Pancuronium improves the neuromuscular transmission defect of human organophosphate intoxication.
Two patients with acute severe organophosphate intoxication showed (1) single evoked compound muscle action potentials (CMAP) with repetitive discharges and (2) prominent decremental responses of CMAP with 20 and 50 Hz supramaximal nerve stimulation. Following the intravenous injection of single small doses of pancuronium, marked improvement in these abnormalities occurred and persisted for several hours. We postulate that the physiologic improvement following low-dose pancuronium results from blockade of acetylcholine receptors, especially those located on the terminal axon responsible for antidromic backfiring.
Besser
R
R
Department of Neurology, University of Mainz, West Germany.
Vogt
T
T
Gutmann
L
L
D000200:Action Potentials / Q000187:drug effects; D006801:Humans; D007306:Insecticides / Q000506:poisoning*; D054833:Isoindoles; D008297:Male; D008475:Median Nerve / Q000187:drug effects / Q000503:physiopathology; D009132:Muscles / Q000187:drug effects / Q000503:physiopathology; D009469:Neuromuscular Junction / Q000187:drug effects* / Q000502:physiology; D062025:Organophosphate Poisoning; D063086:Organothiophosphates; D009946:Organothiophosphorus Compounds / Q000506:poisoning*; D010197:Pancuronium / Q000627:therapeutic use*; D010278:Parathion / Q000506:poisoning*; D013406:Suicide, Attempted; D009435:Synaptic Transmission / Q000187:drug effects*
D007306:Insecticides; D054833:Isoindoles; D063086:Organothiophosphates; D009946:Organothiophosphorus Compounds; D010278:Parathion; C003620:dialifor; D010197:Pancuronium