Neuromuscular Blocking Agents

Question 1

Succinylcholine type of agent….

Answer 1

Depolarizing neuromuscular blocker (non-competitive)

Question 2

Succinylcholine

Answer 2

Have 2 phases

• Cause transient muscle calculation
• Then flaccid paralysis
• There is no reversal, must support through it
• MUST VENTILATE FOR P
• Used for endotracheal intubation

Question 3

Cautions with Succinylcholine

Answer 3

• Hyperkalemia, bradycardia
• Muscle fiber damage – increases in creatinine kinase and postoperative muscle pain
• Apnea – artificial respiration is required

Question 4

Do you need to keep Succinylcholine chilled/refrigerated?

Answer 4

YES! To avoid spontaneous hydrolysis

Question 5

What species have a longer duration of action with Succinylcholine?

Answer 5

RUMINANT b/c of different levels of PChE

Question 6

Canines have what duration of action with Succinylcholine

Answer 6

Up to 20 min

Question 7

Pancuronium

Answer 7

• competitive neuromuscular blockers (non-depolarizing)
• Significant amount is excreted unchanged in the urine (~40% in humans), there is some metabolized by the liver and a small amount excreted in bile

Question 8

Atracurium

Answer 8

• competitive neuromuscular blockers (non-depolarizing)

- Undergoes spontaneous degradation in plasma (does not rely on hepatic or renal function for clearance)

Question 9

Vecuronium AND Rocuronium

Answer 9

• competitive neuromuscular blockers (non-depolarizing)

- Primarily metabolized by the liver and excreted in bile and urine.

Question 10

Difference between Competitive and non-competitive.

Answer 10

Competitive do not have the first phase. There is no initial muscle fasciculation. Just flaccid paralysis.