Neuromuscular Blocking Drugs Flashcards

1
Q

what are Neuromuscular Blocking Drugs

A

interrupt transmission of nerve impulses at the neuromuscular junction

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2
Q

what do NMBDs result in

A

paralysis of striated muscle

consciousness is retained

no analgesia

spontaneous respiration ceases

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3
Q

indications for NMBD

A

position eyeball centrally - intraocular or corneal surgeries, most common

relax resiratory muscles to allow mechanical ventilation - rare

relax muscles for neurological or orthopedic surgeries - rare

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4
Q

T/F mechanical ventilation required with NMBD

A

true

they wont breathe

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5
Q

what is the only sign they will show in response to noxious stimuli

A

tachycardia

high blood pressure

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6
Q

what are some contraindications of NMBDs

A

no possibility to ventiate and monitor

if animals remain conscous - extremely distressing even without pain

insufficient analgesia during surgery

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7
Q

T/F NMDBs must not be used as a sole agent for any kind of procedure (painful or non painful)

A

True!!

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8
Q

depolarizing NMBDs

A

agonist on the nicotinic ACh receptors

cause muscle membrane depolarization

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9
Q

non-depolarizing NMBDs

A

antagonist on the nicotinic ACh receptors

stabilizes muscle membranes

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10
Q

which muscles are the most senesitive and be paralyzed first even at low doses

A

ocular muscles

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11
Q

which muscles are the most resistant and are last to paralyze and first to recover

A

diaphragm

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12
Q

which drugs potentiate NMBD effect

A

inhalational anesthetics

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13
Q

facots that influence the depth of NMBD effect

A

hypothermia

electrolyte abnormalities

age

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14
Q

NMBDs are water/lipid soluble

A

water

dont cross lipid barriers easily

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15
Q

which NMBD is most likely to cause histamine release

A

Atracurcium

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16
Q

T/F side effects at ANS are unlikely with modern NMBDs

17
Q

which are the non-depolarizing NMBDs

A

atacurium

cisatracurium

rocuronium

vecuronium

18
Q

what is the only depolarizing NMBD use in clinic

A

succinylcholine (SCh)

19
Q

what is the phase-1 block

A

sustained membrane depolarization on end plate

initially lead to muscle fasiculation

postjunctional Na channel close and remain closed untill SCh is present

20
Q

what is Phase-2 block

A

after prolonged or high dose SCh

similar to non-depolarizing blockage

21
Q

adverse effect of SCh

A

cardiac arrhythmias

hyperK

fasciculations, myalgia, myoglobinuria

elevated intra-ocular and intra-gastric pressures

may trigger malignant hyperthermia

22
Q

T/F it is impossible to be sure that residual blocking effects are not present only by examining clinical signs

23
Q

what is the acceptable neuromuscular recovery TOF ratio

A

greater than or equal to 0.9

24
Q

sites of stimulation in dogs and cats

A

peroneal nerve

ulnar nerve

25
sites of stimulation for horses
facial nerve peroneal nerve
26
2 stimulation patterns
single twitch train of four (TOF)
27
what is train of four (TOF)
four stimulus following each other ration of the first and last response is termed TOF ratio
28
what do you see with patial bockade with TOF
first twitch is largest and last is smallest
29
what TOF ratio suggest acceptable recovery from blockade
\>0.9
30
antagonizing depolarizing NMBDs
unpredictable and not recommended
31
what is sugammadex
rocuronium reversal agent
32
what should end tidal ISO be kept around
0.9 +/- 0.1%