Pipecuronium - a new neuromuscular blocker
Article Abstract:
Pipecuronium bromide is a member of a class of drugs commonly used during general anesthesia and endotracheal intubation (insertion of tubing in the windpipe), which is now available for use in the US. Many drugs have been used during anesthesia to relax or paralyze the skeletal muscles, enabling usage of lower doses of anesthetic. Pipecuronium bromide is one of the long-acting drugs in this class; it is not recommended for use in procedures lasting less than 90 minutes, or for patients who need extended mechanical ventilation. Pipecuronium is similar to other curare-like drugs, blocking the effects of acetylcholine (a hormone secreted by nerves) at muscles and other sites. The drug effects are reversible with other drugs like neostigmine. However, effects may be prolonged or unpredictable in patients with kidney disorders or those who are obese. A major advantage is that, unlike similar drugs, pipecuronium does not increase heart rate or histamine secretion, which can cause low blood pressure and bronchoconstriction. Side effects, observed in three percent of patients, have included low heart rate and low or high blood pressure. In addition, like other drugs in this class, muscle weakness may persist following surgery. This review suggests that pipecuronium is an effective, long-lasting neuromuscular relaxant with few cardiovascular side effects. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Medical Letter on Drugs and Therapeutics
Subject: Health
ISSN: 0025-732X
Year: 1990
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Nisoldipine - a new calcium channel blocker for hypertension
Article Abstract:
The extended-release calcium channel blocker nisoldipine (Sular) may be an effective treatment for mild to moderate hypertension, or high blood pressure. Similar in structure to nifedipine, nisoldipine acts as a much stronger vasodilator. Although formal evaluation of nisoldipine has not been completed, preliminary reports suggest its antihypertensive effectiveness at daily doses of 20 to 60 milligrams (mg). The manufacturer recommends starting with a dose of 20 mg, although older patients should start with 10 mg. Long-acting nisoldipine may cause side effects similar to other calcium channel blockers, such as dizziness, headache, and rapid heart beat. The cost of long-acting nisoldipine is lower than other comparable antihypertensive drugs.
Publication Name: Medical Letter on Drugs and Therapeutics
Subject: Health
ISSN: 0025-732X
Year: 1996
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Which beta blocker?
Article Abstract:
Any beta blocker can be used to treat hypertension and arrhythmia but only certain beta blockers should be used for heart failure, heart attack, or angina pectoris. A table of all 15 beta blockers available in the US contains information on cost, dosage, and indications.
Publication Name: Medical Letter on Drugs and Therapeutics
Subject: Health
ISSN: 0025-732X
Year: 2001
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