Review important side effects of acetylcholinesterase administration

Increasing the available ACh at the NMJ (a nicotinic receptor) also stimulates muscarinic cholinergic receptors. Of particular concern is the effect on cardiac conduction. Unopposed muscarinic effects impair sinus-node conduction, resulting in sinus bradycardia, junctional rhythms, and in the extreme asystole. To prevent this, anticholinergics are administered in concert with the acetylcholinesterase. Glycopyrrolate, 7 to 15 mcg/kg, is coadministered with neostigmine and atropine, 7 to 10 mcg/kg, with edrophonium so the onset of anticholinergic activity is appropriately timed with the onset of acetylcholinesterase inhibition.

Was this article helpful?

0 0

Post a comment