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18 Cards in this Set
- Front
- Back
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Structurally related to acetylcholine, used to produce muscle paralysis in order to facilitate surgery or artifical ventilation. Full doses lead to respiratory paralysis and require ventilation
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Neuromuscular blocking drugs
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These drugs strongly potentiate and prolong effect of neuromuscular blockade (NMB)
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Inhaled anesthetics, especially isoflurane, aminoglycosides, and antiarrhythmic
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These prevent the action of Ach at the skeletal muscle endplate to produce a "surmountable blockade," effect is reversed by cholinesterase inhibitors (ex. neostigmine or pyridostigmine)
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Nondepolarizing type antagonists
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Non-depolarizing skeletal muscle antagonist that has short duration
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Mivacurium
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Skeletal muscle agent that can block muscarinic receptors
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Pancuronium
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Skeletal muscle agent that undergoes Hofmann elimination (breaks down spontaneously)
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Atracurium
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One depolarizing blocker that causes continuous depolarization and results in muscle relaxation and paralysis, causes muscle pain postoperatively and myoglobinuria may occur
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Succinylcholine
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During Phase I these agents worsen muscle paralysis by succinylcholine, but during phase II they reverse the blockade produced by succinylcholine
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Cholinesterase inhibitors
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characteristics of phase 1 depolarizing blockade include
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well sustained tension during tentanic stimulation
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atropine is administered at the end of anesthesia because…
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to prevent activiation of cardiac muscarinic receptors (secondary to increased ACh due to acetylchoinesterase inhibitors)
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atropine would not be needed to reverse effects of what non-depolarizing relaxant?
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pancuronium because it blocks heart muscarinic receptors
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nondepolarizing block is characterized by…
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poorly sustained tetanic tension
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succinylcholine is associated with what GI SE?
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elevated intragastric pressure
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pt with normal renal and hepatic function is given a neuromuscular blocker that should last 5-10 min; instead it lasted 8 hours; what happened?
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example of genetic variation in drug metabolism (acetylcholinesterase)
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which 2 drugs are associated with hypotension caused by histamine release?
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tubocurarine, mivacurium
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which drug causes hyperkalemia in patients with spinal cord injury or muscular dystrophy?
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succinylcholine
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what drug is used to prevent postop pain caused by succinylcholine?
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vecuronium (prevents muscle fasciculations, any non-depolarizing drug will work)
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premonitory sign of malignant hyperthermia
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trismus (contraction of jaw muscle)
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