Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
22 Cards in this Set
- Front
- Back
|
amino steroid based NMJ blocker suffix
|
-curonium
|
|
|
amino steroid based NMJ blockers-
(4) (metabolism, elimination, type) |
ideal NMJ blocker
non-depolarizing metabolically inactivated rapidly eliminated |
|
|
example of amino steroid NMJ blocker?
|
malouetine
|
|
|
pancuronium- duration, AE (2)
|
longer acting agent
cause increase in BP contraindicated in CAD |
|
|
vecuronium - duration
CV side fx |
intermediate duration
no significant CV side effects |
|
|
pipcuronium- duration
|
longer acting
|
|
|
rocuronium- duration
onset |
intermediate duration
rapid onset |
|
|
tetrahydroisoquinoline- based NMJs suffix
|
-curium
|
|
|
tetrahydroisoquinoline- type of drug
structure (3) |
non depolarizing NMJ blocker
long connecting chain generally contain esters which are hydrolyzed aliphatic diester structure |
|
|
metabolism of atracurium (4)
|
esters rapidly hydrolyzed
not metabolized by kidney or liver can decompose via hoffman elimination (nonenzymatic base catalyzed decomposition- yields laundanosine, which is inactive) useful in pt with renal/hepatic disease |
|
|
atracurium type of drug
|
non depolarizing
|
|
|
laudanosine (2)
|
metabolite via hoffman elimination of atracurium
toxic- decreases seizure threshold |
|
|
ester location in relation to quat ammonium on atracurium
|
2 Cs away...?
|
|
|
2 means of metabolism of atracurium
|
ester hydrolysis
hoffman elimination |
|
|
describe hoffman elimination of atrcurium and it's products
|
hoffmann: no hydrolysis- just cleaves off the ring structures on the ends of molecules, forming laudanosine x2 and the middle aliphatic ester chain ends up with 2 dbl bonds on the ends + esters
|
|
|
describe ester hydrolysis of atracurium and it's products
|
ring structures hydrolyzed off as quat ammonium carboxylic acids x2 + diol
|
|
|
mivacurium SAR and what this implies for isomerism
|
has a dbl bond in middle- thus can have cis/trans
mix of 3 different isomers: cis-trans, trans-trans, cis-cis |
|
|
mivacurium- potency of isomers (3)
|
cis-trans
trans-trans these are both potency (equipotent) cis-cis has little potency |
|
|
ester in relation to quat amine for mivacurium and what this implies for metabolis
|
3 Cs away (vs. atracurium which was 2)
thus does not undergo hoffman elimination |
|
|
doxcurium- metabolism, duration, AE vs other tetrahydroiso NMJs
|
no hoffman elimination (3Cs away from quat amine)
longer acting no CV AE |
|
|
therapeutic apps of NMJs (3)
|
NMJ blockers are adjunct to general anesthesia
reduce depth of anesthesia neccessary decrease risk, quicker recovery time |
|
|
side effects of NMJs (3) and Mechanism of these AEs
|
hypotension
bronchospasm cardiac disturbances depolarizing agents release histamine- which is what causes these AEs |
