Understanding Anesthesiology - The Global Regional Anesthesia ...

Anticholinesterase
Anticholinesterases act in the synaptic cleft of the neuromuscular junction to reverse the effect
of non-depolarizing muscle relaxants (NDMR). They inhibit the action of cholinesterase
thereby decreasing the rate of breakdown of acetylcholine (Ach). The increased concentration
of Ach in turn displaces the NDMR from the Ach receptors and thus restores normal
neuromuscular transmission.
Because anticholinesterases exert their effect at both nicotinic and muscarinic Ach receptors,
their administration must be accompanied by an anitcholinergic (such as atropine or glycopyrrolate)
in order to avoid muscarinic effects including bradycardia, bronchospasm and
excessive salivation.
Neostigmine is a commonly-used anticholinesterase.
Related Glossary Terms
Acetylcholine, Anticholinergic, Atropine, Autonomic nervous system, Cholinesterase, Extubation,
Glycopyrrolate, Muscarinic, Myasthenia gravis, Neostigmine, Neuromuscular junction,
Nicotinic, Non-depolarizing muscle relaxants, Peripheral nerve stimulator, Residual
block, Vagus nerve
Index
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Chapter 3 - General Anesthesia
Chapter 6 - Anticholinesterase and Anticholinergics
Chapter 6 - Anticholinesterase and Anticholinergics
Chapter 6 - Anticholinesterase and Anticholinergics