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Pharmacology and Therapeutic Terminology > Neuromuscular Blockade - Chapter 13 > Flashcards

Neuromuscular Blockade - Chapter 13 Flashcards

1
Q

Neuromuscular Blocking Drugs

A

-Interfere with transmission at the neuromuscular endplate and are primarily used as adjuncts during general anesthesia to paralyze a patient so there is no movement during surgery

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2
Q

Mechanism For Skeletal Muscle Contraction

A
  • Occurs as a response to communication between peripheral nerves and muscles
  • Calcium stimulates the release of ACh which binds to nicotinic receptor sites located in the muscle soleplate. ACh binding causes an influx of calcium and potassium ions which results in muscle contraction
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3
Q

Neuromuscular Blockade MOA

A
  • Increasing inactive ACh nicotinic receptor sites
  • Decreasing ACh release
  • Depleting neuronal ACh
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4
Q

Neuromuscular Blocking Agents (NMBA’s)

A

-Increase the percent of ACh receptor sites that are inactivated, causing relaxation of skeletal muscles

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5
Q

Peripheral Acting Skeletal Muscle Relaxants/Neuromuscular Blockade Agents: Classifications

A
  • Depolarizing blocking agents

- Nondepolarizing blocking agents

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6
Q

Depolarizing Blocking Agents

A
  • Bind to ACh receptors and produce sustained depolarization, causing receptors to their inactive state
  • Rapidly inactivated by cholinesterase enzymes
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7
Q

Depolarizing Blocking Agents Examples

A

-succinylcholine chloride

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8
Q

Brand: Quelicin

A

Generic: succinylcholine chloride

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9
Q

Nondepolarizing Blocking Agents

A

-Common ending: “curonium” and “curium”

  • Interfere with Na+, Ca++, and K+ channels and decrease acetylcholinesterase action
  • Botulin toxin blocks release of ACh from vesicles
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10
Q

Nondepolarizing Blocking Agents Examples

A
  • atracurium
  • cistracurium
  • pancuronium
  • rocuronium
  • vecuronium
  • botulin toxin type A
  • incobotulinum toxin A
  • abotulinum toxin A
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11
Q

Brand: atracurium

A

Generic: atracurium

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12
Q

Brand: Nimbex

A

Generic: cistracurium

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13
Q

Brand: pancuronium

A

Generic: pancuronium

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14
Q

Brand: Zemuron

A

Generic: rocuronium

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15
Q

Brand: vecuronium

A

Generic: vecuronium

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16
Q

Brand: Botox

A

Generic: botulin toxin type A

17
Q

Brand: Xeomin

A

Generic: incobotulinum toxin A

18
Q

Brand: Dysport

A

Generic: abotulinum type A

19
Q

Botulinum Toxin Type A Use

A
  • Temporarily removes wrinkles
  • Excessive sweating
  • Uncontrollable blinking
  • Spasticity associated with cerebral palsy
  • Chronic migraine
  • Overactive bladder
20
Q

Botulinum Toxin Type A ADR’s

A
  • Droopy eyelid muscles
  • Headache
  • Nausea
  • Flulike symptoms
  • Redness
  • Muscle weakness
21
Q

NMBA ADR’s

A
  • Allergic reactions
  • Muscle pain
  • Respiratory depression
  • Cardiac arrest
  • Itching or burning at injection site
  • Hypotension
  • Flushing
  • Tachycardia or bradycardia
22
Q

Strategies for safe use of NMBA’s

A
  • NMBA’s are given USP classification of high alert because improper use can cause permanent injury, respiratory arrest, or death
  • Problems may result from improper selection, storage conditions or labelling, inappropriate dosing, or inadequate patient monitoring
23
Q

Recommendations for Pharmacy Practice with NMBA’s

A

There are recommendations for:

  • Product selection
  • Product storage
  • Limiting access
  • Auxiliary labels and warning labels
  • Ordering practices and dispensing
24
Q

Reversal of Neuromuscular Blockade

A

-Anticholinesterase drugs inhibit the action of ACh esterase at the neuromuscular junction

25
Q

Anticholinesterase Drugs Examples

A
  • edrophonium
  • neostigmine
  • pyridostigmine
26
Q

Brand: Tensilon

A

Generic: edrophonium

27
Q

Brand: Prostigmin

A

Generic: neostigmine

28
Q

Brand: Mestinon, Mestinon SR

A

Generic: pyridostigmine

29
Q

Anticholinesterase Drugs ADR’s

A
  • Salivation
  • Muscle twitching
  • Muscle weakness
  • Abdominal cramping
  • Nausea
  • Increased bronchial secretions
  • Difficulty breathing

Pharmacology and Therapeutic Terminology (97 decks)

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