Chapter 19: Drugs That Block Nicotinic Cholinergic Transmission

Question 1

Nueromuscular drugs mechanism of action

Answer 1

• prevent ACh for activating nicotinic receptors on skeletal muscles, which results in muscle relaxation

Question 2

Neuromuscular drugs cannot cross

Answer 2

• the blood brain barrier
• placenta

Question 3

polarization

Answer 3

positive changes cover the outer surface of the mebrane; negative charges cover the inner membrane

Question 4

depolarization

Answer 4

• postive changes move from the outside to inside
• in response to the binding of ACh to the nicotinic receptors

Question 5

repolarization

Answer 5

• positively charged ions are pumped out of the cell so that the original resting membrane state is restored
• follows unbinding of ACh from endplate of nicotinic receptors

Question 6

competitive (nonpolarizing) neuromuscular blockers

Answer 6

• do not depolarize the motor endplate

Question 7

all neuromuscular blocking agents contain at least one

Answer 7

quaternary nitrogen atom

Question 8

nondepolarizing neuromuscular blockers mechanism of action

Answer 8

• competes with ACH for nicotonic receptors
• blocks receptor activation of acetlcholine

Question 9

competetive neuromuscular blockers pharmacologic effects

Answer 9

• muscle relaxation: flaccid paralysis
• hypotension
• no effect on the CNS

Question 10

when a competitive neuromuscular blocker is administered peak effects persist

Answer 10

20-45 mins and then decline

Question 11

recovery for a cometitive neuromuscular blocker takes

Answer 11

1 hour

Question 12

competetive neuromuscular blocker effect

Answer 12

rapid onset of paralysis

Question 13

Competetive neuromuscular blocker therapeutic uses

Answer 13

muscle relaxation during surgery, mechanical ventilation, endotracheal intubation

Question 14

Competetive neuromuscular blockers adverse effects

Answer 14

• respitory arrest
• hypotension
• atracurium

Question 15

Pancuronium is used for

Answer 15

muscle relaxation during general anesthesia, itubation, and mechanical ventelation

Question 16

does pancuronium cause histamine release, gangloinic blockade, or hyptension

Answer 16

no

Question 17

Pancuronium dise effects

Answer 17

Vagolytic effects may produce tachycardia

Question 18

Pancuronium should be used with caution in

Answer 18

patients with liver disease

Question 19

Pancuronium excretion

Answer 19

primarily through the urine

Question 20

Succinylcholine [Anectine] mechanism of action

Answer 20

depolarizing the neuromuscular blockade

Question 21

Succinylcholine [Anectine] pharmacologic effects

Answer 21

• ultra-short acting (peaks at 1 minute)
• mucle relaxation; state of flaccid paralysis
• no effect on CNS

Question 22

Succinylcholine [Anectine] is eliminated by

Answer 22

plasma cholinesterases

Question 23

Succinylcholine [Anectine] therapeutic uses

Answer 23

• muscle relaxation during endotracheal intubation

Question 24

Succinylcholine [Anectine] causes prolonged apnea in clients with

Answer 24

low pseudocholinesterase activity
- causes paralysis to persists for hours

Question 25

Malignant hyperthermia can be triggered by

Answer 25

succinylcholine

Question 26

Maliganant hyperthermia symptoms

Answer 26

- muscle rigidity, profound elevation of body tempurature, cardiac dysrhythmias, unstable blood pressure, electrolyte derangements, and metabolic acidosis

Question 27

a malignant hyperthermia reaction is determined

Answer 27

genetically

Question 28

between 10% to 70% of patients experience postoperative muscle pain after recieving what medication

Answer 28

succinylcholine

Question 29

postoperative muscle pain after succinylcholine occurs

Answer 29

12-24 hours after surgery

Question 30

pain after succinylcholine is most common in which areas

Answer 30

neck, shoulders, and back

Question 31

hyperkalemia can be caused by

Answer 31

succinylcholine - promotes the release of potassium from tissues

Question 32

significant hyperkalemia is most likely to occur in clients with

Answer 32

major burns, multiple trauma, denervation of skeletal muscles, or upper motor neuron injury

Question 33

hyperkalemia complication

Answer 33

cardiac arrest has resulted

Question 34

treatment for toxicology of succinylcholine

Answer 34

no specific antidote - administered IV

Question 35

toxicology of succinylcholine symptoms

Answer 35

- overdose can cause prolonged apnea - client is awake but paralyzed - suppresses gag reflex