Compounds > pipecuronium
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pipecuronium

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Description

Pipecuronium bromide is a non-depolarizing neuromuscular blocking agent used for skeletal muscle relaxation during anesthesia and surgery. It is a synthetic quaternary ammonium compound, derived from the natural alkaloid tubocurarine. Its chemical synthesis involves the reaction of the bis-quaternary ammonium compound, with a piperidine ring. Pipecuronium acts by competitively blocking the action of acetylcholine at the nicotinic receptors at the neuromuscular junction, preventing muscle contraction. It has a rapid onset of action and a moderate duration, making it suitable for both short and long surgical procedures. Pipecuronium is studied due to its clinical importance in providing muscle relaxation for various surgical procedures, its role in managing muscle spasms, and its potential application in the treatment of certain neurological disorders. The study of pipecuronium continues to explore its pharmacokinetic properties, drug interactions, and potential adverse effects, aiming to optimize its therapeutic use.'

Pipecuronium: A piperazinyl androstane derivative which is a non-depolarizing neuromuscular blocking agent (NEUROMUSCULAR NONDEPOLARIZING AGENTS). It is used as a muscle relaxant during ANESTHESIA and surgical procedures. [Medical Subject Headings (MeSH), National Library of Medicine, extracted Dec-2023]

Cross-References

ID SourceID
PubMed CID50192
CHEMBL ID1201206
CHEBI ID8230
SCHEMBL ID359367
MeSH IDM0026260

Synonyms (16)

Synonym
C07554
68399-58-6
pipecuronium
DB01338
pipecurium
piperazinium, 4,4'-((2beta,3alpha,5alpha,16beta,17beta)-3,17-bis(acetyloxy)androstane-2,16-diyl)bis(1,1-dimethyl-
unii-1n3o74hm92
1n3o74hm92 ,
CHEMBL1201206
4-[(1s,2s,4s,5s,7s,10r,11s,13s,14r,15s)-5,14-bis(acetyloxy)-4-(4,4-dimethylpiperazin-4-ium-1-yl)-2,15-dimethyltetracyclo[8.7.0.0^{2,7}.0^{11,15}]heptadecan-13-yl]-1,1-dimethylpiperazin-1-ium
pipecuronium [who-dd]
pipecuronium [vandf]
SCHEMBL359367
CHEBI:8230 ,
DTXSID20860643
Q20817188

Research Excerpts

Overview

Pipecuronium bromide is a non-depolarizing neuromuscular blocker with similar properties to pancuronium. We considered its haemodynamic effects during general anaesthesia.

ExcerptReferenceRelevance
"Pipecuronium is a steroidal neuromuscular blocking agent. "( Reversal of Pipecuronium-Induced Moderate Neuromuscular Block with Sugammadex in the Presence of a Sevoflurane Anesthetic: A Randomized Trial.
Asztalos, L; Fülesdi, B; Lengyel, S; Nemes, R; Pongrácz, A; Tassonyi, E, 2015)		2.24
"Pipecuronium is a non-depolarizing neuromuscular blocker with similar properties to pancuronium, but without cardiovascular effects. "( Neuromuscular and cardiovascular effects of pipecuronium. A comparative study between different doses.
Braga, Ade F; Braga, FS; Frias, JA; Potério, GM; Rodrigues, Rde C; Yoshioka, L, )		1.84
"Pipecuronium bromide is a new non depolarising muscle relaxant with a long duration of action; we considered its haemodynamic effects during general anaesthesia."( [Evaluation of the hemodynamic effects of pipecuronium bromide. Absence of adverse hemodynamic effects].
Amicucci, G; Ardigò, M; Candiani, A; Dicembrini, A; Latronico, N; Prandini, A; Venturini, M, 1995)		2
"Pipecuronium bromide is a new steroidal non-depolarizing muscle relaxant currently under investigation. "( A dose-response evaluation of pipecuronium bromide in elderly patients under balanced anesthesia.
Azad, SS; Beach, CA; Goldberg, ME; Larijani, GE; Marr, AT; Seltzer, JL, 1989)		2.01
"Pipecuronium bromide is a nondepolarising muscle relaxant which is an analogue of pancuronium. "( Observations on the neuromuscular blocking action of pipecuronium in the dog.
Jones, RS, 1987)		1.97

Effects

Pipecuronium has a relatively rapid onset. It has no acetylcholine-like fragments in contrast with pancuronium.

ExcerptReferenceRelevance
"Pipecuronium has a relatively rapid onset. "( Intubating conditions after pipecuronium bromide: the influence of dose and time.
Azad, SS; Bartkowski, R; Goldberg, ME; Larijani, GE; Marr, A; Seltzer, JL; Weinberger, M, )		1.87
"pipecuronium has no acetylcholine-like fragments in contrast with pancuronium and the interonium distance is also considerably larger than in pancuronium) may predict advantages."( [Pharmacologic effects of pipecuronium bromide (Arduan)].
Bíró, K; Kárpáti, E, 1992)		1.31
"Pipecuronium has a relatively rapid onset. "( Intubating conditions after pipecuronium bromide: the influence of dose and time.
Azad, SS; Bartkowski, R; Goldberg, ME; Larijani, GE; Marr, A; Seltzer, JL; Weinberger, M, )		1.87

Toxicity

ExcerptReferenceRelevance
" Apart from daily stress of paralysis preceding intubation no irreversible toxic changes were detected by laboratory and morphological tests."( Summary of safety tests with pipecurium bromide, a new neuromuscular blocking agent.
Cholnoky, E, 1980)		0.26

Pharmacokinetics

Pipecuronium resembles pancuronium in its pharmacokinetic and neuromuscular blocking profile, but is devoid of cardiovascular effects.

ExcerptReferenceRelevance
" The pharmacokinetic variables were similar for the two groups, and pharmacodynamic analysis revealed a similar sensitivity at the neuromuscular junction."( Pharmacokinetics and pharmacodynamics of pipecuronium bromide (Arduan) in elderly surgical patients.
Diaz, J; Jamdar, SC; Matteo, RS; Ornstein, E; Schwartz, AE, 1992)		0.55
" The elimination half-life in animals was found to be around 40 min, in humans between 44-137 min."( [Pharmacokinetics and metabolism of pipecuronium bromide (Arduan)].
Vereczkey, L, 1992)		0.56
"To study the effects of succinylcholine on subsequent pharmacodynamics of nondepolarizing muscle relaxants, a comparative pharmacodynamic study was carried out in patients having balanced anesthesia (thiopental, fentanyl, nitrous oxide/oxygen) in whom equipotent doses of pipecuronium (80 micrograms/kg) and pancuronium (100 micrograms/kg) were given with or without prior administration of succinylcholine (1 mg/kg)."( Effects of succinylcholine on the pharmacodynamics of pipecuronium and pancuronium.
Dubois, MY; Fleming, NW; Lea, DE, 1991)		0.71
" The pharmacokinetic parameters of pipecuronium were compared with those of pancuronium (0."( [Comparative pharmacokinetics of pipecuronium bromide, pancuronium bromide and vecuronium bromide in anesthetized man].
Hanaoka, K; Kushida, Y; Murakami, S; Numata, K; Sugai, N; Yajima, C; Yamamoto, K; Yamamura, H, 1990)		0.84
" In connection with the pharmacodynamic evaluation, literature on the pipecuronium bromide and on the administration of the muscle relaxants in paediatric anaesthesiology is summarized."( [A pharmacodynamic study of pipecuronium bromide (Arduan) in newborn infants, infants and children].
Praefort, L, 1990)		0.81
" The pharmacokinetic parameters derived by compartmental modelling were (normal vs."( The influence of renal failure on the pharmacokinetics and duration of action of pipecuronium bromide in patients anesthetized with halothane and nitrous oxide.
Caldwell, JE; Canfell, PC; Castagnoli, KP; Fahey, MR; Fisher, DM; Lynam, DP; Miller, RD, 1989)		0.5
" Except for the volume of central compartment, all other pharmacokinetic variables differed significantly between the two experimental groups."( Pharmacokinetics and disposition of pipecuronium bromide in dogs with and without ligated renal pedicles.
Agoston, S; Caldwell, JE; Chung, K; Khuenl-Brady, KS; Miller, RD; Sharma, M, 1989)		0.55
" Absence of renal function significantly altered the pharmacokinetic parameters and prolonged the time-course of the neuromuscular blocking effects of pipecuronium."( Pharmacokinetics and disposition of pipecuronium bromide in the cat.
Agoston, S; Houwertjes, MC; Kersten, UW; Vandenbrom, RH; Wierda, JM, 1988)		0.75
" The pharmacokinetic parameters of pipecurium bromide were found as follows: apparent distribution volume V beta = 261 +/- 28 (n = 8) ml/kg, plasma clearance Cl = 320 +/- 55 (n = 8) ml/min."( Pharmacokinetics of pipecurium bromide, a new non-depolarizing neuromuscular blocking agent, in humans.
Szabó, G; Tassonyi, E; Vereczkey, L, 1981)		0.26
" A two-compartment open model was used for pharmacokinetic analysis."( Pharmacokinetics and pharmacodynamics of pipecuronium in patients with cirrhosis.
D'Honneur, G; Dominique, C; Duvaldestin, P; Haberer, JP; Khalil, M; Kleef, UW, 1993)		0.55
"We compared the pharmacodynamic effects and hospital costs of three long-acting neuromuscular blocking drugs in a prospective, randomized, double-blind manner."( Hemodynamic and pharmacodynamic comparison of doxacurium and pipecuronium with pancuronium during induction of cardiac anesthesia: does the benefit justify the cost?
Brooker, RF; Butterworth, JF; Gravlee, GP; Prielipp, RC; Rathmell, JP, 1993)		0.53
" Pipecuronium resembles pancuronium in its pharmacokinetic and neuromuscular blocking profile, but is devoid of cardiovascular effects."( Clinical pharmacokinetics of the newer neuromuscular blocking drugs.
Atherton, DP; Hunter, JM, 1999)		1.21

