Phenytoin-induced resistance to vecuronium

Chronic phenytoin therapy causes resistance to some nondepolarising muscle relaxants. We have confirmed that this resistance is seen with vecuronium and suggest that at least a week of phenytoin therapy is required for a significant effect to develop. The mechanism of this resistance is not known. W...

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Bibliographic Details
Published in:Anaesthesia and intensive care 1993-04, Vol.21 (2), p.185-191
Main Authors: PLATT, P. R, THACKRAY, N. M
Format: Article
Language:English
Subjects:
Anesthesia Recovery Period
Anesthetics. Neuromuscular blocking agents
Biological and medical sciences
Drug Interactions
Drug Resistance
Humans
Medical sciences
Middle Aged
Multivariate Analysis
Neuromuscular Junction - drug effects
Neuromuscular Junction - physiology
Neuropharmacology
Neurosurgery
Pharmacology. Drug treatments
Phenytoin - administration & dosage
Phenytoin - blood
Phenytoin - pharmacology
Potassium - blood
Receptors, Cholinergic - drug effects
Receptors, Cholinergic - physiology
Regression Analysis
Succinylcholine - pharmacology
Time Factors
Vecuronium Bromide - administration & dosage
Vecuronium Bromide - pharmacology
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Summary:Chronic phenytoin therapy causes resistance to some nondepolarising muscle relaxants. We have confirmed that this resistance is seen with vecuronium and suggest that at least a week of phenytoin therapy is required for a significant effect to develop. The mechanism of this resistance is not known. We have shown that an exaggerated rise in serum potassium after succinylcholine does not occur in patients with demonstrated resistance to vecuronium from chronic phenytoin therapy. This would suggest that significant extrajunctional acetylcholine receptor proliferation is an unlikely mechanism.
ISSN:0310-057X
1448-0271
DOI:10.1177/0310057X9302100209