Malignant Hyperthermia Dantrolene is the drug of choice for the treatment of MH crisis. Dantrolene works by blocking the release of calcium from the sarcoplasmic reticulum of skeletal muscle cells. It crosses the placenta and can be detected in the fetus after maternal administration.
- 1 What is the mechanism of action of dantrolene?
- 2 How does dantrolene lower temperature?
- 3 What does dantrolene block?
- 4 Is dantrolene used for malignant hyperthermia?
- 5 How does succinylcholine cause malignant hyperthermia?
- 6 How do you administer dantrolene for malignant hyperthermia?
- 7 Does succinylcholine treat malignant hyperthermia?
- 8 How quickly does dantrolene work?
- 9 How long does it take for dantrolene to work?
- 10 Does dantrolene cause hyperkalemia?
- 11 Is dantrolene better than baclofen?
- 12 When is dantrolene given?
- 13 What is dantrolene an antidote for?
What is the mechanism of action of dantrolene?
Dantrolene depresses excitation-contraction coupling in skeletal muscle by binding to the ryanodine receptor 1, and decreasing intracellular calcium concentration. Ryanodine receptors mediate the release of calcium from the sarcoplasmic reticulum, an essential step in muscle contraction.
How does dantrolene lower temperature?
Dantrolene crosses the blood-brain barrier and produces mild sedation (13). Like other sedatives (14), it may thus have a central thermoregulatory action. However, the drug’s primary mechanism of action is undoubtedly inhibition of excitation-contraction coupling skeletal muscles (15).
What does dantrolene block?
Dantrolene blocks the release of calcium and disassociates excitation–contraction coupling leading to hypotonia and muscle weakness.
Is dantrolene used for malignant hyperthermia?
While there are many indications for the use of dantrolene, its primary indication, and FDA-approved usage in both children and adults, is for the treatment of malignant hyperthermia: the very rare but life-threatening disorder triggered by general anesthesia.
How does succinylcholine cause malignant hyperthermia?
Malignant hyperthermia (MH) is a clinical syndrome that occurs during anesthesia with a potent volatile agent (e.g., halothane) and the depolarizing muscle relaxant succinylcholine, which produces rapidly increasing temperature and extreme acidosis.
How do you administer dantrolene for malignant hyperthermia?
Malignant hyperthermia treatment: Administer by continuous, rapid IV push. Malignant hyperthermia prophylaxis: Administer IV over approximately 1 hour. Reconstitute 250 mg by adding 5 mL of Sterile Water for Injection (without a bacteriostatic agent). Do not use any other solutions.
Does succinylcholine treat malignant hyperthermia?
The European Malignant Hyperthermia Group guidelines recommend that dantrolene should be available wherever volatile anesthetics or succinylcholine are used .
How quickly does dantrolene work?
Myoglobinuria should be watched for and treated with fluids and diuretics if it occurs. The creatine kinase level will peak about 8-10 hours after the event and should be followed until it returns to near normal. A newer version of dantrolene dissolves in 15 seconds and thereby improves the rapidity of treatment.
How long does it take for dantrolene to work?
Getting the most from your treatment
This is so your doctor can check on your progress, as it may take a few weeks before you begin to feel the benefit from dantrolene. If after six weeks or so you don’t feel you are improving, please speak with your doctor about this, as your treatment could need reviewing.
Does dantrolene cause hyperkalemia?
When used with calcium channel blockers (verapamil or diltiazem), dantrolene may produce life-threatening hyperkalemia and myocardial depression. Otherwise there does not appear to be significant negative interaction with other drugs.
Is dantrolene better than baclofen?
Dantrium (dantrolene) is not a first-choice treatment for general muscle spasms because it can damage your liver. Relaxes your muscles. Lioresal (baclofen) is a first choice treatment for muscle spasticity caused by multiple sclerosis or spinal cord injuries, but it’s not recommended for other types of muscle spasms.
When is dantrolene given?
Oral Administration of Dantrium Capsules: Administer 4 to 8 mg/kg/day of oral Dantrium in three or four divided doses for 1 or 2 days prior to surgery, with the last dose being given with a minimum of water approximately 3 to 4 hours before scheduled surgery.
What is dantrolene an antidote for?
The first volume provides an introduction to the series and reviews three antidotes: naloxone, a specific opioid antagonist used in the treatment of opiate poisoning; flumazenil, used to reverse the sedative, anti-convulsant and muscle-relaxant effects of benzodiazepines; and dantrolene sodium, used in the treatment of …