Neuromuscular Junction Blockers

Question 1

Neuromuscular junction blocker

Primary toxin in curare–> death by paralyzing skeletal muscle

Answer 1

Tubocurarine

Question 2

Neuromuscular junction blocker
Competitive
-Long acting
-Renal elimination
-Will block muscarinic receptors--> tachycardia = ganglionic blockade

Answer 2

Pancuronium

Question 3

Neuromuscular junction blocker
Competitive
-Intermediate acting
-Hydrolyzes spontaneously
-Temperature and pH dependent–> longer halflife at low temp or low pH
-Some renal elimination, but halflife doesn’t increase with renal disease
-Promotes histamine release

Answer 3

Atracurium

Question 4

Neuromuscular junction blocker
Competitive
-Short acting
	-Rapid hydrolysis 
-Promotes histamine release

Answer 4

Mivacurium

Question 5

Neuromuscular junction blocker
Depolarizing = Non-competitive
-Activates AChr and remains bound
-Resistant to acetylcholinesterase–> Not pharmacologically reversable
-Fast acting, short duration
-Can promote histamine release
-Can cause hyperkalemia in initial phase when muscle cells depolarize
-Avoid with excessive soft tissue damage or burns

Answer 5

Succinylcholine