enzyme

Pseudocholinesterase

Pseudocholinesterase is a plasma enzyme produced in the liver that is responsible for the metabolism of the common anesthesia drugs, succinylcholine, and mivacurium, as well as ester local anesthetics, including cocaine. Individuals with a normally functioning version of the enzyme can rapidly and extensively metabolize succinylcholine and mivacurium, leading to their short duration of action (less than 10 minutes for succinylcholine).[6][11] With an inherited deficiency, the defective form of the enzyme is unable to metabolize succinylcholine and mivacurium to the same degree, leading to prolonged neuromuscular paralysis for those who inherited atypical pseudocholinesterase enzyme.[3] Duration of neuromuscular blockade is dependant upon whether the patient is homozygous or heterozygous for the defective enzyme.[6] Heterozygotes will experience a muscular blockade of moderate duration, while homozygotes can have muscular paralysis longer than 2 hours.[6] With an acquired deficiency, there is a decreased ability to degrade the substrate drugs solely due to decreased concentration of the enzyme in the serum.

Ref:
Trujillo R, West WP. Pseudocholinesterase Deficiency. [Updated 2022 Sep 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK541032/

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Added on May 31, 2023 by Barbara Van De Keer

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