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Pcol2 > LESSON 10: Neuromuscular Blocking Drugs > Flashcards

LESSON 10: Neuromuscular Blocking Drugs Flashcards

1
Q

Drugs that completely paralyze skeletal muscles (from normal tone to zero) by interfering with acetylcholine at neuromuscular junction

A

NEUROMUSCULAR BLOCKERS

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2
Q

Drugs that used to relieve skeletal muscle spasm & bring them from hypertonic state to normal muscle tone. (Ex. Dantrolene)

A

SPASMOLYTICS

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3
Q

These drugs interfere with transmission at the neuromuscular end plate and lack central nervous system activity

A

NEUROMUSCULAR BLOCKING DRUG

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4
Q

All of the available neuromuscular blocking drugs bear a structural resemblance to _________________.

A

acetylcholine

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5
Q

All of the neuromuscular blocking drugs are ___________________ and inactive orally and must be administered parenterally.

A

highly
polar (water soluble)

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6
Q

Non-competitive, agonist;
Act on the acetylcholine receptor (agonist drug)

A

DEPOLARIZING

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7
Q

Competitive, antagonist;
Attacks/goes against the acetylcholine receptor;

A

NON-DEPOLARIZING

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8
Q

NON-DEPOLARIZING EXAMPLE

A

Tubocurarine

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9
Q

DEPOLARIZING EXAMPLE

A

Succinylcholine (Anectine)
Decamethonium bromide (Syncurine®)

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10
Q

Ultra Short-Acting

A

Succinylcholine

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11
Q

Short-Acting

A

Mivacurium

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12
Q

Intermediate Acting

A

Vecuronium
● Atracurium
● Rocuronium
● Cis-atracurium

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13
Q

Long-Acting

A

Pancuronium

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14
Q

Resembles two acetylcholine molecules linked end to end, it has two quaternary ammonium cations which interact with the anionic sites on the muscle end plate receptors.

A

DEPOLARIZING

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15
Q

used to produce complete muscle relaxation for various surgical procedures

A

succinylcholine (anectine)

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16
Q

used as a
muscle relaxant for relatively short surgical procedures

A

Decamethonium bromide (Syncurine®)

17
Q

another name for Decamethonium bromide (Syncurine®)

A

Suxamethonium

18
Q

SUCCINYLCHOLINE: MAJOR SIDE EFFECTS

A

Hyperkalemia
Arrhythmia
Myalgia
Increased intraocular pressure
Increased intracranial pressu re (ICP)
Skeletal muscle contractions
Myoglobinuria
Increased intragastric pressure

19
Q

succinylcholine side effects may be reduced by prior administration of non-paralyzing doses of____________________________

A

non-depolarizing neuromuscular-blocking agents.

20
Q

These agents also contain a “double-acetylcholine” form; however this form is hidden by ring systems

A

NON-DEPOLARIZING

21
Q

Contains 1-2 quaternary nitrogens which result in limited lipid-solubility

A

NON-DEPOLARIZING

22
Q

pancuronium brand name

A

Pavulon®

23
Q

NON-DEPOLARIZING drugs combine with________________ and
prevent binding of acetylcholine so prevent depolarization of the muscle cell membrane so inhibiting _______________.

A

nicotinic receptors; muscle contraction

24
Q

NON-DEPOLARIZING drugs competitively block the receptors; this means that you can overcome their action by ____________ (increasing/decreasing) Ach concentration by giving Ach esterase inhibitors such as ____________________

A

increasing; pyridostigmine or neostigmine.

25
Q

2 MAJOR CLASSES OF NON-DEPOLARIZING BLOCKERS

A

Isoquinoline derivatives, Steroid derivatives

26
Q

Isoquinoline derivatives

A

● Tubocurarine
● Atracurium (Tracrium) ● Doxacurium(Nuromax) ● Mivacurium(Mivacron)

27
Q

Steroid derivatives

A

● Pancuronium (Pavulon) ● Vecuronium (Norcuron) ● Pipecuronium (Arduan) ● Rocuronium (Zemuron)

28
Q

Motor weakness, followed by skeletal muscle
flaccidity inexcitability to electrical stimulation

A

NON-DEPOLARIZING

29
Q

Muscle fasciculations (very evident) especially over the chest and abdomen followed by complete paralysis

A

DEPOLARIZING

30
Q

Order of Muscle Movement for NON-DEPOLARIZING

A

● 1 - smaller muscles (eg. facial, foot, hand)
● 2 - larger muscles
(eg. abdominal, trunk)
● 3 - diaphragm

31
Q

Order of Muscle Movement for DEPOLARIZING

A

● 1 - arm, neck, and leg muscles
● 2- facial and pharyngeal muscles
● 3 - muscle follows
respiratory weakness rapidly, usually within 60
seconds

32
Q

Recovery for NON-DEPOLARIZING

A

In reverse order, with the diaphragm regaining function first

33
Q

Recovery for DEPOLARIZING

A

In reverse order

34
Q

CONSIDERATION FOR CHOOSING A MUSCLE RELAXANT

A

Duration of action required
Route of excretion
endency to release histamine
Cardiopulmonary side effects
The ability to reverse the blockage
Contraindication to any specific muscle relaxant.
Cost

Pcol2 (20 decks)

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