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Anesthesiology > Neuromuscular Blockers > Flashcards

Neuromuscular Blockers Flashcards

1
Q

What is the onset of action of succinylcholine?

A

30-60 secs

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2
Q

What is the duration of action of succinylcholine?

A

Less than 10 minutes

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3
Q

What is the MOA of succinylcholine?

A

Ach analog that binds the receptor and is not metabolized by acetycholinesterase

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4
Q

What metabolizes succinylcholine?

A

pseudocholinesterase

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5
Q

What conditions prolong the action of succinylcholine?

A

Liver and renal disease
Pregnancy (lower serum enzyme levels)
Abnormal enzymes as seen in atypical plasma cholinesterase or pseudocholinesterase deficiency
Neostigmine (inhibits pseudocholinesterase)
Hypothermia

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6
Q

Why is a higher dose of succinylcholine required in a pediatric patient?

A

Because there is more extracellular space

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7
Q

What are the effects of succinylcholine?

A

Bradycardia
Hyperkalemia
Fasciculations (prevent with nondepol NMB)
Increased intragastric pressure
Increased IOP
Malignant hyperthermia
Increased ICP, CBF, and activity (prevent with nondepol NMB)

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8
Q

What are the two types of nondepolarizing NMB?

A

Steroidal and Benzylisoquinolones

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9
Q

Which nondepol NMBs are prolonged in liver failure?

A

pancuronium, rocuronium and vecuronium

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10
Q

What do the steroidals tend to be?

A

vagolytic

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11
Q

What do the benzylisoquinolines tend to release and cause?

A

histamine

Causes: hypotension, tachy, flushing, bronchospasm

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12
Q

Which are prolonged in renal failure?

A 
metocurine
gallamine
pancuronium
vecuronium
tubocurarine
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13
Q

Which are renal independent?

A

Rocuronium
atracurium
mivacurium

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14
Q

What two are associated with ICU neuropathy?

A

pancuronium and vecuronium

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15
Q

What conditions is ICU neuropathy associated with?

A

Sepsis, renal failure, high dose steroids

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16
Q

How do patients with ICU neuropathy present?

A

Weakness and inability to come off the ventilator with no sensory deficits

17
Q

What is tubocurarine, atracurium, metocurine, mivacurium associated with?

A

Histamine release

18
Q

Which is metaolism by pseudocholinesterase?

A

mivacurium

19
Q

Which is metabolized by the liver?

A

Vecuronium and pancuronium

20
Q

What does pancuronium cause?

A

Hypotension and brady by vagal blockade

Anesthesiology (19 decks)

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