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16 Cards in this Set

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tubocurarine (curare)
Class: Nondepolarising NM blocker
Action: competitive inhibitor of Nic-NMJ RR (Nic-NMJ antagonist). Ganglionic blockade at very high doses. Causes release of histamine.
Tx: adjuvant to surgical anaesthesia.
Side Effects: due to histamine, vasodilation, hypotension, bronchial/salivary secretion, bronchospasm.
Contrain.: aminoglycoside antibiotics; will compete for neuronal Ca2+, exacerbating NMJ transmission.
Notes: two 4° amines; can't cross BBB.
gentamycin
Class: aminoglycoside antibiotic
Action:
Tx:
Side Effects:
Contrain.: tubocurarine; can inhibit NM transmission by competing for neuronal Ca2+
Notes:
Halothane
Class: general anaesthetic
Action: stabilises the post-synaptic mem. potential.
Tx:
Side Effects:
Contrain.:
Notes: synergistic with tubocurarine
isoflurane
Class: general anaesthetic
Action: stabilises the post-synaptic mem. potential.
Tx:
Side Effects:
Contrain.:
Notes: synergistic with tubocurarine
pancuronium
Class: Nondepolarising NM blocker
Action: no histamine release, some cardiac blockade.
Tx:
Side Effects:
Contrain.:
Notes: 6x potency of tubocurarine. Long duration. Renal elimination.
vecuronium
Class: Nondepolarising NM blocker
Action: no histamine release.
Tx:
Side Effects:
Contrain.:
Notes: liver metabolised; int. duration, 6x potency of tubocurarine.
rocuronium
Class: Nondepolarising NM blocker
Action: no histamine release.
Tx: tracheal intubation
Side Effects:
Contrain.:
Notes: lower potency, rapid onset (use higher dose to speed onset), int. duration.
succinylcholine
Class: depolarising blocker
Action: depolarises the endplate, causing fast Na+ ch. to go to inactive state. Prolonged exposure may desensitise Nic-NMJ.
Tx: mm relaxation during surgery; laryngo-, broncho-, oesophagoscopy; electroshock therapy.
Side Effects:
Contrain.:
Notes:
dantrolene
Class: Spasmolytics
Action: blocks Ca2+ release from the SR
Tx: malignant hyperthermia due to halothane+succinylcholine in pts. with mutant SR.
Side Effects: weakness, sedation, hepatitis (rare).
Contrain.:
Notes: acts mainly on sk. mm., little effect on cardiac or smooth mm.
botulinum Toxin
Class: Presynaptic Release Blocker
Action: cleaves SNARE complex, inhibiting ACh vesicle fusion.
Tx: blepharospasm (eyelids); strabismus; Meige's Syndrome (hemifacial spasm); spasmodic torticollis; spasmodic dysphonia (laryngeal spasms); hyperhidrosis (excessive sweating); cosmetic.
Side Effects: hypersensitivity, dry mouth/swallowing, mm weakness, diplopia, ptosis, mydriasis, constipation.
Contrain.:
Notes:
4-aminopyridine
Class: NM stimulant
Action: blocks K+ ch., delaying repolarisation and prolonging AP. ↑s ACh release.
Tx: LEMS
Side Effects:
Contrain.:
Notes:
prednisolone
Class: steroid
Action: inhibits Ab production.
Tx: Myasthenia Gravis
Side Effects:
Contrain.:
Notes:
azathioprine
Class: immunosuppressant
Action:
Tx: myasthenia gravis
Side Effects:
Contrain.:
Notes:
baclofen (Lioresal)
Class: Spasmolytics
Action: stimulates GABA-B RR, resulting in activating K+ ch. and blocking Ca2+ chh. Causes hyperpolarisation and ↓'d excitability. Interferes with CNS release of excitatory ntms.
Tx: spinal spasticity, spasticity due to MS.
Side Effects: severe drowsiness.
Contrain.:
Notes:
diazepam (Valium)
Class: Spasmolytics; sedative/hypnotic
Action: GABA-A R activator; blocks presynaptic terminal.
Tx: mm spasms
Side Effects: sedation
Contrain.:
Notes:
Cyclobenzaprine (Flexeril)
Class: spasmolytic; nonspecific central depressant
Action: depresses CNS polysynaptic reflexes.
Tx: mm spasm due to local trauma/strain.
Side Effects:
Contrain: spasm from cerebral palsy or spinal cord injury.
Notes: dry mouth, sedation, dizziness.