Neuromuscular blockade reversal

[Jibby321]

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Why can't neostigmine be administered to a patient with NM blockade if they have a train of 4 score of zero? Any links to literature? I tried searching but couldn't find anything.

Thank you

 

[masaraksh]

Because the pharmacy is closed

 

[mik30102]

Hmm never did any of this in pharmacy school 😛. Did a search though and it seems it is just because studies have shown neostigmine just does not work well at these levels of inhibition and that you are better off waiting a bit and putting the patient on mechanical ventilation if need be. https://books.google.com/books?id=-...v=onepage&q=neostigmine train of four&f=false

 

[Psai]

I think it prolongs the blockade instead of reversing it at that point

 

[Jibby321]

Thank you all. I found basically TOF of zero just has too many receptors antagonized so nestingmine won't make any difference in reversal. Which is what I thought before. Was just looking for confirmation. Thanks again.