title: Hexafluorenium-suxamethonium interaction in patients with normal versus atypical cholinesterase.
abstract: The effect of hexafluorenium 0.3 mg/kg on the neuromuscular block of suxamethonium 0.1 mg/kg in a child with homozygote atypical plasma cholinesterase activity and in one of his normal brothers has been compared. In the normal child, hexafluorenium produced a marked potentiation of suxamethonium block, while partially antagonizing the block in the atypical homozygote child. In both situations, the hexafluorenium-suxamethonium block appeared to be antidepolarizing in nature as indicated by tetanic fade and post-tetanic facilitation. It is concluded that, in man, hexafluorenium can modify the action of suxamethonium by two different mechanisms. In patients with normal plasma cholinesterase activity, the anti-esterase effect predominates and results in marked potentiation of suxamethonium block, while in atypical homozygotes a direct antidepolarizing action at the neuromuscular junction may result in a diminished response.
mesh_terms: D002648:Child; D002675:Child, Preschool; D002800:Cholinesterase Inhibitors / Q000494:pharmacology*; D002802:Cholinesterases / Q000097:blood; D004357:Drug Synergism; D004558:Electric Stimulation; D005449:Fluorenes / Q000494:pharmacology*; D006584:Hexamethonium Compounds; D006720:Homozygote; D006801:Humans; D008297:Male; D009119:Muscle Contraction / Q000187:drug effects; D000644:Quaternary Ammonium Compounds / Q000494:pharmacology; D013390:Succinylcholine / Q000037:antagonists & inhibitors / Q000494:pharmacology*
chemical_list: D002800:Cholinesterase Inhibitors; D005449:Fluorenes; D006584:Hexamethonium Compounds; D000644:Quaternary Ammonium Compounds; C005034:hexafluorenium; D002802:Cholinesterases; D013390:Succinylcholine