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Pharmacology > Neuromuscular Blocking Drugs > Flashcards

Neuromuscular Blocking Drugs Flashcards

1
Q

What are NMBD??

A

These are drugs that impair neurotransmission and cause muscle relaxation.

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2
Q

NMBD are classified into two namely??

A

Agonists… Depolarizing, non competitive blockers.

Antagonists… Non depolarizing, competitive blockers.

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3
Q

Examples of depolarizing NMBD agents?

A

Succinylcholine.

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4
Q

Steroid based Non depolarizing NMBD include?

A

Pancuronium
Vercuronium
Rocuronium

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5
Q

Examples of synthetic non depolarizing agents?

A

Atracuronium
Doxacuronium
Mivacuronium

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6
Q

Examples of curare alkaloids non depolarizing agents?

A

Metocuraine

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7
Q

Another name for succinylcholine is?

A

Suxamethonium.

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8
Q

What is the mechanism of action of suxamethonium

A

Read your note

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9
Q

Suxamethonium is hydrolysed by plasma cholinesterase to?

A

Succinyl monochlonine and chlonine

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10
Q

Suxamethonium is stored at?

A

4°C

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11
Q

IV infusion of suxamethonium is given at?

A

5-15mg/kg/hr

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12
Q

Suxamethonium is given intramuscularly at which dose?

A

3-5mg/kg

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13
Q

What are the blocking phases of suxamethonium?

A

Depolarization block.

Desensitisation block.

Phase II block.

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14
Q

What happens in depolarization phase or phase I block recovery?

A

Preceded by muscle fasiculation.

Occurs as a result of suxamethonium stimulating the ach receptors causing repetitive firing.

Phase I block recovery occurs as the suxamethonium diffuses away from the NMJ down a conc gradient

It is metabolised by plasma cholinesterase.

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15
Q

What happens during Desensitisation block?

A

Occurs when ach receptors are insensitive to the channel opening effects of agonists and ach.

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16
Q

What happens during phase II block??

A

Occurs after repeated boluses or prolonged infusion of suxamethonium.

After initial depolarization, the membrane potential returns to the resting stage even when the NMJ is exposed to the drug.

17
Q

What are the indications for suxamethonium?

A

Drug of choice for anesthesia and also when rapid trachea intubation is required.

18
Q

What are the side effects of suxamethonium?

A

Hyperkalamia- it increases k levels by 0.5mmol/L… And it’s worse in burns pts and people with muscle dystrophy cause of proliferation of extra junctional receptors.

Bradycardia.

Muscle pains.

Increased intragastric pressure.

Anaphylaxis.

19
Q

What are the two main causes of reduced plasma cholinesterase activity?

A

Can be congenital or acquired

20
Q

Plasma cholinesterase has 3 variants which are?

A

Atypical
Flouride resistant
Silent

21
Q

Non depolarizing NMBDs are not metabolised at the NM junctions

T/F

A

True

22
Q

How are non depolarizing NMBDs blocks resolved?

A

By dilution with time.

23
Q

There are two groups of non depolarizing NMBDs which are??

A

Benzylisoquinolinum compounds.

Aminosteriods.

24
Q

Examples of benzylisoquinolinum drugs are??

Note: curium

A

Atracurium.
Mivacurium.
Tubocurarine.

25
Q

Which benzylisoquinolinum causes ganglion blockade?

A

Tubocurarine

26
Q

Which benzylisoquinolinum has no direct cardiovascular effects?

A

Atracurium

27
Q

Which benzylisoquinolinum does not release histamine?

A

Cisatracurium

28
Q

Which benzylisoquinolinum has a short duration of action?

A

Mivacurium

29
Q

What is the first steroid NMBD in clinical use?

A

Pancuronium

30
Q

Which Aminosteriods does not release histamine or have any cardiovascular effect?

A

Vercuronium

31
Q

What are anticholinesterases

A

They are acetylcholineestetase inhibitors

32
Q

What are the side effects of anticholinesterases?

A

Bradycardia
Nausea
Bronchospasm
Sweating and salivation
GI upset

Pharmacology (5 decks)

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