Cholinesterases

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Abstract
This article reviews the significance of plasma cholinesterase for the hydrolysis of succinylchohne and mivacurium. As is the case with succinylcholine, a correlation exists between plasma cholinesterase activity and the duration of action of mivacurium. The duration of action of mivacurium is prolonged by 50% in some patients with renal or hepatic disease, and in patients with one abnormal plasma cholinesterase gene. Patients homozygous for the atypical gene are extremely sensitive to even very small doses of the drug. It is pointed out that recent developments in molecular biology have made it possible to identify many of the plasma cholinesterase variants at the DNA level.

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