In pseudocholinesterase deficiency, drug to be used cautiously is-
Ans. is 'b' i.e., Succinylcholine Cholinesterase At cholinergic nerve endings, in erythrocytes, and gray matter there is an enzyme that specfically destroys acetylcholine, true cholinesterase or acetylcholinestrase. In various tissues, especially in plasma, liver, white matter & intestine, there are other esterases which are not specific for acetylcholine but which also destroy other esters, these are called nonspecific or pseudocholinesterase or butyrylcholinesterase. The drugs hydrolyzed by pseudocholinesterase are (Miller 5th/e p. 419, 420) Succinylcholine Cocaine Mivacurium Bambuteral Remifentanil Procaine Pseudocholinesterase is more sensitive to organophosphate anticholinesterase, while true acetylcholinesterase is more sensitive to carbamate anticholinesterase (Physostigmine). Condions where pseudocholinesterase level decreases. Pregnancy Malnutrition CRF Burns Collegen vascular disease Hypothyroidism Malignancy Liver failure
Barbiturate
Succinylcholine
Halothane
Gallamine