Muscle Relaxants (Kruse)

Question 1

What are the nondepolarizing, Isoquinoline derivative, neuromuscular blocking drugs? (5)

Answer 1

-curium: (except for one)

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

Question 2

What are the nondepolarizing, steroid derivative, neuromuscular blocking drugs? (4)

Answer 2

-curonium:

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

Question 3

What are the depolarizing neuromuscular blocking drugs?

Answer 3

Succinylcholine

Question 4

What are the acetylcholinesterase inhibitors? (7)

Answer 4

1) Ambenonium
2) Donepezil
3) Echothiophate
4) Edrophonium
5) Galantamine
6) -Stigmine: Neostigmine, Physostigmine, Pyridostigmine, and Rivastigmine
7) Tacrine

Question 5

What are the antimuscarinic compounds? (2)

Answer 5

1) Atropine

2) Glycopyrrolate

Question 6

What are the cholinesterase reactivators?

Answer 6

Pralidoxime

Question 7

What are the centrally acting spasmolytics (muscle relaxants)? (5)

Answer 7

1) Baclofen
2) Carisoprodol
3) Cyclobenzaprine
4) Diazepam
5) Tizanidine

Question 8

What are the non-centrally acting spasmolytics? (2)

Answer 8

1) Dantrolene

2) Botulinum toxin

Question 9

What are the immunologic drugs for MS? (5)

Answer 9

1) Glucocorticoids
2) Glatiramer acetate
3) Interferon beta 1a and 1b
4) Mitoxantrone

Question 10

The following drugs make up what drug class?

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

Answer 10

Nondepolarizing, isoquinoline derivative, neuromuscular blocking drugs

Question 11

The following drugs make up what drug class?

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

Answer 11

Nondepolarizing, steroid derivative, neuromuscular blocking drugs

Question 12

Succinylcholine makes up what drug class?

Answer 12

Depolarizing neuromuscular blocking drugs

Question 13

The following drugs make up what drug class?

1) Ambenonium
2) Donepezil
3) Echothiophate
4) Edrophonium
5) Galantamine
6) -Stigmine: Neostigmine, Physostigmine, Pyridostigmine, and Rivastigmine
7) Tacrine

Answer 13

Acetylcholinesterase inhibitors

Question 14

The following drugs make up what drug class?

1) Atropine
2) Glycopyrrolate

Answer 14

Antimuscarinic compounds

Question 15

Pralidoxime makes up what drug class?

Answer 15

Cholinesterase reactivators

Question 16

The following drugs make up what drug class?

1) Baclofen
2) Carisoprodol
3) Cyclobenzaprine
4) Diazepam
5) Tizanidine

Answer 16

Centrally acting spasmolytics (muscle relaxants)

Question 17

The following drugs make up what drug class?

1) Dantrolene
2) Botulinum toxin

Answer 17

Non-centrally acting spasmolytics

Question 18

The following drugs make up what drug class?

1) Glucocorticoids
2) Glatiramer acetate
3) Interferon beta 1a and 1b
4) Mitoxantrone

Answer 18

Immunologic drugs for MS

Question 19

Neuromuscular blockers interfere with transmission at the neuromuscular end plate and lack?

Answer 19

CNS activity

Question 20

Neuromuscular blockers are used as adjuncts during?

Answer 20

Anesthesia

Question 21

What are the effects on consciousness or pain threshold with neuromuscular blockers?

Answer 21

No known effects

Question 22

Spasmolytic agents are often called?

Answer 22

Centrally acting muscle relaxants

Question 23

Spasmolytic agents are used to reduce spasticity in a variety of conditions by acting on?

Answer 23

CNS

Question 24

What is the nondepolarizing blockade mechanism of neuromuscular blocking drugs?

What is the prototype?

Answer 24

1) Prevents access of ACh to its receptor and blocks depolarization
2) d-tubocurarine

Question 25

What is the depolarizing blockade mechanism of neuromuscular blocking drugs? What is the prototype?

Answer 25

1) Neuromuscular blockade due to excess of a depolarizing agonist 2) Succinylcholine

Question 26

Why are Vecuronium, Rocuronium, Cisatracurium, and Atracurium commonly used in a clinical setting?

Answer 26

Allows tight control over paralysis due to an intermediate duration of action

Question 27

What are some adverse effects of the neuromuscular blocking drugs?

Answer 27

1) Long acting 2) Hypotension and tachycardia with large doses 3) Histamine release

Question 28

What are used to reverse NMJ blockade? What are often administered with cholinesterase inhibitors to minimize effects at mAChRs?

Answer 28

1) Cholinesterase inhibitors | 2) Anticholinergic agents

Question 29

What is the duration of action for succinylcholine?

Answer 29

1) Ultra-short | 2) Rapid hydrolysis and inactivation by butyrylcholinesterase and pseudocholinesterase

Question 30

What are the MOA for succinylcholine?

Answer 30

1) Phase 1 depolarizing block | 2) Phase 2 desensitizing block

Question 31

In regards to the Phase 1 block of succinylcholine effects: The effects are similar to ACh but? The depolarized membranes remain depolarized and? Flaccid paralysis results due to?

Answer 31

1) It produces a longer effect at the NMJ 2) Unresponsive to subsequent impulses 3) Lack of repolarization

Question 32

In regards to the Phase 2 block of succinylcholine effects: Continued exposure to succinylcholine causes? nAChR behaves as if in a? What happens to the recetpor?

Answer 32

1) Initial end plate depolarization to decrease and the membrane becomes repolarized 2) Prolonged closed state 3) Desensitization

Question 33

Which phase in the depolarizing block of succinylcholine is antagonized by cholinesterase inhibitors?

Answer 33

Phase 2

Question 34

What are the clinical uses of neuromuscular blocking drugs?

Answer 34

1) Surgical relaxation 2) Tracheal intubation 3) Control of ventilation 4) Treatment of convulsions

Question 35

The drugs of choice for rapid sequence intubation are those that act quickly such as?

Answer 35

Succinylcholine

Question 36

The drugs of choice used as adjuncts to general anesthesia for muscle relaxation are those that are of longer duration such as?

Answer 36

Pancuronium

Question 37

Acetylcholinesterase (AChE) inhibitors in this topic are used to?

Answer 37

Reverse pharmacologic paralysis

Question 38

The centrally acting spasmolytic agent Baclofen has what MOA? What effect does this have?

Answer 38

1) GABA(B) agonist | 2) Inhibition of excitatory neurotransmitter release

Question 39

The centrally acting spasmolytic agent Diazepam has what MOA? What effect does this have?

Answer 39

1) Enhance GABA(A) receptor activity in the presence of GABA | 2) CNS depression

Question 40

The centrally acting spasmolytic agent Tizanidine has what MOA? What effect does this have?

Answer 40

1) alpha2 agonist | 2) CNS depression

Question 41

The non-centrally acting spasmolytic agent Dantrolene has what MOA? What effect does this have?

Answer 41

1) Inhibition of ryanodine receptors | 2) Blocks the release of Ca2+

Question 42

The non-centrally acting spasmolytic agent Botulinum toxin has what MOA? What effect does this have?

Answer 42

1) Cleaves the VAMP and blocks fusion to presynaptic membrane 2) Inhibits ACh release