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Other Causes of Reduced Pseudocholinesterase Activity Disease states Drugs (e.g., organophosphates, neostigmine , pyridostigmine) Effects: Prolonged paralysis , including diaphragm involvement Risk of respiratory failure Dibucaine Test Used to diagnose enzyme deficiency: Normal: ~80% inhibition Heterozygotes: 5060% Homozygotes: 2030% Management: Maintain sedation and mechanical ventilation Monitor recovery using train-of-four stimulation Other Contraindications History of malignant hyperthermia Conditions predisposing to overexpression of nAChRs, resulting in an increased incidence of life-threatening hyperkalemia, ventricular arrhythmias and acute rhabdomyolysis (Cooperman 1970

[DOI] [PubMed] [Google Scholar] 40.Martnez-Ua M., Varela-Rey M., Cano A., Fernndez-Ares L., Beraza N., Aurrekoetxea I., Martnez-Arranz I., Garca-Rodrguez J.L., Buqu X., Mestre D., et al