NMJ Blockers Flashcards
(21 cards)
Classified based on
Duration of action
Mechanism of action
Chemistry
Mechanism of action
Long acting
Intermediate acting
Short acting
Long acting
D-tubocurarine
Pancuronium
Doxacurium
Metocurine
Intermediate acting
Vecuronium
Rocuronium
Atracurium
Short acting
Mivacurium
Based on chemistry
Natural alkaloids
Ammonio steroids
Benzylisoquinolines
Natural alkaloids
D-tubocurarine
Semi-Synthetic alkaloid = Alcuronium
Ammonio-steroids
Pancuronium
Benzylisoquinolines
Atracurium
Mivacurium
Based on mechanism of action
Competitive (non-depolarizing)
Depolarizing
Competitive (non-depolarizing) example
D-tubocurarine
Depolarizing example
Succinylcholine
Decamethonium
Xtics of non-depolarizing blockers
- Bind to receptors and prevent NT binding, prevent depolarization
- Poorly absorbed
- Rapidly excreted
- Slow onset of action
- Long duration of action
Non-depolarizing examples
Pancuronium
Atracurium
Mivacurium
Vecuronium
Depolarizing blockers
Succinylcholine
ACh
They are depolarizing agonists in excess
How are agonists like succinylcholine NMB blockers?
They are more resistant to AChE action and polarize more persistently.
Adverse effect of d-tubocurarine
Fall in arterial pressure due to ganglion block and release of histamine, causing brochospasm
How is tachycardia an adverse effect in NMB block?
It is due to ganglion blockade and histamine release
NMBs that cause tachycardia
Atracurium
Mivacurium
Pancuronium
Gallamine
Tubocurarine
Adverse effects of NMBs
- Tachycardia
- Bradycardia (succinylcholine, M2 action)
- Increased intraocular pressure
- Prolonged paralysis (succinylcholine, enzyme inhibition)
- Malignant hyperthermia
Clinical uses of NMBs
- Surgical relaxation
- Tracheal intubation
- Control of ventilation
- Treatment of convulsion (peripheral manifestation)
