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      Discovery, development, and clinical application of sugammadex sodium, a selective relaxant binding agent

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          Abstract

          Neuromuscular blockade, induced by neuromuscular blocking agents, has allowed prescribed immobility, improved surgical exposure, optimal airway management conditions, and facilitated mechanical ventilation. However, termination of the effects of neuromuscular blocking agents has, until now, remained limited. A novel cyclodextrin encapsulation process offers improved termination of the paralytic effects of aminosteroidal non-depolarizing neuromuscular blocking agents. Sugammadex sodium is the first in a new class of drug called selective relaxant binding agents. Currently, in clinical trials, sugammadex, a modified gamma cyclodextrin, has shown consistent and rapid termination of neuromuscular blockade with few side effects. The pharmacology of cyclodextrins in general and sugammadex in particular, together with the results of current clinical research are reviewed. The ability of sugammadex to terminate the action of neuromuscular blocking agents by direct encapsulation is compared to the indirect competitive antagonism of their effects by cholinesterase inhibitors. Also discussed are the clinical implications that extend beyond fast, effective reversal, including numerous potential perioperative benefits.

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          Author and article information

          Journal
          Drug Des Devel Ther
          Drug Design, Development and Therapy
          Drug design, development and therapy
          Dove Medical Press
          1177-8881
          2008
          6 February 2009
          : 2
          : 49-59
          Affiliations
          [1 ] University of North Florida, Nurse Anesthetist Program, Jacksonville, Florida, USA
          [2 ] Shands Jacksonville, Perioperative Services, Jacksonville, Florida, USA
          [3 ] University of Florida, Department of Anesthesiology, Jacksonville, Florida, USA
          Author notes
          Correspondence: Mark Welliver Shands Jacksonville, Department of Anesthesiology, 2nd floor Clinical Center, 655 West 8th St., Jacksonville, FL32209, USA, Fax +1 904 244 4195, Email mark.welliver@ 123456gmail.com
          Article
          dddt-2-49
          2761174
          19920893
          © 2008 Welliver et al, publisher and licensee Dove Medical Press Ltd. This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.
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          Review

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