Dosage Studied

Pipecuronium effective doses 50,90,95 (ED50, ED90, ED95) have been obtained with the cumulative dosage method. Because of the low total plasma clearance in infants, pipe Curonium dosage should be carefully monitored.

ExcerptRelevanceReference
" The cumulative dose-response to pipecuronium was determined in both patients during nitrous oxide-oxygen-narcotic anaesthesia."( Myasthenia gravis and pipecuronium--report of two cases.
Ashour, M; Messahel, F; Naguib, M; Sari-Kouzel, A; Seraj, M, 1992)		0.88
" Responses were defined in terms of percent depression in first-twitch height and train-of-four response, and the dose-response curves were constructed after probit transformation of the responses."( Pipecuronium-induced neuromuscular blockade during nitrous oxide-fentanyl, enflurane, isoflurane, and halothane anesthesia in surgical patients.
Abdulrazik, E; Naguib, M; Seraj, M, 1992)		1.73
" In order to obtain a stable dosage form liophylized ampoules containing mannitol were prepared."( [Pharmaceutic development of injectable Arduan].
Deákné, RE; Guti, Z; Rádi, E, 1992)		0.28
" Before its introduction into clinical practice in the USA, in the first phase of this study the neuromuscular potency of pipecuronium was determined under "balanced" and enflurance anaesthesia by the cumulative log dose-response method in 30 patients each."( Neuromuscular and cardiovascular effects of pipecuronium.
Duncalf, D; Foldes, FF; Goldiner, PL; Nagashima, H; Nguyen, HD, 1990)		0.75
"The purpose of the study was to measure the neuromuscular effects of pipecuronium bromide (Arduan) and to determine its dosage in paediatric anaesthesiology by recording dose-effect curves in children, infants and newborn babies during diazepam, ketamine, fentanyl, nitrous oxide anaesthesia."( [A pharmacodynamic study of pipecuronium bromide (Arduan) in newborn infants, infants and children].
Praefort, L, 1990)		0.81
"We determined the cumulative dose-response relations of pipecuronium in infants and children during nitrous oxidehalothane anesthesia."( Clinical pharmacology of pipecuronium in infants and children during halothane anesthesia.
Brandom, BW; Cook, DR; Dong, ML; Pickle, D; Sarner, JB; Weinberger, MJ, 1990)		0.83
"The dose-response of pipecuronium bromide, the time course of its neuromuscular blocking effects, and the reversibility of the residual block by neostigmine and edrophonium have been investigated in patients undergoing various types of anesthesia."( Dose-response relation and time course of action of pipecuronium bromide in humans anesthetized with nitrous oxide and isoflurane, halothane, or droperidol and fentanyl.
Agoston, S; Richardson, FJ; Wierda, JM, 1989)		0.85
" We examined the dose-response relation of pipecuronium in 27 patients, ages 66-79 years, utilizing the incremental dose method under balanced anesthesia."( A dose-response evaluation of pipecuronium bromide in elderly patients under balanced anesthesia.
Azad, SS; Beach, CA; Goldberg, ME; Larijani, GE; Marr, AT; Seltzer, JL, 1989)		0.83
"Cumulative dose-response curves were constructed to determine the comparative potency of pipecuronium and pancuronium."( Comparative potency of pipecuronium bromide and pancuronium bromide.
Mirakhur, RK; Stanley, JC, 1989)		0.81
" We conclude that there is no clinical indication that the dosage of atracurium and vecuronium during inhalation anesthesia should be reduced, but the doses of pipecuronium and pancuronium should be reduced when prolonged paralysis is not desired."( Interaction between nondepolarizing neuromuscular blocking agents and inhalational anesthetics.
Agoston, S; Hermans, J; Ket, JM; Koot, HW; Rashkovsky, OM; Swen, J, 1989)		0.47
" Dosage was limited by prolonged paralysis time requiring artificial ventilation."( Summary of safety tests with pipecurium bromide, a new neuromuscular blocking agent.
Cholnoky, E, 1980)		0.26
" We studied the dose-response relationships of each drug and their combination with rocuronium in 200 ASA I or II patients during propofol-fentanyl-nitrous oxide-oxygen anaesthesia."( Comparative potency of steroidal neuromuscular blocking drugs and isobolographic analysis of the interaction between rocuronium and other aminosteroids.
Bakhamees, HS; el-Bakry, AK; Magboul, MA; Naguib, M; Samarkandi, AH, 1995)		0.29
" The duration of action and recovery time from 75% to 25% block were longer than those produced by twice the dosage of vecuronium (62."( [A comparison between neuromuscular blocking effects of pipecuronium and vecuronium; a double blind controlled study in collaboration with 5 departments of anesthesiology].
Amaki, Y; Hanaoka, K; Hashimoto, Y; Kobayashi, T; Suzuki, H; Yamamura, H, 1994)		0.53
" The dose-response curves were determined by probit analysis."( Isobolographic and dose-response analysis of the interaction between pipecuronium and vecuronium.
Abdulatif, M; Naguib, M, 1993)		0.52
"We have studied the dose-response relationships for neostigmine and edrophonium during antagonism of neuromuscular block induced by pipecuronium bromide."( Dose-response relationships for edrophonium and neostigmine antagonism of pipecuronium-induced neuromuscular block.
Abdulatif, M; Naguib, M, 1994)		0.72
"The dose-response relationship and the variability of the time variables in pipercuronium neuromuscular blockade were studied in 29 patients (ASA physical status 3) during halothane anaesthesia."( Variability of pipecuronium neuromuscular blockade.
Buzello, W; Diefenbach, C; Mellinghoff, H, 1993)		0.64
"Pipecuronium effective doses 50,90,95 (ED50, ED90, ED95) have been obtained with the cumulative dosage method studying the influences of two different anesthetic techniques (TIVA vs isoflurane), of the patients age, of two different monitoring techniques, force transduction vs accelerometry, both evaluated by T1/TC ratio, ratio between Ist muscular response following the muscle relaxant and the values obtained before its injection, and TOFR, ratio between 4th and Ist response of every train."( [A new instrument for neuromuscular transmission monitoring: the accelerometer Tofguard. Comparative study of isometric force transduction in the assessment of pipecuronium dose-response relationship].
Melloni, C, 1995)		1.93
" Because of the low total plasma clearance in infants, pipecuronium dosage should be carefully monitored to avoid accumulation and prolonged paralysis."( Pharmacokinetics of pipecuronium in infants, children and adults.
Gemperle, G; Morel, DR; Pittet, JF; Rouge, JC; Schopfer, CN; Tassonyi, E; Wilder-Smith, OH, )		0.7
"To compare dose-response relationship and maintenance requirement of pipecuronium in anesthetized infants, children, and adults."( Pipecuronium revisited: dose-response and maintenance requirement in infants, children, and adults.
Erkola, O; Meretoja, OA, 1997)		1.97
" An individual cumulative log-probit dose-response curve was established and maintenance requirement of pipecuronium determined."( Pipecuronium revisited: dose-response and maintenance requirement in infants, children, and adults.
Erkola, O; Meretoja, OA, 1997)		1.95
" Arduan dosage ought to be reduced because of it possible cumulation in blood due to hepatorenal disorders existing in this patients."( [Features of anesthesia in surgical removal of insulinoma].
Kostenko, AA, 1997)		0.3
" The ED50 of each neuromuscular blocker was determined from cumulative log dose-response regression lines (n = 14)."( Adenosine potentiation of neuromuscular blocking agents in guinea-pigs.
Dan, K; Foldes, FF; Kornak, P; Nagashima, H; Nitahara, K; Vizi, ES, 2000)		0.31
[information is derived through text-mining from research data collected from National Library of Medicine (NLM), extracted Dec-2023]

