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DantroleneDantrolene is currently the only specific and effective treatment for malignant hyperthermia. Dantrolene depresses excitation-contraction coupling in skeletal muscle by binding to the ryanodine receptor, and decreasing intracellular calcium concentration. Dantrolene is also used in the management of neuroleptic malignant syndrome, spasticity and Ecstasy intoxication. The major problem with dantrolene is its poor water solubility, and ensuing difficulty rapidly preparing intravenous solutions in emergency situations. Muscle weakness may persist for several days following treatment. A minor problem with dantrolene is that the preparation is not cheap and only has a shelf life of 2 years. Smaller hospitals may not see a case of malignant hyperthermia for more than a decade at a time but will still routinely order dantrolene just in case a case arises.
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