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  • The high incidence of severe liver damage on repeated exposure to halothane has limited its use.
  • Local anaesthetics can affect both autonomic nerves and the neuromuscular junction.
  • They may be used in combination with other bronchodilators.

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This is due partly to prevention of acetylcholine release and partly to non-depolarizing competitive block of the acetylcholine receptors on the postsynaptic membrane. The importance of this clinically is that local anaesthetics should be used with great care in patients suffering from myasthenia gravis because of the danger exacerbating the buy zithromax overnight shipping and precipitating paralysis, particularly of the respiratory muscles. Such patients should be treated as high risk. Cardiac muscle cells are excitable, and hence the diffusion of sodium ions is affected as it is in nervous tissue. The result of this is a slowing of the heart rate. Indeed lidocaine is used for this purpose in the treatment of ventricular arrhythmias.


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