Drug Classes (1)

ClassDescription
steroid ester
[compound class information is derived from Chemical Entities of Biological Interest (ChEBI), Hastings J, Owen G, Dekker A, Ennis M, Kale N, Muthukrishnan V, Turner S, Swainston N, Mendes P, Steinbeck C. (2016). ChEBI in 2016: Improved services and an expanding collection of metabolites. Nucleic Acids Res]

Research

Studies (184)

TimeframeStudies, This Drug (%)All Drugs %
pre-199064 (34.78)18.7374
1990's106 (57.61)18.2507
2000's11 (5.98)29.6817
2010's3 (1.63)24.3611
2020's0 (0.00)2.80
[information is prepared from research data collected from National Library of Medicine (NLM), extracted Dec-2023]

Market Indicators

Research Demand Index: 37.30

According to the monthly volume, diversity, and competition of internet searches for this compound, as well the volume and growth of publications, there is estimated to be strong demand-to-supply ratio for research on this compound.

MetricThis Compound (vs All)
Research Demand Index37.30 (24.57)
Research Supply Index5.60 (2.92)
Research Growth Index4.31 (4.65)
Search Engine Demand Index53.08 (26.88)
Search Engine Supply Index2.00 (0.95)

This Compound (37.30)

All Compounds (24.57)

