Muscle Relaxants Flashcards
Drugs used to reduce abnormally elevated tone caused by neurologic or muscle end plste disease
Spasmolytic drugs
Drugs used to produce muscle paralysis to facilitate surgery or assisted ventilation
Neuromuscular blocking drugs
Type of NM blockade: paralysis from persistent depolarization of the end plate
Depolarizing blockade
Type of NM blockade: paralysis from pharmacologic antagonism of Ach receptors at the end plate
Non-depolarizing / Stabilizing blockade
Reverses non-depolarizing blockade
NEOSTIGMINE
Non-depolarizing blocker with the most rapid time of onset
Rocuronium
Short acting non-depolarizing NM blocker
Mivacurium
Indication for non-depolarizing blocker
Skeletal muscle relaxation during intubation and general anesthesia
Neostigmine MOA
Cholinesterase inhibitor
Non-depolaring NM blocker MOA
Competitive antagonist at skeletal muscle nicotinic Ach receptor
Muscle relaxant metabolized by pseudocholinesterase
Mivacurium
Intermediate acting non-depolarizing NM blocker
Rocuronium
Atracurium
Vecuronium
Nover reversal agent for Rocuronium
Sugammadex
Non-depolarizing NM blocker causing bronchospasm
Atracurium
Rapid spontaneous elimination of Atracurium
Hoffman Elimination
Non-depolarizing NM blocker eliminated in the bile
Vecuronium
Long acting non-depolarizing NM blocker
Pancuronium & Tubocurarine
Lethal Injection cocktail
Thiopental, Pancuronium, Potassium chloride
Phase of Depolarizing NM blockade:
Initial electric discharge - Membrane depolarizes - Transient fasiculations - Flaccid paralysis
Phase 1 - Depolarization
Phase of Depolarizing NM blockade:
Membrane repolarizes - Receptor does not respond to Ach
Phase 2 - Desensitization
Initial twitch then persistent depolarization
Depolarizing NM blocker
Metabolized by pseudocholinesterase
Mivacurium and Succinylcholine
Interaction involved with Malignant Hyperthermia
Succinylcholine and Halothane
Massive calcium release by the SR of the skeletal muscle, mediated by ryanodin receptors
Malignant Hyperthermia
Early sign of Malignant hyperthermia
Trismus
Malignant hyperthermia DOC
Dantrolene