Need to know porphyria, pseudocholinesterase,

 

 

Porphyria

- midazolam is safe

- propofol is safe

 

Esterase (Pseudocholinesterase, plasma cholinesterase, + others??)

 

Pseudocholinesterase

 

======

Dantrolene also contains mannitol and sodium hydroxide

 

Mannitol is also present in vecuronium

 

Sodium hydroxide also present in propofol

 

Dantrolene

Hydantoin derivative

Demonstrated effective in pigs in 1975

 

Elimination halflife 9-12 hr

Exact mechanism of action unknown

Interacts with RYR1 to prevent Ca2+ release from SR

S/E:

• Sedation, confusion
• Muscular weakenss
• Phlebitis/tissue necrosis if extravasated
• Floppy child syndrome (obstetrics)

C/I:

• Calcium channel blockers (esp verapamil) --> hyperkalaemia, severe cardiac depression and arrest

 

=====