Study Types

Publication TypeThis drug (%)All Drugs (%)
Trials62 (29.81%)5.53%
Reviews15 (7.21%)6.00%
Case Studies8 (3.85%)4.05%
Observational0 (0.00%)0.25%
Other123 (59.13%)84.16%
[information is prepared from research data collected from National Library of Medicine (NLM), extracted Dec-2023]
SubstanceRelationship StrengthStudiesTrialsClassesRoles
histamine
[no description available]		4.6332aralkylamino compound;
imidazoles		human metabolite;
mouse metabolite;
neurotransmitter
nitrous oxide
Nitrous Oxide: Nitrogen oxide (N2O). A colorless, odorless gas that is used as an anesthetic and analgesic. High concentrations cause a narcotic effect and may replace oxygen, causing death by asphyxia. It is also used as a food aerosol in the preparation of whipping cream.. dinitrogen oxide : A nitrogen oxide consisting of linear unsymmetrical molecules with formula N2O. While it is the most used gaseous anaesthetic in the world, its major commercial use, due to its solubility under pressure in vegetable fats combined with its non-toxicity in low concentrations, is as an aerosol spray propellant and aerating agent for canisters of 'whipped' cream.		7.16104gas molecular entity;
nitrogen oxide		analgesic;
bacterial metabolite;
food packaging gas;
food propellant;
general anaesthetic;
greenhouse gas;
inhalation anaesthetic;
NMDA receptor antagonist;
raising agent;
refrigerant;
vasodilator agent
4-aminopyridine
[no description available]		1.9610aminopyridine;
aromatic amine		avicide;
orphan drug;
potassium channel blocker
phenytoin
[no description available]		3.3711imidazolidine-2,4-dioneanticonvulsant;
drug allergen;
sodium channel blocker;
teratogenic agent
carbamazepine
Carbamazepine: A dibenzazepine that acts as a sodium channel blocker. It is used as an anticonvulsant for the treatment of grand mal and psychomotor or focal SEIZURES. It may also be used in the management of BIPOLAR DISORDER, and has analgesic properties.. carbamazepine : A dibenzoazepine that is 5H-dibenzo[b,f]azepine carrying a carbamoyl substituent at the azepine nitrogen, used as an anticonvulsant.		3.3711dibenzoazepine;
ureas		analgesic;
anticonvulsant;
antimanic drug;
drug allergen;
EC 3.5.1.98 (histone deacetylase) inhibitor;
environmental contaminant;
glutamate transporter activator;
mitogen;
non-narcotic analgesic;
sodium channel blocker;
xenobiotic
cimetidine
Cimetidine: A histamine congener, it competitively inhibits HISTAMINE binding to HISTAMINE H2 RECEPTORS. Cimetidine has a range of pharmacological actions. It inhibits GASTRIC ACID secretion, as well as PEPSIN and GASTRIN output.. cimetidine : A member of the class of guanidines that consists of guanidine carrying a methyl substituent at position 1, a cyano group at position 2 and a 2-{[(5-methyl-1H-imidazol-4-yl)methyl]sulfanyl}ethyl group at position 3. It is a H2-receptor antagonist that inhibits the production of acid in stomach.		3.1110aliphatic sulfide;
guanidines;
imidazoles;
nitrile		adjuvant;
analgesic;
anti-ulcer drug;
H2-receptor antagonist;
P450 inhibitor
diazepam
Diazepam: A benzodiazepine with anticonvulsant, anxiolytic, sedative, muscle relaxant, and amnesic properties and a long duration of action. Its actions are mediated by enhancement of GAMMA-AMINOBUTYRIC ACID activity.. diazepam : A 1,4-benzodiazepinone that is 1,3-dihydro-2H-1,4-benzodiazepin-2-one substituted by a chloro group at position 7, a methyl group at position 1 and a phenyl group at position 5.		3.78211,4-benzodiazepinone;
organochlorine compound		anticonvulsant;
anxiolytic drug;
environmental contaminant;
sedative;
xenobiotic
droperidol
Droperidol: A butyrophenone with general properties similar to those of HALOPERIDOL. It is used in conjunction with an opioid analgesic such as FENTANYL to maintain the patient in a calm state of neuroleptanalgesia with indifference to surroundings but still able to cooperate with the surgeon. It is also used as a premedicant, as an antiemetic, and for the control of agitation in acute psychoses. (From Martindale, The Extra Pharmacopoeia, 29th ed, p593). droperidol : An organofluorine compound that is haloperidol in which the hydroxy group has been eliminated with the introduction of a double bond in the piperidine ring, and the 4-chlorophenyl group has been replaced by a benzimidazol-2-on-1-yl group. It is used in the management of chemotherapy-induced nausea and vomiting, and in conjunction with an opioid analgesic such as fentanyl to maintain the patient in a calm state of neuroleptanalgesia with indifference to surroundings but still able to cooperate with the surgeon.		6.9710aromatic ketone;
benzimidazoles;
organofluorine compound		anaesthesia adjuvant;
antiemetic;
dopaminergic antagonist;
first generation antipsychotic
edrophonium
Edrophonium: A rapid-onset, short-acting cholinesterase inhibitor used in cardiac arrhythmias and in the diagnosis of myasthenia gravis. It has also been used as an antidote to curare principles.. edrophonium : A quaternary ammonium ion that is N-ethyl-N,N-dimethylanilinium in which one of the meta positions is substituted by a hydroxy group. It is a reversible inhibitor of cholinesterase, with a rapid onset (30-60 seconds after injection) but a short duration of action (5-15 minutes). The chloride salt is used in myasthenia gravis both diagnostically and to distinguish between under- or over-treatment with other anticholinesterases. It has also been used for the reversal of neuromuscular blockade in anaesthesia, and for the management of poisoning due to tetrodotoxin, a neuromuscular blocking toxin found in puffer fish and other marine animals.		5.243phenols;
quaternary ammonium ion		antidote;
diagnostic agent;
EC 3.1.1.8 (cholinesterase) inhibitor
enflurane
Enflurane: An extremely stable inhalation anesthetic that allows rapid adjustments of anesthesia depth with little change in pulse or respiratory rate.. enflurane : An ether in which the oxygen atom is connected to 2-chloro-1,1,2-trifluoroethyl and difluoromethyl groups.		4.9731ether;
organochlorine compound;
organofluorine compound		anaesthetic
fentanyl
Fentanyl: A potent narcotic analgesic, abuse of which leads to habituation or addiction. It is primarily a mu-opioid agonist. Fentanyl is also used as an adjunct to general anesthetics, and as an anesthetic for induction and maintenance. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1078). fentanyl : A monocarboxylic acid amide resulting from the formal condensation of the aryl amino group of N-phenyl-1-(2-phenylethyl)piperidin-4-amine with propanoic acid.		8.751310anilide;
monocarboxylic acid amide;
piperidines		adjuvant;
anaesthesia adjuvant;
anaesthetic;
intravenous anaesthetic;
mu-opioid receptor agonist;
opioid analgesic
guanethidine
Guanethidine: An antihypertensive agent that acts by inhibiting selectively transmission in post-ganglionic adrenergic nerves. It is believed to act mainly by preventing the release of norepinephrine at nerve endings and causes depletion of norepinephrine in peripheral sympathetic nerve terminals as well as in tissues.. guanethidine : A member of the class of guanidines in which one of the hydrogens of the amino group has been replaced by a 2-azocan-1-ylethyl group.. guanethidine sulfate : A organic sulfate salt composed of two molecules of guanethidine and one of sulfuric acid.		210azocanes;
guanidines		adrenergic antagonist;
antihypertensive agent;
sympatholytic agent
halothane
[no description available]		7.54106haloalkane;
organobromine compound;
organochlorine compound;
organofluorine compound		inhalation anaesthetic
isoflurane
Isoflurane: A stable, non-explosive inhalation anesthetic, relatively free from significant side effects.		8.16107organofluorine compoundinhalation anaesthetic
ketamine
Ketamine: A cyclohexanone derivative used for induction of anesthesia. Its mechanism of action is not well understood, but ketamine can block NMDA receptors (RECEPTORS, N-METHYL-D-ASPARTATE) and may interact with sigma receptors.. ketamine : A member of the class of cyclohexanones in which one of the hydrogens at position 2 is substituted by a 2-chlorophenyl group, while the other is substituted by a methylamino group.		2.0510cyclohexanones;
monochlorobenzenes;
secondary amino compound		analgesic;
environmental contaminant;
intravenous anaesthetic;
neurotoxin;
NMDA receptor antagonist;
xenobiotic
lorazepam
