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Anesthesia > Muscle Relaxants > Flashcards

Muscle Relaxants Flashcards

1
Q

What are the cardiovascular side effects of Succinylcholine? (Depolarizing)

A

1) Low doses: Negative chronotropic/inotropic effects
2) High doses: Higher heart rate, contractility, and circulating catecholamine
3) Children: Bradycardia

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2
Q

What are the side effects of Succinylcholine? (Depolarizing)

A

1) Fasciculations
2) Muscle pains
3) Hyperkalemia
4) Malignant hyperthermia
5) Increased ICP
6) Increased intragastric pressure
7) Increased intraocular pressure

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3
Q

What are some conditions that cause succinylcholine-induced hyperkalemia?

A

1) Burns
2) Trauma
3) Neurological conditions
4) Pre-existing hyperkalemia

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4
Q

How is Atracurium metabolized?

A

Hoffman elimination (independent of renal and biliary routes)

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5
Q

What are the side effects of Atracurium?

A

1) Hypotension
2) Reflex tachycardia
3) Cutaneous flush
4) Laudanosine toxicity

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6
Q

Which drug is a stereoisomer of Atracurium?

A

Cisatracurium

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7
Q

Cisatracurium is how many times more potent than Atracurium?

A

4 times

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8
Q

How is Cisatracurium metabolized?

A

Hoffman elimination

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9
Q

Which drug produces dose-dependent increase in histamine:
Atracurium or Cisatracurium?

A

Atracurium

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10
Q

How is Mivacurium metabolized?

A

Pseudocholinesterase

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11
Q

Mivacurium can be markedly prolonged by:

A

Prior admission of pancuronium

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12
Q

How is Doxacurium metabolized?

A

Renally

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13
Q

What is the onset for Doxacurium?

A

4-6 minutes

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14
Q

What is the duration of Doxacurium?

A

60-90 minutes

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15
Q

What are the cardiac and histamine-release side effects of Doxacurium?

A

There are none

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16
Q

Which drugs have a benzylisoquinolone base?

A

1) Atracurium
2) Cisatracurium
3) Mivacurium
4) Doxacurium

17
Q

Which drugs have a steroidal base?

A

1) Pancuronium
2) Pipercuronium
3) Vecuronium
4) Rocuronium

18
Q

How is Pancuronium metabolized?

A

Renally (major) and biliary (minor)

19
Q

If a patient with cirrhosis is given Pancuronium, do we give a higher or a lower dose?

A

Higher

20
Q

What are the side effects of Pancuronium?

A

1) Hypertension
2) Tachycardia
3) Arrhythmias
4) Allergic reactions (bromide)

21
Q

How is Pipercuronium metabolized?

A

Renally

22
Q

What are the cardiovascular side effects of Pipercuronium?

A

None

23
Q

How is Vecuronium metabolized?

A

Renally and Biliary

24
Q

What are the side effects of Vecuronium?

A

1) Potentiation of opioid-induced bradycardia
2) Long term administration = buildup of active
3-hydroxy metabolite = elongates drug clearance
= polyneuropathy

25
Q

Rocuronium is an analogue of ___ designed for:

A

Vecuronium; rapid onset

26
Q

Why is Rocuronium better long-term?

A

Because there are no active metabolites

27
Q

How is Rocuronium metabolized?

A

Hepatic and renal

Anesthesia (3 decks)

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