What does a high dibucaine number mean?
The Dibucaine number is used to differentiate individuals who have substitution mutations of the butyrylcholinesterase enzyme resulting in decreased enzyme function. At least one substitution mutation has been characterized that is capable of altering the efficiency of enzymatic catalysis.
What is dibucaine number test?
The dibucaine number indicates the percent inhibition of enzyme activity by this agent when a serum or plasma sample is tested under standard conditions (inhibition expressed as a percent).
What drugs should be avoided with pseudocholinesterase deficiency?
The use of succinylcholine, mivacurium and ester local anesthetics must be avoided in patients with pseudocholinesterase deficiency because these patients may not be able to metabolize such anesthetics.
Which drugs are metabolized by Pseudocholinesterase?
If you have pseudocholinesterase deficiency, your body lacks or has a reduced amount of the enzyme needed to break down (metabolize) drugs known as choline esters. These drugs, succinylcholine and mivacurium, are used as part of anesthesia to relax the muscles during medical procedures.
What is Pseudocholinesterase test?
Serum cholinesterase is a blood test that looks at levels of 2 substances that help the nervous system work properly. They are called acetylcholinesterase and pseudocholinesterase. Your nerves need these substances to send signals. Acetylcholinesterase is found in nerve tissue and red blood cells.
What is 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.
How do you test for pseudocholinesterase deficiency?
To diagnose inherited pseudocholinesterase deficiency, the abnormal gene that causes the condition are identified using genetic testing. A sample of your blood is collected and sent to a lab for analysis. Ask your doctor if family members should be tested before surgery as well.
What is dibucaine ointment used for?
Dibucaine (dye byoo kane) is a local anesthetic. It is used to decrease pain and itching from minor skin irritations or hemorrhoids.
How do you know if you have pseudocholinesterase deficiency?
Diagnosis. Pseudocholinesterase deficiency may be suspected when you have problems recovering muscle control and breathing after receiving the muscle relaxant succinylcholine or mivacurium as part of anesthesia. A blood test can be done to measure pseudocholinesterase enzyme activity.
How do you know if you have Pseudocholinesterase deficiency?
Where is pseudocholinesterase found?
Pseudocholinesterase is found primarily in the liver.
How is dibucaine used to diagnose substitution mutations?
When administered to humans intravenously, it is capable of inhibiting the plasma cholinesterase ( butyrylcholinesterase) enzyme. The dibucaine number is used to differentiate individuals who have substitution mutations ( point mutations) of the enzyme’s gene, resulting in decreased enzyme function.
Why do we use the dibucaine number for butyrylcholinesterase?
The Dibucaine number is used to differentiate individuals who have substitution mutations of the butyrylcholinesterase enzyme resulting in decreased enzyme function. At least one substitution mutation has been characterized that is capable of altering the efficiency of enzymatic catalysis.
What is the percentage of enzyme activity inhibited by dibucaine?
In normal patients, dibucaine will inhibit 80% of enzyme activity which corresponds to dibucaine number of 80. Heterozygous atypical plasma BuChE occurs in about 4% of the population with the corresponding dibucaine number between 30 and 65.
What is the normal dibucaine number for homozygotes?
Kalow and Genest first described this means of determining butyrylcholinestersase activity in 1957. Typical measurement of dibucaine number in the United States yields values of 80 and above for wild type homozygotes (normal), 40–60 for heterozygotes (atypical), and 20 or less for atypical homozygotes.