Lorazepam: A benzodiazepine used as an anti-anxiety agent with few side effects. It also has hypnotic, anticonvulsant, and considerable sedative properties and has been proposed as a preanesthetic agent.		3.3711benzodiazepine
midazolam
Midazolam: A short-acting hypnotic-sedative drug with anxiolytic and amnestic properties. It is used in dentistry, cardiac surgery, endoscopic procedures, as preanesthetic medication, and as an adjunct to local anesthesia. The short duration and cardiorespiratory stability makes it useful in poor-risk, elderly, and cardiac patients. It is water-soluble at pH less than 4 and lipid-soluble at physiological pH.. midazolam : An imidazobenzodiazepine that is 4H-imidazo[1,5-a][1,4]benzodiazepine which is substituted by a methyl, 2-fluorophenyl and chloro groups at positions 1, 6 and 8, respectively.		6.3253imidazobenzodiazepine;
monofluorobenzenes;
organochlorine compound		anticonvulsant;
antineoplastic agent;
anxiolytic drug;
apoptosis inducer;
central nervous system depressant;
GABAA receptor agonist;
general anaesthetic;
muscle relaxant;
sedative
neostigmine
Neostigmine: A cholinesterase inhibitor used in the treatment of myasthenia gravis and to reverse the effects of muscle relaxants such as gallamine and tubocurarine. Neostigmine, unlike PHYSOSTIGMINE, does not cross the blood-brain barrier.. neostigmine : A quaternary ammonium ion comprising an anilinium ion core having three methyl substituents on the aniline nitrogen, and a 3-[(dimethylcarbamoyl)oxy] substituent at position 3. It is a parasympathomimetic which acts as a reversible acetylcholinesterase inhibitor.		6.9893quaternary ammonium ionantidote to curare poisoning;
EC 3.1.1.7 (acetylcholinesterase) inhibitor
pentobarbital
Pentobarbital: A short-acting barbiturate that is effective as a sedative and hypnotic (but not as an anti-anxiety) agent and is usually given orally. It is prescribed more frequently for sleep induction than for sedation but, like similar agents, may lose its effectiveness by the second week of continued administration. (From AMA Drug Evaluations Annual, 1994, p236). pentobarbital : A member of the class of barbiturates, the structure of which is that of barbituric acid substituted at C-5 by ethyl and sec-pentyl groups.		2.0510barbituratesGABAA receptor agonist
promethazine
Promethazine: A phenothiazine derivative with histamine H1-blocking, antimuscarinic, and sedative properties. It is used as an antiallergic, in pruritus, for motion sickness and sedation, and also in animals.. promethazine : A tertiary amine that is a substituted phenothiazine in which the ring nitrogen at position 10 is attached to C-3 of an N,N-dimethylpropan-2-amine moiety.		1.9510phenothiazines;
tertiary amine		anti-allergic agent;
anticoronaviral agent;
antiemetic;
antipruritic drug;
H1-receptor antagonist;
local anaesthetic;
sedative
propofol
Propofol: An intravenous anesthetic agent which has the advantage of a very rapid onset after infusion or bolus injection plus a very short recovery period of a couple of minutes. (From Smith and Reynard, Textbook of Pharmacology, 1992, 1st ed, p206). Propofol has been used as ANTICONVULSANTS and ANTIEMETICS.. propofol : A phenol resulting from the formal substitution of the hydrogen at the 2 position of 1,3-diisopropylbenzene by a hydroxy group.		6.7955phenolsanticonvulsant;
antiemetic;
intravenous anaesthetic;
radical scavenger;
sedative
sevoflurane
Sevoflurane: A non-explosive inhalation anesthetic used in the induction and maintenance of general anesthesia. It does not cause respiratory irritation and may also prevent PLATELET AGGREGATION.. sevoflurane : An ether compound having fluoromethyl and 1,1,1,3,3,3-hexafluoroisopropyl as the two alkyl groups.		9.4922ether;
organofluorine compound		central nervous system depressant;
inhalation anaesthetic;
platelet aggregation inhibitor
succinylcholine
Succinylcholine: A quaternary skeletal muscle relaxant usually used in the form of its bromide, chloride, or iodide. It is a depolarizing relaxant, acting in about 30 seconds and with a duration of effect averaging three to five minutes. Succinylcholine is used in surgical, anesthetic, and other procedures in which a brief period of muscle relaxation is called for.. succinylcholine : A quaternary ammonium ion that is the bis-choline ester of succinic acid.		10.7261quaternary ammonium ion;
succinate ester		drug allergen;
muscle relaxant;
neuromuscular agent
prednisolone
Prednisolone: A glucocorticoid with the general properties of the corticosteroids. It is the drug of choice for all conditions in which routine systemic corticosteroid therapy is indicated, except adrenal deficiency states.. prednisolone : A glucocorticoid that is prednisone in which the oxo group at position 11 has been reduced to the corresponding beta-hydroxy group. It is a drug metabolite of prednisone.		3.111011beta-hydroxy steroid;
17alpha-hydroxy steroid;
20-oxo steroid;
21-hydroxy steroid;
3-oxo-Delta(1),Delta(4)-steroid;
C21-steroid;
glucocorticoid;
primary alpha-hydroxy ketone;
tertiary alpha-hydroxy ketone		adrenergic agent;
anti-inflammatory drug;
antineoplastic agent;
drug metabolite;
environmental contaminant;
immunosuppressive agent;
xenobiotic
pilocarpine
Pilocarpine: A slowly hydrolyzed muscarinic agonist with no nicotinic effects. Pilocarpine is used as a miotic and in the treatment of glaucoma.. (+)-pilocarpine : The (+)-enantiomer of pilocarpine.		210pilocarpineantiglaucoma drug
amifampridine
Amifampridine: 4-Aminopyridine derivative that acts as a POTASSIUM CHANNEL blocker to increase release of ACETYLCHOLINE from nerve terminals. It is used in the treatment of CONGENITAL MYASTHENIC SYNDROMES.		1.9610aminopyridine
tubocurarine
Tubocurarine: A neuromuscular blocker and active ingredient in CURARE; plant based alkaloid of Menispermaceae.. tubocurarine : A benzylisoquinoline alkaloid muscle relaxant which constitutes the active component of curare.. isoquinoline alkaloid : Any alkaloid that has a structure based on an isoquinoline nucleus. They are derived from the amino acids like tyrosine and phenylalanine.		4.4751bisbenzylisoquinoline alkaloiddrug allergen;
muscle relaxant;
nicotinic antagonist
gallamine triethiodide
Gallamine Triethiodide: A synthetic nondepolarizing blocking drug. The actions of gallamine triethiodide are similar to those of TUBOCURARINE, but this agent blocks the cardiac vagus and may cause sinus tachycardia and, occasionally, hypertension and increased cardiac output. It should be used cautiously in patients at risk from increased heart rate but may be preferred for patients with bradycardia. (From AMA Drug Evaluations Annual, 1992, p198)		2.6830
norethindrone
Norethindrone: A synthetic progestational hormone with actions similar to those of PROGESTERONE but functioning as a more potent inhibitor of ovulation. It has weak estrogenic and androgenic properties. The hormone has been used in treating amenorrhea, functional uterine bleeding, endometriosis, and for CONTRACEPTION.. norethisterone : A 17beta-hydroxy steroid that is testosterone in which the hydrogen at position 17 is replaced by an ethynyl group and in which the methyl group attached to position 10 is replaced by hydrogen.		3.111017beta-hydroxy steroid;
3-oxo-Delta(4) steroid;
terminal acetylenic compound;
tertiary alcohol		progestin;
synthetic oral contraceptive
pyridostigmine bromide
Pyridostigmine Bromide: A cholinesterase inhibitor with a slightly longer duration of action than NEOSTIGMINE. It is used in the treatment of myasthenia gravis and to reverse the actions of muscle relaxants.		4.3422pyridinium salt
methohexital
Methohexital: An intravenous anesthetic with a short duration of action that may be used for induction of anesthesia.. methohexital : A barbiturate, the structure of which is that of barbituric acid substituted at N-1 by a methyl group and at C-5 by allyl and 1-methylpent-2-ynyl groups.		3.3611acetylenic compound;
barbiturates		drug allergen;
intravenous anaesthetic
ethynodiol diacetate
Ethynodiol Diacetate: A synthetic progestational hormone used alone or in combination with estrogens as an oral contraceptive (CONTRACEPTIVES, ORAL).		3.4920steroid ester;
terminal acetylenic compound		contraceptive drug;
estrogen receptor modulator;
synthetic oral contraceptive
galantamine
