Curare

History

It is at the time of a voyage in Guyana that Sir Walter Raleigh brings back about 1596 a poison called curari in which the Indians of South America soaked their arrows, enabling them to increase the effectiveness of their hunting. The game was poisoned by muscular paralysis a few minutes after being touched, which avoided frightening the other potential targets. The consumption of the meat remained possible, the curare not being active in the event of ingestion.

Harold Randall Griffith (1894 - 1985) and Enid Johnson use in 1942, the intocostrin or d-tubocurarine to cause a muscular relaxation at the time of a general anesthesia.

Since 1943, Wintersteiner Oscar and James Dutcher begin the marketing of D Tubocurarine, extracted from Chondodendron tomentosum .

Pharmacology

By extension, a curare indicates a drug with the properties curarizing, used in Anesthésie to cause a muscular relaxation. The indications for the administration of a curare are:

to facilitate the Intubation trachéale;
to decrease the muscular tone to facilitate an surgical operation;
to facilitate the mechanical Ventilation (to avoid asynchronie patient-ventilator)
to remove cramp them for example in the Sismothérapie.

Depolarizing curare

The only depolarizing curare used usually in hospital medium is the succinylcholine ( Anectine , Celocurine ). Its fixing with the receiving S of the Acétylcholine involves a prolonged depolarization of the muscle. The fasciculations (muscular Spasms) which it involves are the cause of muscular pains to the alarm clock of the patient (ache).

Curare not depolarizing

It is the case of the near total of the blockers neuromusculaires. Their fixing with the receiving S of the Acétylcholine does not involve depolarization of the muscle.

Undesirable effects

The curares are among the substances used in anesthesiology those which expose to the greatest risk of allergic reaction serious. The Paralysie that they involve makes an respiratory assistance essential, and its impossibility can involve dramatic consequences. The use of these drugs is reserved to the experts having received a training in anesthesia and reanimation.

References

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