Akinesis Flashcards
Are muscle relaxants always given?
NO!!
always given for abdo surgery
what are the two types of muscle relaxants?
Depolarising & non-depolarising
How do depolarising relaxants work?
Depolarising agents act as ACh receptor antagonists
Not metabolised by Ace cholinesterase, so binding is prolonged
How do non-depolarising relaxants work?
Act as competitive antagonists: bind to ACh receptors but are unable to induce ion channel openings - prevent ACh from binding so end plate potentials don’t form
Succinylcholine (Suxamethonium) is what kind of relaxant?
Depolarising
Why is suxamethonium often used in RSI?
Rapid onset and offset - so if there is difficult intubation, they will start to breathe again
Give 4 cons of suxamethonium
- muscle pain & fasciculations
- Rise in ICP, IOP & gastric pressure
- Hyperkalaemia
- Malignant hyperthermia
What is a benefit of using non-depolarising relaxants?
Fewer side effects
Give examples of non-depolarising relaxants
short acting: mivacurium (15-30 min)
intermediate: vecuronium (30-60 min)
panconium (>60 min)
how are they reversed?
Neostigmine and glycopyrrolate
How does neostigmine?
Prevents breakdown of acetylcholine
Why does glycopyrrolate have to be given alongside neostigmine?
Neostigmine has muscarinic effects (e.g. bradycardia), so must be combined with an ANTIMUSCARINIC AGENT
Glycopyrrolate blocks receptors on the heart, preventing bradycardia
What is the muscle relaxant for RSI?
Suxamethonium
What is another name for suxamethonium?
Succinylcholine
