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Pharmacology Fall 2015 > L 19 > Flashcards

Flashcards in L 19 Deck (15)
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1
Q

How to administer non-depolarizing NM blockers

A

All are highly ionized and will not be absorbed

Must be injected

2
Q

NM Blockers and the CNS

A

Being highly ionized, do not cross BBB

Paralyzed but awake

3
Q

How to reverse a NM block

A

Administer AchE Inhibitors like Neostigmine to increase Ach in cleft

4
Q

Double burst results for non-depolarizing vs depolarizing drugs

A

Non-depolarizing: Posttetanic potentiation, and a fade

Depolarizing: no fade, no Posttetanic potentiation

5
Q

Succinylcholine

A

Depolarizing NMJ Blocker
Made of two Ach molecules
Has same effect as Ach, except lasts longer and leads to desensitization=> paralysis
Effects cannot be overcome with AchE Inhibitors because it is non-competitve.
Allows lots of Na into cell, and K out of cell–problematic for hypersensitive people

6
Q

Contraindications for succinylcholine

A

Children

7
Q

What can increase NMJ blockade?

A

Inhaled anesthetics (Isoflurane)
Antibiotics
Tetracyclines
Ca channel blockers

8
Q

How will myasthenia gravis patients respond to succinylcholine?

A

Greater response due to less N receptors

9
Q

How do burn victims respond to non-depolarizing NMJ blockers?

A

They are more resistant because they have more N receptors. But, succinylcholine is not good for them for the same reason. =>K+ loss from the cell and potentially heart failure.

10
Q

d-Tubocurarine

A

Non-Depolarizing NMJ blocker

Releases lots of histamine which can cause hypotension and bronchospasm

11
Q

Atracurium

A

Non-depolarizing NMJ blocker

Releases histamine liked-Tubocurarine

12
Q

Cisatracurium

A

Non-depolarizing NMJ blocker

Unlikely to release histamine

13
Q

Hexamethonium

A

Ganglion blocker

Non-depolarizing competitive antagonist

14
Q

Mecamylamine

A

Ganglion blocker

Enters brain–causes tremor, sedation, altered mentation

15
Q

Effects of ganglion blockers

A

Block all ANS ganglia, effects depend on dominant tone in tissue
Eye: cycloplegia, mydriasis
BV: orthostatic hypotension (lost symp stimulation)
Heart: tachycardia
GU: urinary retention, no ejaculation/erection
No sweating
ANS drugs will have same or enhanced effect because target organs not blocked, but feedback mechanisms will decrease