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Pharm SS > Muscle Relaxants > Flashcards

Muscle Relaxants Flashcards

1
Q

Laudanosine

A

atracurium and cisatracurim (1/5th the amount)

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2
Q

Laudanosine

A

atracurium and cisatracurim (1/5th the amount)

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3
Q

Hoffman elimination?

A

Atracurium (1/3, and 2/3 ester hydrolysis); Cisatracurium

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4
Q

CI in renal dysfunction?

A

Cisatracurium, Vecuronium, Pancuronium, d Tubo, Doxa, Piper. (miva and atra ok? )

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5
Q

Eliminated by biliary?

A

vec and roc

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6
Q

Eliminated by biliary 50% unchaged

A

Roc

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7
Q

Dose decrease not required in RF, but decrease required in liver failure

A

Roc

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8
Q

Do not mix with barbs?

A

Vecuronium rocuronium, atracurium

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9
Q

Renal, biliary, hepatic disease prolongs E1/2t?

A

Roc, Vec, Pan

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10
Q

3 metabolites, one is 50% as potent?

A

Pancuronium: desacetylpancuronium (avoid in renal failure)

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11
Q

contraindicated in pseudocholinesterase deficiency or atypical plasma cholinesterases?

A

mivacurane

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12
Q

Renal excretion?

A

D- tubo, meto, pan, gallamine, doxa, pipercurium

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13
Q

100% unchaged by kidneys, contraindicated in renal failure?

A

gallamine

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14
Q

Short acting?

A

Rapacuronium, mivacurium, roc

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15
Q

How long is short acting?

A
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16
Q

How long is intermediate actin?

A

30-60 min onset 2-2.5 min

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17
Q

How long is long acting?

A

60-120 mins (onset 2-6 min)

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18
Q

Intermediate acting agents?

A

Vec, atra, cis, roc

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19
Q

Long acting agents?

A

pan, pip, dox, d- tubo, meto, gallamine, alcuro

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20
Q

Hoffman metabolism affects from alkalosis?

A

alkalosis increases metabolis

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21
Q

Hoffman effect from acidosis?

A

acidosis decreases metabolism

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22
Q

What agents cause histamine release?

A

DAMS

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23
Q

what agents decrease Bp?

A

M, D, Sux

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24
Q

bronchospasm?

A

V,A,M,P

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25
Q

increase hr?

A

A,M,P,D

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26
Q

decrease hr?

A

Sux

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27
Q

Does hypothermia prolong or decrease block?

A

prolong

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28
Q

burns increase or decrease block?

A

decrease

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29
Q

what two things decrease DOA of blocks?

A

anticonvulsants and burns

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30
Q

Do dantrolene and ketamine affect depolarizing or non depolarizing?

A

NON- only.

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31
Q

What is the homozygous typical dibucaine number?

A

70-80; 4-6 mins

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32
Q

what is the heterozygous atypical number?

A

50-60; 20-30 mins

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33
Q

what is the homozygous atypical number?

A

20-30; 4-8 hours

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34
Q

What is the chemical structure of NDMR?

A

quarternary ammonium

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35
Q

What are the side effects of Sux?

A

Hyperkalemia, muscle pains, increased ICP, IOP, IGP, master spasm, MH trigger, salivation, myoglobinemia, arrythmias, trismus

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36
Q

What are the side effects of Sux?

A

Hyperkalemia, muscle pains, increased ICP, IOP, IGP, master spasm, MH trigger

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37
Q

increases risk for sux hyperkalemia?

A

burns, trauma, nerve damage, neuromuscular disease, renal failure

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38
Q

long acting muscle relaxants recovery time?

A

40-70 mins

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39
Q

how are long acting excreted?

A

kidneys unchaged, avoid in renal failure

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40
Q

Intermediate have ___ as long DOA than the long acting

A

1/2

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41
Q

mivacuriums DOA is _____% shorter than intermediates?

A

30-40%

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42
Q

Priming principle, administer 10% how many mins before induction?

A

5

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43
Q

dose of defasciculating Vec and Roc?

A

Vec: 0.01 mg/kg
Roc: 0.06-0.1mg/kg

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44
Q

Very cardiac stable, minimal HR increase and BP decrease

A

Rocuronium

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45
Q

Causes bronchospasm

A

Vec

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46
Q

hypercarbia after administration enhances NMB?

A

Vecuronium

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47
Q

Respiratory acidosis enchances DOA makes it resistant to neostigmine

A

Pancuronium

48
Q

vecuronium is how much protein bound?

A

60-80%

49
Q

vecuronium is how much protein bound?

A

60-80%

50
Q

Hoffman elimination?

A

Atracurium (1/3, and 2/3 ester hydrolysis); Cisatracurium

51
Q

CI in renal dysfunction?

A

Cisatracurium, Vecuronium, Pancuronium, d Tubo, Doxa, Piper. (miva and atra ok? )

52
Q

Eliminated by biliary?

A

vec and roc

53
Q

Eliminated by biliary 50% unchaged

A

Roc

54
Q

Dose decrease not required in RF, but decrease required in liver failure

A

Roc

55
Q

Do not mix with barbs?

A

Vecuronium rocuronium, atracurium

56
Q

Renal, biliary, hepatic disease prolongs E1/2t?

