MSK: Skeletal Muscle Relaxants Flashcards
What is the root word of all the non-depolarizing neuromuscular blockers?
-cur-
What is the only depolarizing neuromuscular blocker?
Succinylcholine
-activates receptor so you will see things like muscle fasiculations
What are the centrally acting spasmolytics? (5)
Baclofen Carisprodol Cyclobenzaprine Diazepam Tizanidine
What are the non-centrally activating spasmolytics? (2)
Dantrolene
Botulism toxin
What are the immunologic drugs for MS? (according to Kruse)
Glucocorticoids
Glatiramer Acetate
Interferons (beta)
Mitoxantrone
How do the non-depolarizing (-curarines) work to cause muscle paralysis?
Prevents acess to ACh as a pure antagonist effect
What is the effect of succinylcholine on muscles?
Excess depolarization causes flaccid paralysis
Which neuromuscular blocker is fastest onset, and has shortest duration?
Succinylcholine
-used when inducing intubation due to rapid on and off effects
What drugs are the intermediate acting neuromuscular blockers? (4)
Atracurium
Cisatracurium
Rocuronium
Vecuronium
Great for adjuncts to general anesthesia to do intermediate duration
Which class of neuromuscular blockers cause the least amount of histamine to be released with them?
Steroid derivatives
-Pancuronium, Pipercuronium, Rocuronium, and Vecuronium
How do you reverse the neuromuscular blockade?
Cholinesterase inhibitor (-stigmine) + Anticholinergic (atropine, glycopyrrolate) to reduce effects of Ach at mAChRs
Why do some people have prolonged effects from succinylcholine?
They have a polymorphism in pseudocholinesterase
- cannot break down succinylcholine as fast
- -just wait it out, and eventually they will have less paralysis
Describe the phases of succinylcholine
Phase 1=depolarizing
-this phase produces the flaccid paralysis
Phase 2=desensitizing
-nerves become less sensitized, and membrane becomes repolarized
Which phase (1 or 2) can be reversed with cholinesterase inhibitors?
Phase 2
-phase 1 is not affected
Ambenonium, Echothiophate, and tacrine MOA?
AChE inhibitors