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HLST220: Pharmacology > Chapter 19: Drugs That Block Nicotinic Cholinergic Transmission > Flashcards

Chapter 19: Drugs That Block Nicotinic Cholinergic Transmission Flashcards

1
Q

Nueromuscular drugs mechanism of action

A
  • prevent ACh for activating nicotinic receptors on skeletal muscles, which results in muscle relaxation
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2
Q

Neuromuscular drugs cannot cross

A
  • the blood brain barrier
  • placenta
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3
Q

polarization

A

positive changes cover the outer surface of the mebrane; negative charges cover the inner membrane

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4
Q

depolarization

A
  • postive changes move from the outside to inside
  • in response to the binding of ACh to the nicotinic receptors
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5
Q

repolarization

A
  • positively charged ions are pumped out of the cell so that the original resting membrane state is restored
  • follows unbinding of ACh from endplate of nicotinic receptors
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6
Q

competitive (nonpolarizing) neuromuscular blockers

A
  • do not depolarize the motor endplate
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7
Q

all neuromuscular blocking agents contain at least one

A

quaternary nitrogen atom

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8
Q

nondepolarizing neuromuscular blockers mechanism of action

A
  • competes with ACH for nicotonic receptors
  • blocks receptor activation of acetlcholine
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9
Q

competetive neuromuscular blockers pharmacologic effects

A
  • muscle relaxation: flaccid paralysis
  • hypotension
  • no effect on the CNS
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10
Q

when a competitive neuromuscular blocker is administered peak effects persist

A

20-45 mins and then decline

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11
Q

recovery for a cometitive neuromuscular blocker takes

A

1 hour

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12
Q

competetive neuromuscular blocker effect

A

rapid onset of paralysis

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13
Q

Competetive neuromuscular blocker therapeutic uses

A

muscle relaxation during surgery, mechanical ventilation, endotracheal intubation

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14
Q

Competetive neuromuscular blockers adverse effects

A
  • respitory arrest
  • hypotension
  • atracurium
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15
Q

long acting agents

A
  • Doxacurium
  • metocurine
  • pipecuronium
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16
Q

intermediate acting agents

A
  • cisatracurium
  • pancuronium
  • rocuronium
  • vercuronium
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17
Q

short acting agents

A
  • mivacurium
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18
Q

Atracurium is used for

A

muscle relaxation during surgery

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19
Q

Atracurium side effects

A
  • can cause hypotension as a result of histamine release
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20
Q

atracurium excretion

A

primarily by plasma cholinesterase

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21
Q

Atracurium may be desireable for patient with

A

renal or hepatic dysfunction

22
Q

Pancuronium is used for

A

muscle relaxation during general anesthesia, itubation, and mechanical ventelation

23
Q

does pancuronium cause histamine release, gangloinic blockade, or hyptension

A

no

24
Q

Pancuronium dise effects

A

Vagolytic effects may produce tachycardia

25
Q

Pancuronium should be used with caution in

A

patients with liver disease

26
Q

Pancuronium excretion

A

primarily through the urine

27
Q

Rocuronium [Zemuron] is used for

A

muscle relaxation during intubation, surgury, and mechanical ventelation

28
Q

Rocuronium [Zemuron] takes effect in

A
  • 1-3 minutes
  • persist for 20-40
29
Q

does Rocuronium [Zemuron] cause histamine release

A

no

30
Q

Rocuronium [Zemuron] elimination

A

hepatic metabolism

31
Q

Vecuronium [Norcuron] is an analogue of

A

pancuronium

32
Q

Vecuronium [Norcuron] is used for

A

muscle relaxation during intubation, general anesthesia, and mechanical ventilation

33
Q

Vecuronium [Norcuron] is excreted primarily in the

A

bile

34
Q

Vecuronium [Norcuron] should be used with caution in patients with

A

liver dysfunction and patients who are obese
- paralysis may be prolonged

35
Q

Succinylcholine [Anectine] mechanism of action

A

depolarizing the neuromuscular blockade

36
Q

Succinylcholine [Anectine] pharmacologic effects

A
  • ultra-short acting (peaks at 1 minute)
  • mucle relaxation; state of flaccid paralysis
  • no effect on CNS
37
Q

Succinylcholine [Anectine] is eliminated by

A

plasma cholinesterases

38
Q

Succinylcholine [Anectine] therapeutic uses

A
  • muscle relaxation during endotracheal intubation
39
Q

Succinylcholine [Anectine] causes prolonged apnea in clients with

A

low pseudocholinesterase activity
- causes paralysis to persists for hours

40
Q

Malignant hyperthermia can be triggered by

A

succinylcholine

41
Q

Maliganant hyperthermia symptoms

A
  • muscle rigidity, profound elevation of body tempurature, cardiac dysrhythmias, unstable blood pressure, electrolyte derangements, and metabolic acidosis
42
Q

a malignant hyperthermia reaction is determined

A

genetically

43
Q

treatment of malignant hyperthermia

A
  • discontinuation of succinylcholine
  • cooling patient with external ice packs and intravenous infusion of cold saline
  • administering intravenous dantrolene (reduce skeletal muscle metabolic activity
44
Q

between 10% to 70% of patients experience postoperative muscle pain after recieving what medication

A

succinylcholine

45
Q

postoperative muscle pain after succinylcholine occurs

A

12-24 hours after surgery

46
Q

pain after succinylcholine is most common in which areas

A

neck, shoulders, and back

47
Q

hyperkalemia can be caused by

A

succinylcholine
- promotes the release of potassium from tissues

48
Q

significant hyperkalemia is most likely to occur in clients with

A

major burns, multiple trauma, denervation of skeletal muscles, or upper motor neuron injury

49
Q

hyperkalemia complication

A

cardiac arrest has resulted

50
Q

treatment for toxicology of succinylcholine

A

no specific antidote
- administered IV

51
Q

toxicology of succinylcholine symptoms

A
  • overdose can cause prolonged apnea
  • client is awake but paralyzed
  • suppresses gag reflex

HLST220: Pharmacology (23 decks)

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