Skeletal Muscle Relaxants

Question 1

What are the 2 types of Neuromuscular Blocking agents?

Answer 1

Non-Depolarizing

Depolarizing

Question 2

What is the Depolarizing Neuromuscular Blocking Agent?

Answer 2

Succinylcholine

Question 3

Besides Succinylcholine, the rest of the Neuromuscular Blocking Agents are ____

Answer 3

Non-depolarizing

Question 4

The Isoquinolone Derivatives that are Neuromuscular Blocking end in what?

Answer 4

–Curium or Curarine

Question 5

The Steroid Derivatives that are Neuromuscular Blocking Agents end in what?

Answer 5

–Nium

Question 6

What are 3 long acting Neuromuscular Blocking Agents?

Answer 6

Doxacurium
Pancuronium
Piperuronium

Question 7

Do Neuromuscular Blockers have CNS activity?

Answer 7

No – just interfere with transmission at NMJ

Question 8

The Non-depolarizing Neuromuscular Blocking Agents MOA

Answer 8

Prevent access of Ach to its receptor and block depolarization

Question 9

The Depolarizing Neuromuscular Blockage Agent MOA

Answer 9

Blockade that results from excess of a depolarizing agent

Question 10

What are 3 possible adverse effects of Neuromuscular Blocking Agents?

Answer 10

Hypotension
Tachycardia
Histamine release – bronchospasm

Question 11

Which Neuromuscular Blocking Agents have less Histamine release?

Answer 11

Steroids – nium

Question 12

What drug class is used to reverse the NMJ Blockade?

Answer 12

Cholinesterase (-)’s +/- Anticholinergics

Question 13

What drug class is used to reverse the NMJ Blockade?

Answer 13

Cholinesterase (-)’s +/- Anticholinergic Agents

Question 14

What are the 2 phases of Succinylcholine’s MOA?

Answer 14

Phase 1 Depolarizing Block

Phase 2 Desensitizing Block

Question 15

How does Phase 1 Depolarizing Block work with Succinylcholine?

Answer 15

Longer Ach effects at NMJ which causes the membranes to be depolarized and unresponsive

Question 16

What is the manifestation of Phase 1 Depolarizing Block of Succinylcholine?

Answer 16

Flaccid paralysis with lack of repolarization

Question 17

How does Phase 2 Desensitizing Block work with Succinylcholine?

Answer 17

Depolarization decreases with continued exposure and then receptors become desensitized

Question 18

What are 2 Anti-muscarinic Agents? (Anticholinergics)

Answer 18

Atropine

Glycopyrrolate

Question 19

What is 1 Cholinesterase Reactivator?

Answer 19

Pralidoxime

Question 20

What is 1 Cholinesterase Reactivator?

Answer 20

Pralidoxime

Question 21

What can Pralidoxime do?

Answer 21

(Cholinesterase Reactivator)

= Reverse organophosphates sensory changes

Question 22

If you were to choose a Cholinesterase (-) to reverse a pharmacologic paralysis, which one would you choose?

Answer 22

Neostigmine

Question 23

If you were to choose a Cholinesterase (-) to reverse a pharmacologic paralysis, which one would you choose?

Answer 23

Neostigmine

Question 24

What 3 Cholinesterase (-)’s can be used to treat Myasthenia Gravis?

Answer 24

Neostigmine
Pyridostigmine
Ambenonium

Question 25

What 3 Cholinesterase (-)'s can treat Myasthenia Gravis?

Answer 25

Neostigmine Pyridostigmine Ambenonium

Question 26

Muscle Relaxants are known as?

Answer 26

Spasmolytic Agents

Question 27

Generally, what do Spasmolytic Agents do?

Answer 27

Provide relief from discomfort and pain of muscle spasms

Question 28

What are 2 Centrally Acting Muscle Relaxants that you need to know?

Answer 28

Carisoprodol | Cyclobenzaprine

Question 29

What are 2 Centrally Acting Spasmolytic Agents that you need to know?

Answer 29

Carisoprodol | Cyclobenzaprine

Question 30

What are the adverse effects of Carisoprodol?

Answer 30

Addictive potential with anxiolytic effects

Question 31

Which Centrally acting muscle relaxant has an addictive potential with anxiolytic effects?

Answer 31

Carisoprodol

Question 32

What is an adverse effect of Cyclobenazprine?

Answer 32

Drowsiness

Question 33

Which Centrally acting muscle relaxant can cause drowsiness?

Answer 33

Cyclobenzaprine

Question 34

What are 2 Non-Centrally acting muscle relaxants?

Answer 34

Dantrolene | Botulinum Toxin

Question 35

What are 4 drugs for Multiple Sclerosis?

Answer 35

Glucocorticoids Glatiramer Acetate IFN-beta-1a/1b Mitoxantrone

Question 36

What are 4 drugs for Multiple Sclerosis?

Answer 36

Glucocorticoids Glatiramer Acetate IFN-beta-1a/1b Mitoxantrone

Question 37

What is Glatiramer Acetate made of?

Answer 37

4 AA polymers that are similar to myelin basic protein

Question 38

What is the MOA for Glatiramer Acetate?

Answer 38

(+) T Suppressor Cells specific for myelin antigen

Question 39

Where do IFN-beta-1a/1b drugs act?

Answer 39

BBB

Question 40

What is the MOA for IFN-beta-1a/1b?

Answer 40

Interfere with T cell adhesion by binding VLA-4 or by (-) expression of MMP on T cells

Question 41

What is the MOA for Mitoxantrone?

Answer 41

Intercalates into DNA to cause cross-links and strand breaks

Question 42

Which drug for MS can intercalate into DNA and cause cross-links and strand breaks?

Answer 42

Mitoxantrone

Question 43

Which drug for MS can interfere with T cell adhesion by binding VLA-4 or by (-) expression of MMP on T cells?

Answer 43

IFN-beta-1a/1b

Question 44

Which drug for MS (+) T suppressor cells specific for myelin antigen?

Answer 44

Glatiramer Acetate