Nicotinic antagonists

Question 1

nondepolarizing competitive antagonists MOA

Answer 1

hold the Nm receptor closed, preventing Na+ flow and depolarization–> no muscle contraction

Question 2

effect of nondepolarizing blockers can be overcome with

Answer 2

ACh, as they are competitive antagonists

Question 3

the only depolarizing blocker

Answer 3

succinylcholine

Question 4

succinylcholine MOA

Answer 4

holds Nm open, continual flow of Na+ causes continual, longer than normal depolarization, which causes Nm to desensitize to subsequent ACh stimulation

Question 5

neuromuscular blocking agents DO NOT

Answer 5

produce unconsciousness or anesthesia because they do not enter the brain

Question 6

due to their high degree of ionization

Answer 6

neuromuscular blocking agents are NOT absorbed orally and do NOT enter CNS. IV ONLY.

Question 7

nondepolarzing blockers interfere with the mobilization of ACh from the nerve terminal by

Answer 7

blocking pre-junctional sodium channels

Question 8

endplate potential _______ when a nondepolarizing blocker is taken

Answer 8

decreases, an action potential can no longer be generated –> lack of muscle contraction (paralysis)

Question 9

pharmacologic reversal for nondepolarizing blockers

Answer 9

cholinesterase inhibitors (increase ACh which can outcompete blockers)

Question 10

muscles that are affected first by nondepolarizing blockers

Answer 10

small muscles followed by larger muscles

Question 11

muscles that are affected last by nondepolarizing blockers

Answer 11

diaphragm, intercostal muscles

Question 12

onset of action and recovery from succinylcholine are ________, so it’s used for

Answer 12

rapid

short procedures

Question 13

succinylcholine’s action is terminated by

Answer 13

plama pseudocholinesterase

Question 14

dibucaine

Answer 14

a local anesthetic that causes inhibition of AChE

Question 15

abnormal dibucaine number

Answer 15

20%: abnormal cholinesterase acitivity, succinylcholine with last way too long

Question 16

normal dibucaine number

Answer 16

80%: cholinesterase functions normally and succinylcholine will be short acting

Question 17

delay recover from succinylcholine

Answer 17

cholinesterase inhibitors

Question 18

succinycholine contraindications

Answer 18

soft tissue damage, burns, non-traumatic rhabdomyolisis, spinal cord injuries, muscular dystrophy, <8 years old

Question 19

inhaled anesthetic

Answer 19

halothane

Question 20

halothane is notorious for

Answer 20

malignant hyperthermia (also succ can cause)

Question 21

malignant hyperthermia from succinylcholine/halothane treatment

Answer 21

dantrolene

Question 22

patients who are at higher risk of too much K+ released by succinylcholine

Answer 22

burns, nerve degeneration, head trauma, peritoneal infection, kidney disease

Question 23

prolonged release of potassium by succinylcholine + risk factor can cause

Answer 23

cardiac arrest, life threatening esp in CHF

Question 24

malignant hyperthermia by succinylcholine/halothan MOA

Answer 24

uncontrolled release of Ca++ from sarcoplasmic reticulum –> muscle rigidity and high temperature

Question 25

ventilation use of neuromuscular blocking agents

Answer 25

paralyze diaphragm so a ventilator can be used. intubation, bronchoscopy.

Question 26

surgery use of neuromuscular blocking agents

Answer 26

paralysis, relax muscles for surgery

Question 27

orthopedic use of neuromuscular blocking agents

Answer 27

allow manipulation of bones

Question 28

other random ass use of neuromuscular blocking agents

Answer 28

decrease convulsions/muscle spasms (fine) in ECT (idk).

Question 29

ganglion blockers are considered

Answer 29

nondepolarizing competitivie antagonists

Question 30

2 ganglion blockers

Answer 30

hexamethonium mecamylamine (not used clinically)

Question 31

effects of ganglion blockers

Answer 31

fire PNS and SNS so it depends on the dominant tone of the organ

Question 32

ganglion blocker effects in eye

Answer 32

PNS blocked: cycloplegia, mydriasis

Question 33

ganglion blocker effects on blood vessels

Answer 33

SNS blocked: vasodilation causes drop in BP, orthostatic hypotension

Question 34

ganglion blocker effects on heart

Answer 34

SNS blocked: contractility reduced | PNS blocked: decrease in vagal tone causes tachycardia

Question 35

GU ganglion blocker effects

Answer 35

PNS blocked: urinary retention, esp. BPH

Question 36

sex ganglion blocker effects

Answer 36

PNS blocked: erectile dysfunction | SNS blocked: reduced ejaculation

Question 37

ganglion blocker effects on body temp

Answer 37

SNS blocked: can't sweat | maintain body heat through vasodilation

Question 38

ganglion blocker effects if combined with autonomic drugs

Answer 38

normal/exaggerated effects on target organ receptors which are not blocked Feedback and reflexes are decreased/abolished