muscle relaxant + anticholinergics

Question 1

succ

1. mech
2. onset, duratin
3. metabolism
4. indication
5. side effect
6. CI

Answer 1

1. mimics Ach and bind to Ach receptor causing prolonged depol, initial fasciculations seen, temporary paralysis to blocked ACh receptors
2. 30-60s, 3-5 min
3. hydrolyzed by plasma cholinesterase in plasma
4. RSI, short procedure - obesity, trauma, pregnancy, ECT, laryngospasm
5. . may stimulate muscarinic cholinergic autonomic receptors: braducardia, dysarrythmia, sinus arrest, increased sev og salivary gland
   - hyperkalemia
   trigger MH, increased ICP, fasciculations
6. hypersens, allergi, MH, myotonia, hyperkalemia

Question 2

NDMR
1. drugs
2. indication
3 other

Answer 2

1. mivacuronium, rocuronium, vecuronium, pancuronium
2. assist ventilation, assist mech ventilation in som ICU patients, reduce fasciculations and post-o myalgias secondary to SCh
3. tachycardia in pancuronium. quick onset rocuronium -DOC RSI. Cisatracurium for patients with renal and hepatic insuff

Question 3

cholinestease inh + anticholinergic

1. cholinesterase inh drugs
2. action
3. anticholinergic drug

Answer 3

1. neostigmine - intermediate duration and onset, pyridostigmine - longest, edrophonium - shortest
2. inh enzym degrad og ACh, increase Ach at nicotinic and muscarinic receptors, displace NDMR. cause bradycardia, salivation, bowel peristalisis…. therefor with
3. glycopyrrate, atropine