Muscle Blockers Flashcards
why don’t muscle blockers effect the brain or CNS?
polar compounds can’t go thru BBB so must give IV
how long do short acting non depolarizing neuromuscular blockers work? long acting? what is the only long acting neuromuscular blocker?
short: 30-60 minutes
long: 60-120 minutes
only long acting: pancuronium
increasing the length of use of non depolarizing muscle blocker does what to duration of action?
prolongs it
remember for ICU
how to reverse effects of non depolarizing agent?
acetylcolinesterase inhibitors to increase ACh concentration
what mm is last affected by non depolarizing blockers?
diaphragm
DOA of succinylcholine?
5-10 minutes
MOA of succinylcholine
binds & activates the nicotinic receptor once causing one transmission of an impulse to the muscle.
Doesn’t transmit anymore and doesn’t leave the receptor either.
It sits there blocking the channel
Normal closure of the gate is prevented and the blocker moves in and out rapidly
Muscle stays in depolarized state, unable to repolarize while succinylcholine sits there.
how long do fasciculations last after dosing succinylcholine? how long until paralysis?
30 seconds of fasciculations
90 seconds until paralysis
CVS affects of nondepolarzing blockers?
hypotension (prevent with antihistamines)
tachycardia
CVS affects of depolarizing blockers?
arrhythmia when given with other anesthetics
what drug causes hyperkalemia? who does it happen to?
succinylcholine if given to pt with burns, nerve damage, neuromuscular disease, or trauma
what drug causes most mm pain after paralysis?
succinylcholine
succinylcholine + volatile anesthetics =
malignant hyperthermia from abnormal release of Ca from stores in skeletal mm
treatment: dantrolene
muscular blockers + aminoglycosides (Abx) =
increased blockade
Abx decrease the release of ACh and can lead to respiratory depression
increased age + NM blockers =
increased effect (decrease dose if older than 70)