Galantamine: A benzazepine derived from norbelladine. It is found in GALANTHUS and other AMARYLLIDACEAE. It is a cholinesterase inhibitor that has been used to reverse the muscular effects of GALLAMINE TRIETHIODIDE and TUBOCURARINE and has been studied as a treatment for ALZHEIMER DISEASE and other central nervous system disorders.. galanthamine : A benzazepine alkaloid isolated from certain species of daffodils.		1.9610benzazepine alkaloid fundamental parent;
benzazepine alkaloid;
organic heterotetracyclic compound;
tertiary amino compound		antidote to curare poisoning;
cholinergic drug;
EC 3.1.1.7 (acetylcholinesterase) inhibitor;
EC 3.1.1.8 (cholinesterase) inhibitor;
plant metabolite
alpha-aminopyridine
alpha-aminopyridine: RN given refers to parent cpd; structure in Merck Index, 9th ed, #485. aminopyridine : Compounds containing a pyridine skeleton substituted by one or more amine groups.		1.9610
metocurine
metocurine: from Chinese herb Cyclea hainanensis Mrr		7.6730isoquinolines
magnesium sulfate
Magnesium Sulfate: A small colorless crystal used as an anticonvulsant, a cathartic, and an electrolyte replenisher in the treatment of pre-eclampsia and eclampsia. It causes direct inhibition of action potentials in myometrial muscle cells. Excitation and contraction are uncoupled, which decreases the frequency and force of contractions. (From AMA Drug Evaluations Annual, 1992, p1083). magnesium sulfate : A magnesium salt having sulfate as the counterion.		3.4311magnesium salt;
metal sulfate;
organic magnesium salt		anaesthetic;
analgesic;
anti-arrhythmia drug;
anticonvulsant;
calcium channel blocker;
cardiovascular drug;
fertilizer;
tocolytic agent
androstane-3,17-diol
Androstane-3,17-diol: The unspecified form of the steroid, normally a major metabolite of TESTOSTERONE with androgenic activity. It has been implicated as a regulator of gonadotropin secretion.		14.011132317-hydroxy steroid;
3-hydroxy steroid;
androstanoid
vecuronium bromide
Vecuronium Bromide: Monoquaternary homolog of PANCURONIUM. A non-depolarizing neuromuscular blocking agent with shorter duration of action than pancuronium. Its lack of significant cardiovascular effects and lack of dependence on good kidney function for elimination as well as its short duration of action and easy reversibility provide advantages over, or alternatives to, other established neuromuscular blocking agents.. vecuronium bromide : The organic bromide salt of a 5alpha-androstane compound having 3alpha-acetoxy-, 17beta-acetoxy-, 2beta-piperidinino- and 16beta-N-methylpiperidinium substituents.		10.933411organic bromide salt;
quaternary ammonium salt		muscle relaxant;
neuromuscular agent;
nicotinic antagonist
sufentanil
Sufentanil: An opioid analgesic that is used as an adjunct in anesthesia, in balanced anesthesia, and as a primary anesthetic agent.. sufentanil : An anilide resulting from the formal condensation of the aryl amino group of 4-(methoxymethyl)-N-phenyl-1-[2-(2-thienyl)ethyl]piperidin-4-amine with propanoic acid.		10.243anilide;
ether;
piperidines;
thiophenes		anaesthesia adjuvant;
intravenous anaesthetic;
mu-opioid receptor agonist;
opioid analgesic
atracurium
Atracurium: A non-depolarizing neuromuscular blocking agent with short duration of action. Its lack of significant cardiovascular effects and its lack of dependence on good kidney function for elimination provide clinical advantage over alternate non-depolarizing neuromuscular blocking agents.. atracurium : A diester compound consisting of pentane-1,5-diol with both hydroxyls bearing 3-[1-(3,4-dimethoxybenzyl)-6,7-dimethoxy-2-methyl-3,4-dihydroisoquinolinium-2(1H)-yl]propanoyl groups.		9.08164diester;
quaternary ammonium ion		muscle relaxant;
nicotinic antagonist
alfentanil
Alfentanil: A short-acting opioid anesthetic and analgesic derivative of FENTANYL. It produces an early peak analgesic effect and fast recovery of consciousness. Alfentanil is effective as an anesthetic during surgery, for supplementation of analgesia during surgical procedures, and as an analgesic for critically ill patients.. alfentanil : A member of the class of piperidines that is piperidine having a 2-(4-ethyl-5-oxo-4,5-dihydro-1H-tetrazol-1-yl)ethyl group at the 1-position as well as N-phenylpropanamido- and methoxymethyl groups at the 4-position.		6.9710monocarboxylic acid amide;
piperidines		central nervous system depressant;
intravenous anaesthetic;
mu-opioid receptor agonist;
opioid analgesic;
peripheral nervous system drug
adenosine
quinquefolan B: isolated from roots of Panax quinquefolium L.; RN not in Chemline 10/87; RN from Toxlit		210adenosines;
purines D-ribonucleoside		analgesic;
anti-arrhythmia drug;
fundamental metabolite;
human metabolite;
vasodilator agent
cisatracurium
cisatracurium: RN refers to (1R-(1alpha,2alpha(1'R*,2'R*)))-isomer. cisatracurium : A diester that is the (1R,1'R,2R,2'R)-diastereoisomer of atracurium, a quaternary ammonium ion consisting of pentane-1,5-diol with both hydroxy functions bearing 3-[1-(3,4-dimethoxybenzyl)-6,7-dimethoxy-2-methyl-3,4-dihydroisoquinolinium-2(1H)-yl]propanoyl groups. The active species in the skeletal muscle relaxant cisatracurium besylate.		3.110diester;
quaternary ammonium ion		muscle relaxant;
nicotinic antagonist
lf 14
LF 14: affects mammalian non-myelinated nerve fibers; structure given in first source		1.9610
dihydrochandonium iodide
dihydrochandonium: RN given refers to di-iodide; RGH-4201 refers to di-bromide salt		2.3820
atropine
tropan-3alpha-yl 3-hydroxy-2-phenylpropanoate : A tropane alkaloid that is (1R,5)-8-methyl-8-azabicyclo[3.2.1]octane substituted by a (3-hydroxy-2-phenylpropanoyl)oxy group at position 3.		2.3820
pancuronium
Pancuronium: A bis-quaternary steroid that is a competitive nicotinic antagonist. As a neuromuscular blocking agent it is more potent than CURARE but has less effect on the circulatory system and on histamine release.. pancuronium : A steroid ester in which a 5alpha-androstane skeleton is C-3alpha- and C-17beta-disubstituted with acetoxy groups and 2beta- and 16beta-disubstituted with 1-methylpiperidinium-1-yl groups. It is a non-depolarizing curare-mimetic muscle relaxant.		11.514721acetate ester;
steroid ester		cholinergic antagonist;
muscle relaxant;
nicotinic antagonist
rocuronium
Rocuronium: An androstanol non-depolarizing neuromuscular blocking agent. It has a mono-quaternary structure and is a weaker nicotinic antagonist than PANCURONIUM.. rocuronium : A 5alpha-androstane compound having 3alpha-hydroxy-, 17beta-acetoxy-, 2beta-morpholino- and 16beta-N-allyllyrrolidinium substituents.		8.371223alpha-hydroxy steroid;
acetate ester;
androstane;
morpholines;
quaternary ammonium ion;
tertiary amino compound		drug allergen;
muscle relaxant;
neuromuscular agent
enkephalin, leucine
Enkephalin, Leucine: One of the endogenous pentapeptides with morphine-like activity. It differs from MET-ENKEPHALIN in the LEUCINE at position 5. Its first four amino acid sequence is identical to the tetrapeptide sequence at the N-terminal of BETA-ENDORPHIN.. Leu-enkephalin : A pentapeptide comprising L-tyrosine, glycine, glycine, L-phenylalanine and L-leucine residues joined in sequence by peptide linkages. It is an endogenous opioid peptide produced in vertebrate species, including rodents, primates and humans that results from decomposition of proenkephalin or dynorphin and exhibits antinociceptive properties.		2.3820pentapeptide;
peptide zwitterion		analgesic;
delta-opioid receptor agonist;
human metabolite;
mu-opioid receptor agonist;
neurotransmitter;
rat metabolite
etomidate
Etomidate: Imidazole derivative anesthetic and hypnotic with little effect on blood gases, ventilation, or the cardiovascular system. It has been proposed as an induction anesthetic.. etomidate : The ethyl ester of 1-[(1R)-1-phenylethyl]-1H-imidazole-5-carboxylic acid. It is an intravenous general anaesthetic with no analgesic activity.		3.3611ethyl ester;
imidazoles		intravenous anaesthetic;
sedative
thiobarbital
thiobarbital: structure		1.9710
capsaicin
ALGRX-4975: an injectable capsaicin (TRPV1 receptor agonist) formulation for longlasting pain relief. capsaicinoid : A family of aromatic fatty amides produced as secondary metabolites by chilli peppers.		210capsaicinoidnon-narcotic analgesic;
TRPV1 agonist;
voltage-gated sodium channel blocker
thiopental
Thiopental: A barbiturate that is administered intravenously for the induction of general anesthesia or for the production of complete anesthesia of short duration.. thiopental : A barbiturate, the structure of which is that of 2-thiobarbituric acid substituted at C-5 by ethyl and sec-pentyl groups.		2.3720barbituratesanticonvulsant;
