SKELETAL MUSCLE RELAXANTS

Question 1

used to produce muscle paralysis to facilitate surgery or assisted ventilation

Answer 1

NMB drugs

Question 2

used to reduce abnormally elevated tone caused by neurologic or muscle end plate disease

Answer 2

Spasmolytic drugs

Question 3

DEPOLARIZING BLOCKADE

Answer 3

paralysis from persistent depolarization of the end plate (succinylcholine)

ineffective muscle contraction

Question 4

NONDEPOLARIZING OR STABILIZING BLOCKADE

Answer 4

competitive antagonists at the acetylcholine receptor of the end plate
(tubocurarine)

reversible by increasing Ach or giving Ach inhibitors ( neostigmine, edrophonium, physostigmine, pyridostigmine, rivastigmine, donepezil)

Question 5

Lethal Injection Drugs

Answer 5

Thiopental 5g
Pancuronium 100mg
Potassium Chloride 100mEq

Question 6

NONDEPOLARIZING NMB DRUGS

Answer 6

Natural Alkaloid
Isoquinoline
Amino-steroid

Question 7

NATURAL ALKALOID

Answer 7

TUBOCURARINE

Question 8

ISOQUINOLINE

Answer 8

ATRACURIUM
CISATRACURIUM
MIVACURIUM

Question 9

AMINOSTEROID

Answer 9

VECURONIUM
ROCURONIUM
PANCURONIUM

Question 10

undergoes Hoffman Elimination or rapid spontaneous breakdown yielding Laudanosine (seizure causing)

Answer 10

ATRACURIUM AND CISATRACURIUM

Question 11

undergoes bile elimination

Answer 11

Vecuronium

Question 12

with additional moderate block on cardiac muscarinic receptors

Answer 12

Pancuronium

Question 13

metabolized by pseudocholinesterase

Answer 13

mivacurium, succinylcholine

Question 14

most rapid onset

Answer 14

rocuronium

Question 15

main reversing agent

Answer 15

NEOSTIGMINE

Question 16

reversing agent for ROCURONIUM

Answer 16

SUGAMMADEX

Question 17

NMB DOF for hemodynamically compromised patients

Answer 17

CISATRACURIUM, VECURONIUM, ROCURONIUM

Question 18

short acting nondepo NMB

Answer 18

MIVACURIUM

DOA: 10-20 MINUTES

Question 19

rare interaction of succinylcholine and possibly tubocurarine with inhaled anesthetic halothane

Answer 19

MALIGNANT HYPERTHERMIA

Question 20

early sign of malignant hyperthermia

Answer 20

trismus

Question 21

DEPOLARIZING NMB

Answer 21

SUCCINYLCHOLINE

Question 22

NMB OF CHOICE FOR RAPID SEQUENCE INDUCTION

Answer 22

SUCCINYLCHOLINE

Question 23

MOA: SUCCINYLCHOLINE

Answer 23

Agonist at ACh N receptors causing initial twitch then persistent depolarization

Question 24

PHASES OF DEPOLARIZING BLOCKADE

Answer 24

Phase 1 DEPOLARIZATION
membrane depolarizes with initial electric discharge

transient fasciculations followed by flaccid paralysis

Phase 2 DESENSITIZATION
membrane repolarizes but receptor is desensitized to the effects of ACh

Question 25

Centrallt Acting Spasmolytic Drugs
GABA B AGONIST
Facilitates spinal inhibition of motor neurons

Answer 25

BACLOFEN

Question 26

Centrally Acting Spasmolytic Drugs

Answer 26

BACLOFEN

ORPHENADRINE, CHLORPHENESIN, METHOCARBAMOL, CYCLOBENZAPRINE

DIAZEPAM

TIZANIDINE

Question 27

Spasmolytic Drug with strong antimuscarinic effec

Answer 27

ORPHENADRINE
CHLORPHENESIN
METHOCARBAMOL
CYCLOBENZAPRINE

Question 28

Spasmolytuc drug with alpha 2 agonist effect in th spinal cord

Answer 28

TIZANIDINE

Question 29

DIRECT ACTING MUSCLE RELAXANTS

Answer 29

DANTROLENE

EPERISONE

Question 30

MOA: DANTROLENE

Answer 30

CCB

block RYR1 Ca release channels in the SR of skeletal muscles

Question 31

MOA: EPERISONE

Answer 31

relaxes both skeletal and vascular smooth muscles