- muscle spasm - spinal injury - muscle spasticity r/t cerebral palsy, spincal cord injury, + multiple sclerosis

muscarinic antagonist AE

- mydriasis - delirium - flushing - hyperthermia - decr secretions - dry mouth - dry eyes - anhidrosis - photophobia - constipation - tachycardia

Misc CNS - NMB + muscle relaxer Flashcards by jessica quintos

centrally acting muscle relaxants

drugs

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

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peripherally acting muscle relaxant

drug

dantrolene

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*baclofen

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

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*baclofen

VERY SLEEPY
CNS DEPRESS
dissy
weak
seizure

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*baclofen

RN/teaching

no ETOH

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

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*cyclobenzaprine

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

liver toxicity
anti ACH
photosensitivity

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muscarinic agonist aka

“i cant pee… help me!”

urinary retention

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muscarinic agonist

drug

BETHANECHOL
*-chol like cholinergic

pilocarpine
acetylcholine

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muscarinic agonist

MOA

incr bladder pressure + contraction of detrusor muscle

-helps w excretion of urine

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muscarinic agonist

sludge, dumbbells, ACH crisis

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muscarinic agonist

asthma + hyperthyroidism

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muscarinic agonist

admin 1 hr before or 2hr after meals

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muscarinic antagonist aka

im peeing toooo much

incontinence
ANTI CHOLINERGIC

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*muscarinic antagonist

drugs (3)

OXYBUTIN
darifenacin
solifenacin

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muscarinic antagonist

mydriasis
delirium
flushing
hyperthermia
decr secretions
dry mouth
dry eyes
anhidrosis
photophobia
constipation
tachycardia

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NMB

Neuromuscular Blockers

2 types of NMB

1 Depolarizing

2 Non-Depolarizing

Depolarizing NMB

drugs

Succinylcholine

-RSI Intubation

Non-Depolarizing NMB

drugs (5)

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

*Succinylcholine

hyper-K
MALIGNANT HYPERTHERMIA
muscle pains

*Malignant Hyperthermia

s/s

muscle rigidity
incr in temp

-if intubated also rise in ETCO2is first

*Malignant Hyperthermia

Dantrolene
ice packs all over
chilled IV soln
room temp down
bair hugger off

*Succinylcholine

can cause hyper-K

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

NMBs + CNS

safety equipments

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

*NMBs + CNS | reversal medications

old skool: NEOSTIGMINE, Panc, Atra new skool: SUGAMMADEX, Roc, Vec **must be on EKG, SpO2, BIS (in OR)

why is lidocaine often used in intubation?

shown to decr ICP + cough reflex

*why is fentanyl often used in intubation?

- decr BP secondary to catecholamine release - for PAIN + SEDATION - patient doesn't lose consciousness, can still feel everything!

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

muscle rigidity | malignant hyperthermia

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

SUGAMMADEX is used to reverse paralysis

what drug class is fentanyl?

opioid

anticholinergics/antimuscucarinic | drugs

DICYCLOMINE, atropine benztropine trihexyphenidyl ipratropium oxybutynin glycopyrrolate

which anticholinergics/antimuscucarinic | drug can cross BBB

DICYCLOMINE

anticholinergics/antimuscucarinic | CNS effects

confusion, hallucination, insomnia

anticholinergics/antimuscucarinic CI

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