drug allergen;
environmental contaminant;
intravenous anaesthetic;
sedative;
xenobiotic
mivacurium
Mivacurium: An isoquinoline derivative that is used as a short-acting non-depolarizing agent.		7.6991isoquinolines
toxiferine
Toxiferine: A curare alkaloid that is a very potent competitive nicotinic antagonist at the neuromuscular junction.		1.9610alkaloid
naloxone
Naloxone: A specific opiate antagonist that has no agonist activity. It is a competitive antagonist at mu, delta, and kappa opioid receptors.. naloxone : A synthetic morphinane alkaloid that is morphinone in which the enone double bond has been reduced to a single bond, the hydrogen at position 14 has been replaced by a hydroxy group, and the methyl group attached to the nitrogen has been replaced by an allyl group. A specific opioid antagonist, it is used (commonly as its hydrochloride salt) to reverse the effects of opioids, both following their use of opioids during surgery and in cases of known or suspected opioid overdose.		1.9710morphinane alkaloid;
organic heteropentacyclic compound;
tertiary alcohol		antidote to opioid poisoning;
central nervous system depressant;
mu-opioid receptor antagonist
rapacuronium
rapacuronium: 16-N-allyl-17-beta-propionate analog of vecuronium; structure given in first source		4.2930steroid ester
lisinopril
Lisinopril: One of the ANGIOTENSIN-CONVERTING ENZYME INHIBITORS (ACE inhibitors), orally active, that has been used in the treatment of hypertension and congestive heart failure.		3.1110dipeptideEC 3.4.15.1 (peptidyl-dipeptidase A) inhibitor
enalapril
Enalapril: An angiotensin-converting enzyme inhibitor that is used to treat HYPERTENSION and HEART FAILURE.. enalapril : A dicarboxylic acid monoester that is ethyl 4-phenylbutanoate in which a hydrogen alpha to the carboxy group is substituted by the amino group of L-alanyl-L-proline (S-configuration).		3.4920dicarboxylic acid monoester;
dipeptide		antihypertensive agent;
EC 3.4.15.1 (peptidyl-dipeptidase A) inhibitor;
geroprotector;
prodrug
enkephalin, leucine-2-alanine
Enkephalin, Leucine-2-Alanine: A delta-selective opioid (ANALGESICS, OPIOID). It can cause transient depression of mean arterial blood pressure and heart rate.		2.3820
enkephalin-leu, ala(2)-arg(6)-
enkephalin-Leu, Ala(2)-Arg(6)-: RN refers to (L-Arg-L-Tyr-D-Ala-L-Phe-L-Leu)-isomer		2.3820
3-deacetylvecuronium
3-deacetylvecuronium: RN given refers to parent cpd (2beta,3alpha,5alpha,16beta,17beta)-isomer; structure given in first source		1.9710steroid ester
dioxonium
dioxonium: RN given refers to diiodide without isomeric designation; structure		3.0610
glucagon
Glucagon: A 29-amino acid pancreatic peptide derived from proglucagon which is also the precursor of intestinal GLUCAGON-LIKE PEPTIDES. Glucagon is secreted by PANCREATIC ALPHA CELLS and plays an important role in regulation of BLOOD GLUCOSE concentration, ketone metabolism, and several other biochemical and physiological processes. (From Gilman et al., Goodman and Gilman's The Pharmacological Basis of Therapeutics, 9th ed, p1511). glucagon : A 29-amino acid peptide hormone consisting of His, Ser, Gln, Gly, Thr, Phe, Thr, Ser, Asp, Tyr, Ser, Lys, Tyr, Leu, Asp, Ser, Arg, Arg, Ala, Gln, Asp, Phe, Val, Gln, Trp, Leu, Met, Asn and Thr residues joined in sequence.		1.9910peptide hormone
norgestrel
Norgestrel: A synthetic progestational agent with actions similar to those of PROGESTERONE. This racemic or (+-)-form has about half the potency of the levo form (LEVONORGESTREL). Norgestrel is used as a contraceptive, ovulation inhibitor, and for the control of menstrual disorders and endometriosis.		3.1110
allopurinol
Allopurinol: A XANTHINE OXIDASE inhibitor that decreases URIC ACID production. It also acts as an antimetabolite on some simpler organisms.. allopurinol : A bicyclic structure comprising a pyrazole ring fused to a hydroxy-substituted pyrimidine ring.		1.9710nucleobase analogue;
organic heterobicyclic compound		antimetabolite;
EC 1.17.3.2 (xanthine oxidase) inhibitor;
gout suppressant;
radical scavenger
ConditionIndicatedRelationship StrengthStudiesTrials
Neuromuscular Blockade
The intentional interruption of transmission at the NEUROMUSCULAR JUNCTION by external agents, usually neuromuscular blocking agents. It is distinguished from NERVE BLOCK in which nerve conduction (NEURAL CONDUCTION) is interrupted rather than neuromuscular transmission. Neuromuscular blockade is commonly used to produce MUSCLE RELAXATION as an adjunct to anesthesia during surgery and other medical procedures. It is also often used as an experimental manipulation in basic research. It is not strictly speaking anesthesia but is grouped here with anesthetic techniques. The failure of neuromuscular transmission as a result of pathological processes is not included here.		05.9774
Neuromuscular Junction Diseases
Conditions characterized by impaired transmission of impulses at the NEUROMUSCULAR JUNCTION. This may result from disorders that affect receptor function, pre- or postsynaptic membrane function, or ACETYLCHOLINESTERASE activity. The majority of diseases in this category are associated with autoimmune, toxic, or inherited conditions.		03.511
Sensitivity and Specificity
Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed)		02.4120
Clostridium tetani Infection
[description not available]		03.4311
Tetanus
A disease caused by tetanospasmin, a powerful protein toxin produced by CLOSTRIDIUM TETANI. Tetanus usually occurs after an acute injury, such as a puncture wound or laceration. Generalized tetanus, the most common form, is characterized by tetanic muscular contractions and hyperreflexia. Localized tetanus presents itself as a mild condition with manifestations restricted to muscles near the wound. It may progress to the generalized form.		03.4311
Disease Models, Animal
Naturally-occurring or experimentally-induced animal diseases with pathological processes analogous to human diseases.		02.0510
Airway Hyper-Responsiveness
[description not available]		02.0310
Bronchial Hyperreactivity
Tendency of the smooth muscle of the tracheobronchial tree to contract more intensely in response to a given stimulus than it does in the response seen in normal individuals. This condition is present in virtually all symptomatic patients with asthma. The most prominent manifestation of this smooth muscle contraction is a decrease in airway caliber that can be readily measured in the pulmonary function laboratory.		02.0310
Arteriosclerosis, Coronary
[description not available]		04.3411
Anesthesia
A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures.		09.49209
Coronary Artery Disease
Pathological processes of CORONARY ARTERIES that may derive from a congenital abnormality, atherosclerotic, or non-atherosclerotic cause.		04.3411
Allergy, Drug
[description not available]		01.9610
Complication, Intraoperative
[description not available]		01.9610
Drug Hypersensitivity
Immunologically mediated adverse reactions to medicinal substances used legally or illegally.		01.9610
Muscle Relaxation
That phase of a muscle twitch during which a muscle returns to a resting position.		06.4492
Pregnancy
The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.		06.14121
Muscle Contraction
A process leading to shortening and/or development of tension in muscle tissue. Muscle contraction occurs by a sliding filament mechanism whereby actin filaments slide inward among the myosin filaments.		06.89165
Body Weight
The mass or quantity of heaviness of an individual. It is expressed by units of pounds or kilograms.		03.7521
Aging
The gradual irreversible changes in structure and function of an organism that occur as a result of the passage of time.		07.0573
Coronary Heart Disease
[description not available]		02.3720
Heart Valve Diseases
Pathological conditions involving any of the various HEART VALVES and the associated structures (PAPILLARY MUSCLES and CHORDAE TENDINEAE).		03.7621
Coronary Disease
An imbalance between myocardial functional requirements and the capacity of the CORONARY VESSELS to supply sufficient blood flow. It is a form of MYOCARDIAL ISCHEMIA (insufficient blood supply to the heart muscle) caused by a decreased capacity of the coronary vessels.		02.3720
Aortic Diseases
Pathological processes involving any part of the AORTA.		01.9610
Arrhythmia
[description not available]		03.3711
Cardiac Diseases
[description not available]		04.0631
Arrhythmias, Cardiac
