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Musculoskeletal 3.1 > Msk 17 & 18 > Flashcards

Msk 17 & 18 Flashcards

1
Q

Which type of muscle relaxant interferes with neurotransmissino at the neuromuscular junction, but lacks central nervous system activity?

A

Neuromuscular blocking agents

  • aduncts in general surgery
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2
Q

Which type of muscle relaxant mostly acts on the central nervous system?

A

Spasmolytic drugs

  • treats muscle spasticity caused by CNS disorders
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3
Q

Adverse effects of muscle relaxant drugs manifest on what nervous system?

A

Autonomic

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4
Q

In the synaptic cleft, ACh binds to what type of receptors on the motor end plate to generate a EPSP?

A

Nicotinic

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5
Q

What type of drug is a competitive nicotinic receptor antagonists?

A

Non-depolarizing agents

  • curariform drugs
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6
Q

What type of drug is a nicotinic receprot agonist?

A

Depolarizing agents

Succinylcholine

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7
Q

What is the sequence of muscle paralysis?

A

Small, rapidly moving

Large limb & turnk

Intercostals

Diaphragm

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8
Q

What is an adverse effect of Pancuronium?

A

Tachycardia - inhibition of the parasympathetic vaus n.

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9
Q

What is the only route of administration for muscle relaxants?

A

IV

Poor absorption from GI tract

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10
Q

Which drug undergoes spontaneous nonezymatic degradation and is preferred for patients with imparied liver and kidney function?

A

Cisatracurium

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11
Q

This drug is used to attenuate muscle relaxation by increasing junctional ACh levels. Used to treat overdose of non-depolarizing neuromuscular blockers. Used at the end of surgery.

A

Cholinesterase Inhibitors

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12
Q

These drugs potentiate muscle relaxing effects. Dosage of synergistic drug must be reduced when used together.

A

Inhalational anesthetics

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13
Q

What type of drug are isoflurane and halothane?

A

Inhalational anesthetics

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14
Q

This drug inhibits ACh release from cholinergic nerves by competing with Ca2+. Synergizes with non-depolarizing blockers to potentiate muscle relaxation.

A

Aminoglycoside antibiotics

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15
Q

Gentamicin and tobramycin are examples of what type of drug

A

Aminoglycoside antibiotics

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16
Q

These drugs enhance muscle-relaxing effects

A

Calcium-channel blockers

17
Q

This non-depolarizing neuromuscular blocker causes moderate histamine release and ganglionic blockade, and is now rarely used as a therapeutic agent.

A

Tubocurarine

18
Q

This non-depolarizing neuromuscular blocker is vagolytic and causes moderate tachycardia.

A

Pancuronium

19
Q

This non-depolarizing neuromuscular blocker has the most rapid onset of action and is useful for rapid tracheal intubation.

A

Rocuronium

20
Q

This depolarizing neuromuscular blocking agent binds to nicotinic receptors at the motor end plate and causes membrane depolarization

A

Succinylcholine

21
Q

Which depolarizing neuromuscular blocking agent is insensitive to AChE?

A

Succinylcholine

22
Q

Prolonged depolarization of muscle cell membrane causes_______.

A

Muscle paralysis

23
Q

An imbalance between descending excitatory and inhibitory pathways results in ______.

A

Spasticity

24
Q

This depolarizing neuromuscular blocking agent causes transient fasciculations followed by flaccid paralysis. The second phase of this drug causes membrane desensitization to the effect of ACh.

A

Succinylcholine

25
Q

For succinylcholine elimination, what is the plasma cholinesterase involved?

A

Butyrylcholinesterase

26
Q

Pt prepared for surgery develops severe hyperthermia, metabolic acidosis, and tachycardia (malignant hyperthermia). The physician immediately requests:

A

Rapid cooling

Control of acidosis

Administration of Dantrolene

27
Q

What receptor does Dantrolene bind to?

A

GABAB

28
Q

What is the mechanism of Tizanidine?

A

Centrally acting a2-adrenoceptor agonist

  • decreases excitatory NT release in spinal cord
29
Q

a2 autoreceptors exist where?

What does it modulate?

A

Presynaptic adrenergic neurons

Inhibits release of norepinepherine

30
Q

a2 heteroreceptors exist where?

Binding to this receptor modulates what?

A

Presynaptic non-adrenergic neurons

Inhibits release of glutamate

31
Q

Tizanidine is metabolized by hepatic _______, and excreted in urine and feces.

A

CYP1A2

32
Q

Which receptor does Diazepam bind to?

A

GABAA

Agonist - causes Cl- influx and hyperpolarization of postsynaptic neurons 17/18.48

33
Q

What are two important drugs for acute local muscle spasm?

What is their mechanism of action?

A

Cyclobenzaprine (Flexeril)

Metaxalone (Skelaxin)

MOA unknown

34
Q

Cyclobenzaprine (Flexeril) and Metaxalone (Skelaxin) are used in the treatment of acute muscle spasms due to _________________, not ____________.

A

local tissue trauma or muscle strains

NOT

due to CNS disorders!

35
Q

Succinylcholine increases intracellular K+ release (causing muscle weakness). Thus, administration is contraindicated in patients with:

A

Burns

Spinal cord injury

muscular dystrophy

36
Q
A

Musculoskeletal 3.1 (14 decks)

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