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Anaesthesiology > MUSCLE RELAXANTS > Flashcards

MUSCLE RELAXANTS Flashcards

1
Q

Do children need muscle relaxants?

A

No

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2
Q

Why do we use muscle relaxants?

A

-to facilitate surgery (laparoscopic, ophthal ,ENT etc.)
-to facilitate Rapid sequence induction
-

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3
Q

How does the NMJ work?

A

There is calcium that causes a action potential as it causes acetycholine to work on the nicotinic receptor on the muscle. This also facilitates the release of potassium

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4
Q

What class of muscle relaxant is suxamethnonium?

A

Depolariser

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5
Q

Which muscles are we relaxing?

A

Skeletal muscle fibres

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6
Q

Do muscle relaxants cause analgesia?

A

No

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7
Q

What is the mechanism of action of non-depolarising muscle relaxants?

A

-They sit on the nicotinic receptors and prevent Ach from sitting on the receptor and making sure that no muscle contraction takes place

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8
Q

Is the duration of suxamethonium long or short?

A

Short out of all the muscle relaxants

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9
Q

Why is it safe to use non-depolarising relaxants in mothers?

A

It does not cross the BBB

and placenta

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10
Q

Why is it that the more non-depolarising muscle relaxant that I give the bigger the paralysis?

A

-Because it is dose dependant

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11
Q

What is the mechanism of action of suxamethonium?

A
  • Acts similarly to Ach and binds to nicotinic receptor however it is 1000x stronger
  • When injected once it gives a phase I block
  • When injected twice it causes a phase II block which is similar to non-depolarising muscle relaxants
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12
Q

Why does suxamethonium not need a reversal agent?

A

Because it is naturally broken up by the plasma cholinesterases

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13
Q

What is the dosage of suxamethnonium?

A

1-2mg/kg in adults IV

2-4mg/kg IM

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14
Q

How long do we have until it starts to wear off?

A

6-12 minutes

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15
Q

How long do we have until it starts working?

A

60 seconds

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16
Q

What are the indications of using suxamethonium?

A
  1. short operations<12 minutes
  2. Laryngospasm
  3. Rapid sequence induction(when we try to prevent aspiration of stomach contents)
17
Q

What is the autonomic nervous system made up of?

A
  1. parasympathetic

2. sympathetic system

18
Q

Parasympathetic?

A

The ACh will work and synapse onto the muscarinic receptors causing effects such as bradycardia

19
Q

Sympathetic?

A

The Ach will work and synapse on the noradrenergic receptors and possibly cause tachycardia

20
Q

What is the function of parasympathetic stimulation on the lungs?

A
  1. secretions
  2. bronchospasm
    so suxamethonium will be contraindicated in patients with these lung problems
21
Q

Why is suxamethonium contra-indicated with patients that already have high potassium?

A
  • This is associated with patients who have upper motor neuron lesions
  • burn patients up to 6 months
  • Malignant hyperthermia
  • myopathies
  • muscular atrophy and muscle trauma
  • increased cranial pressure
22
Q

What will happen to the patient if the potassium increases by 8 per litre?

A

Diastolic cardiac pressure

23
Q

What will happen to the patient if the potassium increases by 8kpa per litre?

A

Diastolic cardiac arrest

24
Q

What are the side effects/complication of Suxamethoniu?

A
  1. fasciculations
  2. muscle pain
  3. malignant hyperthermia
  4. prolonged apneoa
  5. anaphylactic reaction
  6. bronchospasm/increased secretions
25
Q

What is the cause of the suxamethonium apnoa?

A

Low concentrations of pseudo cholinesterases
Heterozygote: minutes
Homozygote: hours

26
Q

What are the properties of rocuronium?

A
  1. Stays in the fridge
  2. onset of action: 60 seconds
  3. Duration of action: 60secs-3 minutes
    Metabolised in the liver
27
Q

What are the properties of vecuronium?

A
  1. It is a powder
  2. onset of action: 2-3 minutes
  3. duration of action: 30-45 minutes
  4. metabolised in the liver
28
Q

What are the properties of cisatriqurium?

A
  1. It is kept in the fridge
  2. onset of action is: 3-5 minutes
  3. duration is 30-45 minutes
  4. eliminated via the Hoffman elimination
29
Q

What are the properties of pancuronium?

A
  1. Kept in the fridge
  2. 5 minutes
  3. offset: 45-60 minutes
  4. excreted by the renal system
  5. causes tachycardia
30
Q

Which muscle relaxant doesn’t get eliminated by the hepato-biliary excretion?

A

Cisatricurium

Anaesthesiology (25 decks)

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