Twenty Years’ Experience with Decamethonium

  • G. E. Hale Enderby
Part of the Handbuch der experimentellen Pharmakologie / Handbook of Experimental Pharmacology book series (HEP, volume 42)


The successful introduction of curare into anaesthesia by Griffith and Johnson (1942) was a major advance in modern medicine which stimulated the search for other “curare-like” drugs. In 1948 Barlow and Ing, Paton and Zaimis synthesized and tested independently a number of compounds in which quaternary nitrogen atoms were separated by straight carbon chains of various lengths. In the two letters published by “Nature”, Barlow and Ing, Paton and Zaimis described the curare-like action of these polymethylene bis-quaternary ammonium salts. Later that same year a report from Paton and Zaimis on the clinical potentialities of certain bis-quaternary salts causing neuromuscular and ganglionic block, namely decamethonium and hexamethonium, also appeared. Understandably tubocurarine was taken as the standard, the main difference between decamethonium and tubocurarine being then reported as a “sparing of respiration” by decamethonium in the monkey and cat. Indeed a “ratio of respiratory activity” was described, being the dose producing cessation of respiration in 50% of the animals divided by the dose which produced muscle weakness for 10 min. Other advantages claimed for decamethonium were that it had less ganglionic action than tubocurarine, caused less histamine release and could be synthesised easily. Although the action of decamethonium was not antagonised by neostigmine or eserine it was antagonised by pentamethonium. Quite rightly, Paton and Zaimis claimed that decamethonium “merits consideration as a substitute for tubocurarine”. It is interesting to note that they also made the suggestion that hexamethonium might be useful in the treatment of hypertension.


Nitrous Oxide Histamine Release Control Ventilation Ganglionic Block Neuromuscular Blocking Drug 
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© Springer-Verlag Berlin · Heidelberg 1976

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  • G. E. Hale Enderby

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