14. Skeletal muscle relaxants acting on the neuromuscular junction

Question 1

Skeletal muscle relaxants acting on the neuromuscular junction

Answer 1

Presynaptically & postsynapticly acting

Question 2

Presynaptically acting

Answer 2

Botulinum toxin
ω-conotoxin
Tetracyclines
aminoglycosides

Question 3

Postsynaptically acting

Answer 3

non depolarizing & Depolarizing muscle relaxants

Question 4

Botulinum toxin

Answer 4

ACh release inhibitor (VAMP + SNAP inhibitor)

Question 5

ω-conotoxin

Answer 5

blockade of Ca++ channels

Question 6

Curare derivatives

Answer 6

Competitive antagonists of NACh muscular receptors
IV administration 
no central effect 
2-6 min to full paralysis 
AE: recurarization

drugs types …
Isoquinolines
Steroids

Question 7

Depolarizing muscle relaxants

Answer 7

Succinylcholine

Question 8

Isoquinolines

Answer 8

suffix -curium

Doxacurium
Atracurium
Cisatracurium
Mivacurium

Question 9

Steroids

Answer 9

suffix -curonium

Pancuronium
Pipecuronium
Vecuronium
Rocuronium

Question 10

druges that inhibit the curare effect (recurarization)

Answer 10

Acetylcholinesterase inhibitors (Neostigmine given with atropine)
sugammadex

Question 11

curare derivative effect

Answer 11

non-depolarizing muscle relaxation by blocking the

muscular nicotinic acetylcholine receptor

Question 12

sugammadex

Answer 12

neutralizes the steroid structures in the plasma

Question 13

Succinylcholine

Answer 13

synthetics nicotinic componed
selective agonist NM R
DOA 5-10min
diffused quickly
metabolized by pseudocholinesterase in the blood then liver
for surgery, intubation, invasive diagnostic procedures
AE: Malignant hyperthermia, muscle pain, arrhythmia

Question 14

Dantrolene

Answer 14

inhibits Ca++ release in skeletal muscle
for malignant hyperthermia
ryanodine antagonist
AE: Hepatotoxic

Question 15

Doxacurium

Answer 15

Long acting

Question 16

Atracurium

Answer 16

Intermediate acting
hoffman elimination (spontaneous)
AE: histamine release & metabolite causes convolutions

Question 17

Cisatracurium

Answer 17

Intermediate acting 
hoffman elimination (spontaneous)

Question 18

Mivacurium

Answer 18

Short acting
elimination by pseudocholinesterase
AE: histamine release

Question 19

Pancuronium

Answer 19

Long acting
Elimination by kidney
AE: ganglionic block (HT, tachycardia), M2 receptor blockade, NE release + reuptake inhibitor

Question 20

Pipecuronium

Answer 20

Long acting

Elimination by kidney

Question 21

Vecuronium & Rocuronium

Answer 21

Intermediate acting

metabolized by the liver

Question 22

non depolarizing muscle relaxants

Answer 22

Curare derivatives

Question 23

recurarization

Answer 23

increase in neuromuscular block after a variable period of recovery