Any disturbances of the normal rhythmic beating of the heart or MYOCARDIAL CONTRACTION. Cardiac arrhythmias can be classified by the abnormalities in HEART RATE, disorders of electrical impulse generation, or impulse conduction.		03.3711
Heart Diseases
Pathological conditions involving the HEART including its structural and functional abnormalities.		04.0631
Heart Disease, Ischemic
[description not available]		03.7721
Myocardial Ischemia
A disorder of cardiac function caused by insufficient blood flow to the muscle tissue of the heart. The decreased blood flow may be due to narrowing of the coronary arteries (CORONARY ARTERY DISEASE), to obstruction by a thrombus (CORONARY THROMBOSIS), or less commonly, to diffuse narrowing of arterioles and other small vessels within the heart. Severe interruption of the blood supply to the myocardial tissue may result in necrosis of cardiac muscle (MYOCARDIAL INFARCTION).		03.7721
Diplopia
A visual symptom in which a single object is perceived by the visual cortex as two objects rather than one. Disorders associated with this condition include REFRACTIVE ERRORS; STRABISMUS; OCULOMOTOR NERVE DISEASES; TROCHLEAR NERVE DISEASES; ABDUCENS NERVE DISEASES; and diseases of the BRAIN STEM and OCCIPITAL LOBE.		03.3711
Chronic Kidney Failure
[description not available]		02.3820
Kidney Failure, Chronic
The end-stage of CHRONIC RENAL INSUFFICIENCY. It is characterized by the severe irreversible kidney damage (as measured by the level of PROTEINURIA) and the reduction in GLOMERULAR FILTRATION RATE to less than 15 ml per min (Kidney Foundation: Kidney Disease Outcome Quality Initiative, 2002). These patients generally require HEMODIALYSIS or KIDNEY TRANSPLANTATION.		02.3820
Cardiovascular Stroke
[description not available]		03.3711
Myocardial Infarction
NECROSIS of the MYOCARDIUM caused by an obstruction of the blood supply to the heart (CORONARY CIRCULATION).		03.3711
Embryopathies
[description not available]		03.3711
Craniocerebral Injuries
[description not available]		03.3711
Injuries, Multiple
[description not available]		03.3711
Craniocerebral Trauma
Traumatic injuries involving the cranium and intracranial structures (i.e., BRAIN; CRANIAL NERVES; MENINGES; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage.		03.3711
Alcoholic Cirrhosis
[description not available]		01.9810
Liver Cirrhosis, Alcoholic
FIBROSIS of the hepatic parenchyma due to chronic excess ALCOHOL DRINKING.		01.9810
Cardiovascular Diseases
Pathological conditions involving the CARDIOVASCULAR SYSTEM including the HEART; the BLOOD VESSELS; or the PERICARDIUM.		02.910
Asystole
[description not available]		01.9910
Hyperpotassemia
[description not available]		01.9910
Peripheral Nerve Diseases
[description not available]		01.9910
Atrioventricular Nodal Re-Entrant Tachycardia
[description not available]		01.9910
Heart Arrest
Cessation of heart beat or MYOCARDIAL CONTRACTION. If it is treated within a few minutes, heart arrest can be reversed in most cases to normal cardiac rhythm and effective circulation.		01.9910
Hyperkalemia
Abnormally high potassium concentration in the blood, most often due to defective renal excretion. It is characterized clinically by electrocardiographic abnormalities (elevated T waves and depressed P waves, and eventually by atrial asystole). In severe cases, weakness and flaccid paralysis may occur. (Dorland, 27th ed)		01.9910
Peripheral Nervous System Diseases
Diseases of the peripheral nerves external to the brain and spinal cord, which includes diseases of the nerve roots, ganglia, plexi, autonomic nerves, sensory nerves, and motor nerves.		01.9910
Tachycardia, Ventricular
An abnormally rapid ventricular rhythm usually in excess of 150 beats per minute. It is generated within the ventricle below the BUNDLE OF HIS, either as autonomic impulse formation or reentrant impulse conduction. Depending on the etiology, onset of ventricular tachycardia can be paroxysmal (sudden) or nonparoxysmal, its wide QRS complexes can be uniform or polymorphic, and the ventricular beating may be independent of the atrial beating (AV dissociation).		01.9910
Adenoma, beta-Cell
[description not available]		01.9910
Cancer of Pancreas
[description not available]		01.9910
Insulinoma
A benign tumor of the PANCREATIC BETA CELLS. Insulinoma secretes excess INSULIN resulting in HYPOGLYCEMIA.		01.9910
Pancreatic Neoplasms
Tumors or cancer of the PANCREAS. Depending on the types of ISLET CELLS present in the tumors, various hormones can be secreted: GLUCAGON from PANCREATIC ALPHA CELLS; INSULIN from PANCREATIC BETA CELLS; and SOMATOSTATIN from the SOMATOSTATIN-SECRETING CELLS. Most are malignant except the insulin-producing tumors (INSULINOMA).		01.9910
Complications, Pregnancy
[description not available]		0210
Placental Insufficiency
Failure of the PLACENTA to deliver an adequate supply of nutrients and OXYGEN to the FETUS.		0210
Benign Supratentorial Neoplasms
[description not available]		03.3911
Innate Inflammatory Response
[description not available]		0210
Extravasation of Contrast Media
[description not available]		0210
Inflammation
A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function.		0210
Cancer of Mediastinum
[description not available]		03.3911
Mediastinal Neoplasms
Tumors or cancer of the MEDIASTINUM.		03.3911
Retroperitoneal Neoplasms
New abnormal growth of tissue in the RETROPERITONEAL SPACE.		03.3911
Acute Kidney Failure
[description not available]		01.9810
Acute Kidney Injury
Abrupt reduction in kidney function. Acute kidney injury encompasses the entire spectrum of the syndrome including acute kidney failure; ACUTE KIDNEY TUBULAR NECROSIS; and other less severe conditions.		01.9810
Anti-MuSK Myasthenia Gravis
[description not available]		01.9810
Myasthenia Gravis
A disorder of neuromuscular transmission characterized by fatigable weakness of cranial and skeletal muscles with elevated titers of ACETYLCHOLINE RECEPTORS or muscle-specific receptor tyrosine kinase (MuSK) autoantibodies. Clinical manifestations may include ocular muscle weakness (fluctuating, asymmetric, external ophthalmoplegia; diplopia; ptosis; and weakness of eye closure) and extraocular fatigable weakness of facial, bulbar, respiratory, and proximal limb muscles. The disease may remain limited to the ocular muscles (ocular myasthenia). THYMOMA is commonly associated with this condition.		06.9810
Bile Duct Obstruction, Extrahepatic
[description not available]		01.9710
Blood Pressure, High
[description not available]		03.3611
Hypertension
Persistently high systemic arterial BLOOD PRESSURE. Based on multiple readings (BLOOD PRESSURE DETERMINATION), hypertension is currently defined as when SYSTOLIC PRESSURE is consistently greater than 140 mm Hg or when DIASTOLIC PRESSURE is consistently 90 mm Hg or more.		03.3611
Female Genital Diseases
[description not available]		01.9710
Genital Diseases, Female
Pathological processes involving the female reproductive tract (GENITALIA, FEMALE).		01.9710
Bradyarrhythmia
[description not available]		03.3511
Blood Pressure, Low
[description not available]		03.3511
Bradycardia
Cardiac arrhythmias that are characterized by excessively slow HEART RATE, usually below 50 beats per minute in human adults. They can be classified broadly into SINOATRIAL NODE dysfunction and ATRIOVENTRICULAR BLOCK.		03.3511
Hypotension
Abnormally low BLOOD PRESSURE that can result in inadequate blood flow to the brain and other vital organs. Common symptom is DIZZINESS but greater negative impacts on the body occur when there is prolonged depravation of oxygen and nutrients.		03.3511
Metabolic Acidosis
[description not available]		01.9710
Acidosis, Respiratory
Respiratory retention of carbon dioxide. It may be chronic or acute.		01.9710
Alkalosis
A pathological condition that removes acid or adds base to the body fluids.		06.9710
Alkalosis, Respiratory
A state due to excess loss of carbon dioxide from the body. (Dorland, 27th ed)		01.9710
Acidosis
A pathologic condition of acid accumulation or depletion of base in the body. The two main types are RESPIRATORY ACIDOSIS and metabolic acidosis, due to metabolic acid build up.		06.9710
Congenital Dysplasia Of The Hip
[description not available]		01.9610
ENT Diseases
[description not available]		01.9610
Female Genital Neoplasms
[description not available]		01.9610
Pregnancy, Tubal
The most common (		01.9610
Genital Neoplasms, Female
Tumor or cancer of the female reproductive tract (GENITALIA, FEMALE).		01.9610