A

Roc, Vec, Pan

57
Q

3 metabolites, one is 50% as potent?

A

Pancuronium: desacetylpancuronium (avoid in renal failure)

58
Q

contraindicated in pseudocholinesterase deficiency or atypical plasma cholinesterases?

A

mivacurane

59
Q

Renal excretion?

A

D- tubo, meto, pan, gallamine, doxa, pipercurium

60
Q

100% unchaged by kidneys, contraindicated in renal failure?

A

gallamine

61
Q

Short acting?

A

Rapacuronium, mivacurium, roc

62
Q

How long is short acting?

A
63
Q

How long is intermediate actin?

A

30-60 min onset 2-2.5 min

64
Q

What will increase DOA of anticholinesterases?

A

RF

65
Q

Intermediate acting agents?

A

Vec, atra, cis, roc

66
Q

Long acting agents?

A

pan, pip, dox, d- tubo, meto, gallamine, alcuro

67
Q

Hoffman metabolism affects from alkalosis?

A

alkalosis increases metabolis

68
Q

Hoffman effect from acidosis?

A

acidosis decreases metabolism

69
Q

What agents cause histamine release?

A

DAMS

70
Q

what agents decrease Bp?

A

M, D, Sux

71
Q

bronchospasm?

A

V,A,M,P

72
Q

increase hr?

A

A,M,P,D

73
Q

decrease hr?

A

Sux

74
Q

Does hypothermia prolong or decrease block?

A

prolong

75
Q

burns increase or decrease block?

A

decrease

76
Q

what two things decrease DOA of blocks?

A

anticonvulsants and burns

77
Q

Do dantrolene and ketamine affect depolarizing or non depolarizing?

A

NON- only.

78
Q

What is the homozygous typical dibucaine number?

A

70-80; 4-6 mins

79
Q

what is the heterozygous atypical number?

A

50-60; 20-30 mins

80
Q

what is the homozygous atypical number?

A

20-30; 4-8 hours

81
Q

What is the chemical structure of NDMR?

A

quarternary ammonium

82
Q

Are benzylisoquinolines water or fat soluble?

A

water

83
Q

What are the side effects of Sux?

A

Hyperkalemia, muscle pains, increased ICP, IOP, IGP, master spasm, MH trigger

84
Q

increases risk for sux hyperkalemia?

A

burns, trauma, nerve damage, neuromuscular disease, renal failure

85
Q

long acting muscle relaxants recovery time?

A

40-70 mins

86
Q

how are long acting excreted?

A

kidneys unchaged, avoid in renal failure

87
Q

Intermediate have ___ as long DOA than the long acting

A

1/2

88
Q

mivacuriums DOA is _____% shorter than intermediates?

A

30-40%

89
Q

Priming principle, administer 10% how many mins before induction?

A

5

90
Q

dose of defasciculating Vec and Roc?

A

Vec: 0.01 mg/kg
Roc: 0.06-0.1mg/kg

91
Q

Very cardiac stable, minimal HR increase and BP decrease

A

Rocuronium

92
Q

Causes bronchospasm

A

Vec

93
Q

hypercarbia after administration enhances NMB?

A

Vecuronium

94
Q

Respiratory acidosis enchances DOA makes it resistant to neostigmine

A

Pancuronium

95
Q

82% protein bound?

A

atracurium

96
Q

vecuronium is how much protein bound?

A

60-80%

97
Q

How is doxacurium eliminated?

A

renal unchange

98
Q

Avoid in asthma and COPD?

A

d-tubo, atracurium

99
Q

is sux highly protein bound?

A

no

100
Q

CI of sux

A

duchennes, myalgias, atypical pc, burns,

101
Q

E/T and DOA of succinylcholine

A

E1/2T: 2-4 mins; DOA 8-15 mins

102
Q

Dose for Atropine?

A

0.01 mg/kg

103
Q

Dose for glycopyrolate:

A

0.01 -0.02 mg/kg

104
Q

dose for scopolamine

A

0.3-0.6 mg/kg

105
Q

Onset of anticholinergics in order of quickest to slowest

A

Atropine (1m)

106
Q

what reversal agent do you pair atropine with?

A

edrophonium (0.5-1.0mg/kg)

107
Q

What agent do you pair glycopyrolate with?

A

Neostigmine (0.05-0.07 mg/kg)

108
Q

Dose for pyridostigmine?

A

0.2mg/kg with glycol 0.01mg/kg

109
Q

how are anticholinesterases metabolized?

A

hepatic metabolism (25%) and renal (75)

110
Q

Pyridostigmine peak:

A

12 min

111
Q

Neostigmine peak:

A

7-10 mins

112
Q

What will increase DOA of anticholinesterases?

A

RF

113
Q

DOA and E1/t of Atropine:

A

Duration of action of 30-60 minutes; E½t is 2.3 hrs; 18% unchanged via urine the rest is undergoes hydrolysis

114
Q

Glyco DOA and E1/2T?

A

slower onset of 2-3 minutes; duration of action of 30-60 minutes;
E½t is 1.25 hrs;
80% unchanged via urine (quaternary amine)

115
Q

Scopolamine metabolism?

A

extensively to 1% uchgd kidneys. E12t is 5 hours

Pharm SS (12 decks)

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