Possible Interaction: Neostigmine and Tubocurarine

“After five minutes, neostigmine could rapidly and effectively reverse a blocking dose of tubocurarine.”

“It is concluded that the degree of reversal by neostigmine is related inversely to the concentration of tubocurarine at the time of reversal.”

“Data are presented in favour of the regulatory role … anions: 1) gradual inhibition of the enzyme with proserin brings about the change of the transport activation energy and irregular shift of temperature … curves; 2) complexing of different AChE inhibitors (succinyl cholinechlorine, tetraethyl ammonium, tetramethyl ammonium, d-tubocurarin , proserin) … velocity.”

“Pharmacokinetics of edrophonium and neostigmine when antagonizing D-tubocurarine neuromuscular blockade in man.”

“5 6 Large doses of anticholinesterase were used in children at this time: neostigmine 0.08 mg kg 91 was given to antagonize tubocurarine in neonates, who were thought to need an even higher dose than adults to obtain reliable recovery.”

“ Neostigmine failed to modify the development of neuromuscular block in the presence of a high local concentration of tubocurarine.”

“d - Tubocurarine was added to antagonize the nicotinic effects of neostigmine , in particular muscle twitching.”

“The most likely cause was the return of muscle paralysis after the apparent antagonism of tubocurarine by neostigmine (recurarization).”

“SummaryRecent evidence has suggested that intraoperative administration of neostigmine to reverse the effects ofd-tubocurarine has contributed to anastomotic disruption or leakage of large-intestinal anastomoses.”

“The authors also reviewed a previous study in which the tubocurarine-induced neuromuscular blockage was reversed with neostigmine administered from 3 to 90 minutes after the tubocurarine.”

“The optimum dose of neostigmine required to establish the complete reversal of severe neuromuscular blockade due to tubocurarine would appear to be in the region of 4 to 5 mg.”

“… tubocurarine …) Neostigmine was the most potent antagonist, pyridostigmin less active, and edrophonium the least potent of the three compounds; b) the duration of the anticurare effect … respectively; and c ) intravenously administered edrophonium produced the most rapid antagonism of the effects of tubocurarine followed in order by neostigmine and pyridostigmin.”