Blocking Agents

Front 1

Dehydration causes muscle relaxant sensitivity

Back 1

1.Decreases neuromuscular excitability.

2. Increases plasma concentration of the relaxant and intensifies the action.

3. Renal function is slowed, duration time and metabolites are prolonged.

Front 2

Sodium deficit

Back 2

Will prolonged block. May create a partial block without drugs.

Front 3

Potassium deficiency

Back 3

Increases blocking action of non depolarizing agents

Front 4

Potassium deficiency

Back 4

Requires larger doses of depolarizing agents. The decrease appears to stabilize the muscle end plate. Contraction does not occur readily.

Front 5

Magnesium increased concentration causes

Back 5

Flaccid paralysis.

Enhanced non-depolarizing block

And potentiates a block produced by succinylcholine.

Front 6

Calcium deficiency

Back 6

Prolonged non-depolarizing effects by reducing the amount of acetylcholine and inhibition of neuromuscular transmission.

Front 7

Calcium chloride administration

Back 7

Antagonizes non-depolarizing effects such as pancuronium.

Pronounced antagonism of respiratory depression produced by succinylcholine.

Front 8

Acidosis causes

Back 8

Intensified effects of pancuronium

Front 9

Alkalosis causes

Back 9

Decreased effects of pancuronium

Front 10

Acidosis causes

Back 10

Diminished action of agents such as rocuronium and succinylcholine.

Front 11

Alkalosis causes

Back 11

Decreased effects of pancuronium.

Front 12

Catecholamines

Back 12

Epinephrine and ephedrine have a reversal effect on skeletal muscle

Front 13

Catecholamines release acetylcholine

Back 13

Causes inhibition of acetylcholinesterase, decreases excitability of muscle fiber, and release of potassium. (Epi and ephedrine)

Front 14

Mycins (aminoglycoside antibiotics)

Back 14

Several have a non-depolarizing blocking property. The meds potentiate the blockade by inhibiting the presynaptic release of acetylcholine.

Front 15

Cardiac dysrhythymic drugs

Back 15

IV lido potentiates preexisting block.

Lido stabilizes the postsynaptic membrane and depressed the muscle fiber.

Front 16

Quinidine interferes with

Back 16

The presynaptic release of acetylcholine at the junction. It intensifies the blockade of all agents.

Front 17

Calcium channel blockers

Back 17

Inhibition the calcium entry which causes a reduction in acetylcholine release followed by a Decrease on muscle function

Front 18

Hypothermia

Back 18

Antagonizes pancuronium

Potentiates succinylcholine

Carefully watch infant who have poor regulation.

Front 19

Inhalation agents

Back 19

Depress CNS and ultimately reduce skeletal muscle tone.

Isoflurane and non-depolarizing agent combo in phase I need close monitor.

Front 20

Non-depolarizing paralysis order

Back 20

1. Small muscles, eyes, face, fingers

2. Medium, tongue, cheeks, limbs

3. Large, neck, shoulders, abd, dorsal

4. Special, intercostal, larynx, diaphragm.

Front 21

Prolonged succinylcholine response

Back 21

Deficient pseudocholinesterase level

Overdose

Temperature changed

Acid base imbalance

Carcinoma

Anti tumor agents

Antibiotics

Myasthenia gravis

Liver disease

Front 22

Phase 1 block

Back 22

A depolarizing block of ordinary character. Dose dependent.

Front 23

Phase 2 block, dual block

Back 23

Causes by a conformational change in the pre and post synaptic cholinergic receptors. A desensitization to the stimulation of acetylcholine because of the prolonged depolarization at the motor end plate.

Front 24

Neostigmine can cause bradycardia

Back 24

If the combo was atropine, it may exhaust before. Showing Brady.

Glycopyrrolate used

Front 25

Dermatome levels

Back 25

Allow assessment of neuraxial blockade.

Front 26

Spinal needle placement

Back 26

Below L2

Front 27

Spinal Anesthesia

Back 27

Local anesthetic are deposited in the subarachnoid space

Front 28

Spinal contraindications

Back 28

PT refusal

Severe aortic-mitral stenosis

Hypovolemia

Local allergy

Increased ICP

Infection at site

Sepsis it bacteremia

Coagulation meds

Front 29

PDPH

Back 29

Post-dural puncture headache

Front 30

Epidural analgesia

Back 30

Via epidural space, fentanyl and bupivacaine

Front 31

Blockade hypotension

Back 31

Leg raising

Fluid bolus

Vasopressors- norepinephrine,

ephedrine, phenylephrine, epi.

Bradycardia tx

Asystole, ACLS protocol

Front 32

Blockade n/v

Back 32

Assoc with hypotension tx cause

O2

Front 33

Block urinary retention

Back 33

Bladder scan & catheter insertion

Front 34

Block hypothermia

Back 34

Centrally mediated vasodilation and inhibits periph. Vasoconstriction.

Recognize and restore

Front 35

Spinal or epidural hematoma

Back 35

Early recognition & treatment

Low back pain, motor changes, bowel or bladder dysfunction.

Awareness of coagulation altering meds.

Emergent decompression

Front 36

Anticholinergic agents counteract

Back 36

Adverse effects of anticholinesterases

Front 37

Antibiotics, gent, tobra

Back 37

Aminoglycosides have been reported to have a magnesium like effect on the neuromuscular junction. Amphotericin induced ...