Intro to NMJ Pharmacology Flashcards
cisatracurium
nondepolarizing isoquinoline derivative
tubocurarine
nondepolarizing isoquinoline derivative
pancuronium
steroid derivative nondepolarizing agent
rocuronium
steroid derivative nondepolarizing agent
vecuronium
steroid derivative nondepolarizing agent
succinylcholine
depolarizing neuromuscular blocking agent
dantrolene
spasmolytic - muscle relaxant
echothiophate
acetylcholinesterase inhibitor
edrophonium
acetylcholinesterase inhibitor
neostigmine
acetylcholinesterase inhibitor
physostigmine
acetylcholinesterase inhibitor
pyridostigmine
acetylcholinesterase inhibitor
atropine
antimuscarinic
pralidoxime
cholinesterase reactivator
spasmolytics
centrally acting
nondepolarizing neuromuscular blocking agent
agonist at nAChR
depolarizing neuromuscular blocking agent
excess of depolarizing agonist
ex. succinylcholine
all neuromuscular blocking agents
highly polar and inactive orally
must be given parenterally**
quaternary nitrogen
make poorly lipid soluble - limit CNS entry
kidney excretion
longer half life
liver excretion
shorter half life
rocuronium
fast onset and short duration of action
diaphragm
last muscle to be paralyzed and quickest to recover
reversal of neuromuscular blockade
reversed with ACh or succinylcholine
also - may give cholinesterase inhibitor
edrophonium
pure cholinesterase inhibitor
neostigmine and pyridostigmine
cholinesterase inhibitor AND increase release of ACh at motor nerve terminal
large dose of neuromuscular blockade
enter pore of nAChR - more intense blockade - diminish ability of acetylcholinesterase inhibitor to antagonize effect
adverse of nondepolarizing agents
histamine release
-wheals, bronchospasm, hypotension
tubocuraine
declined use
- because of histamine release
- and very long duration of action
inhaled anesthetic
potentiate neuromuscular blockade
aging and neuromuscular response
longer duration of action with nondepolarizing agents in older patient - bc of reduced hepatic and renal function
so need to decrease dose**
usually age >70yo