Muscle relaxants Flashcards
How do you pretreat brady from succs with peds?
Atropine 0.02mg/kg
How do you pretreat fasciculation’s from succs?
Defasiculating dose:
Roc 0.06-0.1
If you give a defasiculating dose of roc, then what will your succs dose be?
1.5-2.0mg/kg
How much can sucs increase your K levels by?
0.5-1.0 mEq/L
How can you prevent myalgias from succs?
Defasiculating dose
NSAIDs
What’s the onset time after adm sucs for the pt to have myalgias
24-48hrs
How long can myalgias last?
2-7 days
How can you prevent an increase in ICP that occurs with sucs adm?
Defasiculating dose
Lidocaine adm
Hyperventilation
DO NOT adm sucs to …. (muscle and electrolytes)
MH
Third degree burns
Severe muscle trauma
Muscle wasting
Hyper K
Muscular dystrophy
Rhabdo
DO NOT adm sucs to …. (CNS, patients, and diseases)
Spinal chord injury
Sepsis
Atypical P-AchE
Allergy
CHILDREN
If you’re administering atracurium, how can you decrease the histamine release?
Pretreat with antihistamines
Push med slowly
What does prostacyclin do to the plt plug?
prevents it from forming
Do you increase or decrease your NDMR with a burn patient?
Increase!
Which electrolyte imbalances augment NDMRs?
HyperMg
HypoCa
HypoK
You have a neonate your going to arm a NDMR. What are you doing with the dose?
Nothing
unless its atrocurium (then 1/2 it)
Things to remember about atrocurium
Histamine release- BRONCHOSPASM
Drop in SVR and increase in CI
Decrease neonate dose in 1/2
High Laudinsoine toxicity
What patients will have an prolonged DOA of roc?
hepatic failure
pregancy
elderly
obese
Who will you increase your roc dose?
patients with liver diseas
Who will have an increased DOA with vec?
Renal failure patients
AIDs
Elderly
Post partum
Obese
What drugs will precipitate with Thiopental increasing risk of PE?
Atrocurium
Cisatrocurium
Vecuronium
What does pancuronium do to CV?
increase HR, MAP, CO
Blocks muscarinic receptors of the SA node
Increases catacholamine release
What does vec do to the CV?
typically no effects
minimal increase in HR and BP
What does roc do to the CV?
nothing really
What pt population will you decrease your neostigmine dose with?
Elderly and peds
What is the Neostigmine:glyco ration?
1: 0.2mg
Does glyco cross the BBB?
Yes
What else is neostigmine used to treat?
MG, paralytic ileus, and bladder atony
What are the chemical strucures of the anticholinesterases?
Quatranary ammonium
