Neuromuscular Blocker Reversal - Paralytics (Part 4) - ICU Drips

In this this final lesson we take a look at the intricacies of the group of medications that we have available when it comes to neuromuscular blocker reversal.

We start off with a quick overview of the autonomic nervous system, focusing on the parasympathetic nervous system and the use of acetylcholine as a messenger to activate the muscarinic receptors. The reason this is important is in order to reverse our paralytics, we need to provide high amounts of acetylcholine. The way that we do this is by blocking an enzyme called acetylcholinesterase that normally breaks down Ach.

Unfortunately though, these medications block this enzyme throughout our patients bodies and lead to an abundance of Ach everywhere which can lead to massive activation of their parasympathetic nervous system and comes with some very serious side effects, including bradycardia and asystole.

In order to prevent this from happening, we have to use an anti-muscarinic (anticholinergic) drug to block the muscarinic receptors from being activated by Ach. These medications must be given at the same time that our acetylcholinesterase inhibitors are given. We have a few medications that can do the job, but Glycopyrrolate is our first line drug, backed up by atropine when that medication fails to perform.

We conclude the lesson talking about a newcomer to the world of paralytic reversal with a medication called Sugammadex that directly binds our aminosteroids and prevents them from activating Ach receptors.

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Don't forget to check out the playlist for this series of lessons here: https://www.youtube.com/playlist?list=PL2oVjKTYocdPLrS0odnyih8wf6zZ7WfVW

Also check out these other great lessons and series of lessons below!

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Blood Tubes - Order of Draw: https://youtu.be/mAmwdDdbkUI
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Видео Neuromuscular Blocker Reversal - Paralytics (Part 4) - ICU Drips канала ICU Advantage