Pharmacology Test 4 - Skmr

Front 1

Used in ICU to induce muscle paralysis
Interfere with transmission at NMJ
Lack CNS activity
Mainly used as adjuncts during general anesthesia

Back 1

Neuromuscular Blockers

Front 2

Reduce spasticity
Used to treat chronic pain and fibromyalgic conditions

Back 2

Spasmolytics

Front 3

non-depolarizing NM blockers block action of ? at Nm receptors

depolarizing blockers block by using an ?

Back 3

ACh

agonist (succinyl choline)

Front 4

Both nondepolarizing and depolarizing have 2 ?

Back 4

quaternary nitrogens

Front 5

depolarizing NM have ? structure similar to ?

Back 5

linear ; ACh

Front 6

Non depol. NM blockers conceal double ACh structures in ?

Back 6

a ring system

Front 7

All steriodal muscle relaxants are metabolized to ?

Back 7

3, 17 hydroxy products

Front 8

Intermediate acting
Hepatic and spontaneous degradation (laudanosine, long half life, crosses bbb, may cause seizures)
Causes transient hypotension (histamine release)

Back 8

Atracurium (generic, Tracrium):

Front 9

Potent isomer of atracurium
Produces less laudanosine and is less likely to release histamine
Has replaced atracurium

Back 9

Cisatracurium (Nimbex):

Front 10

Shortest acting (duration 15 min)
Rapidly inactivated by plasma cholinesterases (liver disease patients or genetic deficiency of cholinesterase, renal impairment)
Onset is slower than succinylcholine, histamine release

Back 10

Mivacurium (Mivacron):

Front 11

Short duration of action (5-10 min)
Highly metabolized by cholinesterases (plasma, liver)
Metabolite (succinylmonocholine) is rapidly degraded
Plasma esterases (prolonged duration in patients with abnormal variant of cholinesterase)

Back 11

Succinylcholine (generic, Anectine)

Front 12

measure of the ability of the patient to metabolize succinylcholine
Normally, dibucaine inhibits normal enzyme activity by 80% and abnormal enzyme by 20%

Back 12

dibucaine number

Front 13

act competitive antagonists at the nicotinic muscle receptors at the NMJ
Effect of neostigmine, edrophonium, and pyridostigmine
In larger doses, can block the pore
Can also block prejunctional sodium channels

Back 13

Non Depolarizing blockers

Front 14

succinlycholine, are agonists on the Nm receptors, stimulate rec at low conc, block the pore at high conc

Back 14

depolarizing blockers

Front 15

Depolarization, prolonged flickering, unresponsive to stimuli
Flaccid paralysis
Augmented by ChEI

which phase I or II?

Back 15

phase I

Front 16

Membrane repolarization
Similar to nondepolarizing block
Reversible by ChEI

Which phase I or II?

Back 16

phase II

Front 17

Adverse affects of depolarizing blockade

Back 17

hyperkalemia, increased intraocular pressure, increased intragastric pressure, muscle pain

Front 18

Submitted for FDA approval as a reversal drug
Rapidly inactivates steroidal NMN blockers by forming an inactive complex

Back 18

Sugammadex

Front 19

antagonize NM blockade by nondepolarizing blockers

Back 19

ChEI (Neostigmine, pyridostigmine)

Front 20

Mechanism
Used in patients with almost any type of muscle spasm

spasmolytic

Back 20

Diazepam (Valium)

Front 21

GABAB agonist
Reduce release of
Excitatory nt in brain, spinal cord
Reduce pain, inhibit release
of substance P
Start at 15 mg dose 2x daily
Increase as tolerated to 100
Adverse effects:
Drowsiness
Increased seizures in epileptic patients

Back 21

Baclofen (Lioresal)

Front 22

spasmolytic
a2 agonist
Both pre and postsynaptic inhibition in spinal cord
Inhibits nociceptive transmission in spinal cord dorsal horn
Adverse effects:
Drowsiness, hypotension, dry mouth, asthenia

Back 22

Tizanidine (Zanaflex):

Front 23

Progabide (GABAA and GABAB agonist)
Glycine, inhibitory neurotransmission

spasmolytic

Back 23

gabapentin (neurontin)

Front 24

Blocks excitation-contraction coupling
Doses start at 25 mg daily, may increase up to 100 mg daily
Used in malignant hyperthermia (1 mg/kg IV)

spasmolytic

Back 24

dantrolene