's disease. Despite their current use successive studies have shown that they only confer a modest benefit which must be balanced against their well-established serious side effects (extrapyramidal symptoms, str...
journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章,评审
doi:10.1080/14737175.2018.1476140
更新日期:2018-06-01 00:00:00
abstract::Attention-deficit/hyperactivity disorder (ADHD) is a highly heritable condition that affects a significant number of children and adults worldwide. During the past 30 years, the diagnosis and treatment of ADHD has relied on clinical assessment and empirical experience with stimulant medications. More recently, advance...
journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章,评审
doi:10.1586/14737175.7.4.351
更新日期:2007-04-01 00:00:00
abstract::Recent evidence suggests that active trigger points (TrPs) in neck and shoulder muscles contribute to tension-type headache. Active TrPs within the suboccipital, upper trapezius, sternocleidomastoid, temporalis, superior oblique and lateral rectus muscles have been associated with chronic and episodic tension-type hea...
journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章,评审
doi:10.1586/ern.11.138
更新日期:2012-03-01 00:00:00
abstract::Zonisamide (Zonegran, Eisai, Inc.) is a broad spectrum antiepileptic drug indicated for use as adjunctive therapy in the treatment of partial seizures. Zonisamide has multiple mechanisms of action, which may explain widespread reports of its utility in focal epilepsy and generalized epilepsy, and for nonseizure disord...
journal_title:Expert review of neurotherapeutics
pub_type: 历史文章,杂志文章,评审
doi:10.1586/14737175.4.6.935
更新日期:2004-11-01 00:00:00
abstract::Many antiepileptic drugs (AEDs) have therapeutic applications that extend beyond epilepsy to include neuropathic pain, migraine headaches and psychiatric disorders. The risk of some AEDs has been clearly established, but for newer drugs, small sample sizes and polytherapy exposures preclude a conclusive determination ...
journal_title:Expert review of neurotherapeutics
pub_type: 杂志文章,评审
doi:10.1586/ern.10.57
更新日期:2010-06-01 00:00:00