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1 Pharmacology > Misc CNS - NMB + muscle relaxer > Flashcards

Misc CNS - NMB + muscle relaxer Flashcards

1
Q

centrally acting muscle relaxants

drugs

A 
1 benzodiazepines
2 baclofen 
3 cyclobenzaprine (no more than 3 wks)
4 tizanidine
5 carisoprodol (no more than 3 wks)
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2
Q

peripherally acting muscle relaxant

drug

A

dantrolene

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3
Q

*baclofen

Tx

A
  • muscle spasm
  • spinal injury
  • muscle spasticity r/t cerebral palsy, spincal cord injury, + multiple sclerosis
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4
Q

*baclofen

AE

A 
VERY SLEEPY
CNS DEPRESS
dissy
weak
seizure
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5
Q

*baclofen

RN/teaching

A

no ETOH

don’t drive!!! (CNS DEPRESS + SLEEEEPY)

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6
Q

*cyclobenzaprine

AE

A

shouldn’t use more than 3 weeks
-no evidence that it works beyond that

liver toxicity
anti ACH
photosensitivity

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7
Q

muscarinic agonist aka

A

“i cant pee… help me!”

urinary retention

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8
Q

muscarinic agonist

drug

A

BETHANECHOL
*-chol like cholinergic

pilocarpine
acetylcholine

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9
Q

muscarinic agonist

MOA

A

incr bladder pressure + contraction of detrusor muscle

-helps w excretion of urine

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10
Q

muscarinic agonist

AE

A

sludge, dumbbells, ACH crisis

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11
Q

muscarinic agonist

CI

A

asthma + hyperthyroidism

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12
Q

muscarinic agonist

RN

A

admin 1 hr before or 2hr after meals

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13
Q

muscarinic antagonist aka

A

im peeing toooo much

  • incontinence
  • ANTI CHOLINERGIC
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14
Q

*muscarinic antagonist

drugs (3)

A

OXYBUTIN
darifenacin
solifenacin

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15
Q

muscarinic antagonist

AE

A
  • mydriasis
  • delirium
  • flushing
  • hyperthermia
  • decr secretions
  • dry mouth
  • dry eyes
  • anhidrosis
  • photophobia
  • constipation
  • tachycardia
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16
Q

NMB

A

Neuromuscular Blockers

17
Q

2 types of NMB

A

1 Depolarizing

2 Non-Depolarizing

18
Q

Depolarizing NMB

drugs

A

Succinylcholine

-RSI Intubation

19
Q

Non-Depolarizing NMB

drugs (5)

A 
1 atracurium
2 cisatracurium
3 rocuronium (RSI Intubation)
4 vecuronium
5 pancuronium
20
Q

*Succinylcholine

AE

A
  • hyper-K
  • MALIGNANT HYPERTHERMIA
  • muscle pains
21
Q

*Malignant Hyperthermia

s/s

A
  • muscle rigidity
  • incr in temp

-if intubated also rise in ETCO2is first

22
Q

*Malignant Hyperthermia

Tx

A
  • Dantrolene
  • ice packs all over
  • chilled IV soln
  • room temp down
  • bair hugger off
23
Q

*Succinylcholine

CI

A

can cause hyper-K

—so contraindicated in crush injuries, poly-trauma, burns, K>5.5, MG patients

24
Q

NMBs + CNS

safety equipments

A
  • crash cart aka emergency resuscitative equipt
  • BVM ambubag
  • O2 w connection ““X-mas tree”
  • suction set-up w yankauer suction tip catheter
  • bedside hrt monitor
  • constant SpO2
  • train of 4
  • reversal meds
25
Q

*NMBs + CNS

reversal medications

A

old skool: NEOSTIGMINE, Panc, Atra
new skool: SUGAMMADEX, Roc, Vec

**must be on EKG, SpO2, BIS (in OR)

26
Q

why is lidocaine often used in intubation?

A

shown to decr ICP + cough reflex

27
Q

*why is fentanyl often used in intubation?

A
  • decr BP secondary to catecholamine release
  • for PAIN + SEDATION
  • patient doesn’t lose consciousness, can still feel everything!
28
Q

succs is a paralytic, if ____ occurs then _____ is happening

A

muscle rigidity

malignant hyperthermia

29
Q

if you paralyze the patient, what drug would you want in the room?

A

SUGAMMADEX is used to reverse paralysis

30
Q

what drug class is fentanyl?

A

opioid

31
Q

anticholinergics/antimuscucarinic

drugs

A

DICYCLOMINE,
atropine
benztropine
trihexyphenidyl

ipratropium
oxybutynin
glycopyrrolate

32
Q

which anticholinergics/antimuscucarinic

drug can cross BBB

A

DICYCLOMINE

33
Q

anticholinergics/antimuscucarinic

CNS effects

A

confusion, hallucination, insomnia

34
Q

anticholinergics/antimuscucarinic

CI

A
  • glaucoma
  • myasthenia gravis
  • BPH
  • GI/GU obstruction
  • antihistamines
  • 1st gen TCA
  • antipsychotic

1 Pharmacology (33 decks)

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