Skeletal Muscle Relaxant Pharm Flashcards
Nondepolarizing Neuromuscular Blockers
Mechanism of Action, Adverse Effects (4)
Competitive nAchR antagonist
Hypotension
Tachycardia
Bronchospasm
Increased secretions
Isoquinolone Nondepolarizing Agents
Examples (5) with Duration of Action
Atracurium: intermediate
Cisatracurium: intermediate
Doxacurium: long
Mivacurium: short
Tubocurarine: long
Steroid Nondepolarizing Agents
Examples (4) with Duration of Action
Pancuronium: long
Pipecuronium: long
Rocuronium: intermediate
Vecuronium: intermediate
Succinylcholine
Classification, Duration of Action, Adverse Effects (3) Contraindication, Black Box Warning
MOA: Phase 1 (2) Phase 2 (3)
Depolarizing Neuromuscular blocker
Ultra-short acting
Cardiac arrhythmias
Hyperkalemia
Increased Intraocular Pressure
Malignant hypertension
Risk of Cardiac arrest
Phase 1:
Activated Achr causing NMJ depolarization
Flaccid paralysis caused by lack of repolarization
Phase 2:
Continued exposure causes decreased depolarization and membrane repolarizes
Receptor acts as if in prolonged closed state
Receptor desensitized
Neuromuscular Blocking Drugs
Indications (4)
Surgical relaxation (long acting drugs)
Tracheal intubation (short acting drugs)
Control of ventilation
Treatment of convulsions
Acetylcholinesterase Inhibitors
Examples (10)
Ambenonium
Edrophonium
Echothiophate
Donepezil
Tacrine
Galantamine Neostigmine Physostigmine Pyridostigmine Rivastigmine
Acetylcholinesterase Inhibitors
Succinylcholine Adjunct Uses (2)
Therapeutic Uses (5)
Adverse Effects (2)
Phase 1: Augments blockade
Phase 2: Antagonizes blockade
Myasthenia gravis Reversal of pharmacologic paralysis Glaucoma Dementia Antidote to anticholinergic poisoning
CNS hyperstimulation (lipid soluble agents) PSNS Effects
Baclofen
Classification, Mechansim of Action (2) Adverse Effects (2)
Centrally acting spasmolytic agent
GABA-b agonist
Inhibits excitatory neurotransmitter release
Seizures (in epileptics)
Psych issues
Carisoprodol
Classification, Adverse Effect, Metabolism
Centrally acting spasmolytic agent
Addictive
Metabolized by CYP2C19 to anxiolytic meprobamate
Cyclobenzaprine
Classification, Brand Name, Metabolism, Adverse Effects (3)
Centrally acting spasmolytic agent
Flexeril
CYP450 metabolized
Drowsiness
Dizziness
Xerostomia
Diazepam
Classification, MOA, Adverse Effects (2)
Centrally acting spasmolytic agent
Enhances GABAa receptor activity in presence of GABA
CNS depression
Sedation
Tizanidine
Classification, MOA, Adverse Effects (4)
Centrally acting spasmolytic agent
Alpha-2 agonist
Drowsiness
Hypotension
Dry mouth
Muscle weakness
Dantrolene
Classification, MOA (2) Indication, Adverse Effects (3)
Non-Centrally acting spasmolytic agent
Inhibits ryanodine receptor
Blocks SR release of Calcium
Malignant Hyperthermia cure
Muscle Weakness
Sedation
Hepatitis
Botulinum Toxin
Classification, MOA (2) Indications (4) Adverse Effect
Non-Centrally acting spasmolytic agent
Cleaves VAMP to block vesicular release of Ach
Dystonia (strabismus, blepharospasm)
Primary Axillary Hyperhidrosis
Chronic Migraine
Focal Spasticity
Focal Muscle Weakness
Multiple Sclerosis Treatments
Drugs (4) with Mechanisms of Action (1/2/1/1)
Glucocorticoids: immunosuppression
Interferons: Bind VLA-4 on T cells to stop adhesion or stopping MMP expression by T cells
Glatiramer Acetate: induce T cell suppressor cells for myelin proteins
Mitoxantrone: intercalates with DNA causing strand breaks
