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13 Cards in this Set
- Front
- Back
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What are the 3 indications for NMBA?
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1. Increase surgical exposure
2. Assist ventilation 3. Keep eye position central. |
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Decribe the MOA of NMBA?
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They attach to the nicotinic receptors within the neuromscular junction on the motor end plate which inhibit the Ach from binding and stimulating the muscle.
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List the sequence of paralysis.
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1. Face, jaw and tail
2. Neck and distal limbs 3. Proximal limbs 4. Pharynx and larynx 5. Abdominal wall 6. Thoracic wall 7. Diaphragm ( recovery occurs in reverse order. ) |
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What are the 2 clinical relevence to the sequence of paralysis and recovery?
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1. Animal may be able to breathe spontaneously but if extubated too early they are not able to protect their airway. Risk of resp obstruction due to paralysis of pharyngeal muscles.
2. Animal that able to breathe adequately but have peripheral muscle weakness > Important in horses > ataxia = increase injury risk. |
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What are the 7 factors that affect the activity of NMBA?
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1. Electrolytes
2. Acid - base status 3. Hypothermia 4. Anaesthetic agents 5. Renal and hepatic function 6. Neuromuscular disease 7. Antibiotics |
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What are the 3 precautions for use of NMBA?
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1. Ensure adequate depth of anaesthesia
Monitor physiological variables Monitor end-tidal concentration of agent 2. Respiratory muscle paralysis: Provide ventilatory assistance 3. Factors that alter activity: adjust dose rate in presence of factors that increase activity if NMBA |
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How do we monitor neuromuscular block activity?
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Nueromuscular block is monitored using a peripheral nerve stimulator. Stimulation of the facial nerve, ulna nerve and peroneal nerve have all been used.
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Describe the actions, use and metabolism of Suxamethonium?
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Muscle relaxation preceded by muscle contraction
Infrequently used to intubate cats Metabolised by pseudocholinesterase (produced in the liver) |
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What are the side effects on the heart?
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This agent stimulate muscarinic receptors on the heart which results in bradycardia and hypotension.
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What are the 6 other effects of Suxamethonium?
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1. Increased intraocular pressure
2. increased intra- gastric pressure 3. Increased intracranial pressure 4. Myalgia 5. Hyperkalaemia 6. Prolonged apnoea |
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What are the 5 contraindications?
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1. Major burns
2. Ocular injury 3. CNS injury 4. Pre-existing hyperkalaemia 5. Disorders of neuromuscular junctions. |
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What is the reversal of non-depolarising (competitive ) neuromuscular block?
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Anticholinesterases: Neostigmine; Endrophonium
MUST have some spontaneous recovery of muscle function to work effectively |
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What is the reversal of non-depolarising (competitive ) neuromuscular block side effects? 4?
How do you stop it? |
1, Increased GIT mobility
2. Bronchoconstriction 3. Bradycardia 4. increased salivation. >> Use atropine |
