Neuromuscular Blocking Drugs

Question 1

sequence of muscle paralysis from first to last

Answer 1

1. eyes
2. limbs
3. body
4. diaphragm

Question 2

what are factors that influence NMBDs?

Answer 2

1. Temperature
2. acid-base
3. fluid and electrolyte imbalance
4. other drugs

Question 3

How do NMBDs influence temperature?

Answer 3

• hyperthermia: antagonizes non-depolarizing blockade and prolongs depolarizing blockade
• hypothermia: prolongs non-depolarizing blockade

Question 4

How do NMBDs influence acid-base?

Answer 4

• resp acidosis enhances non-depolarizing

- inadequate reversal of non-depolarizing block–> resp acidosis –> enhances blockade

Question 5

example of a non-depolarizing block

Answer 5

curare (edrophonium, atracurium)

Question 6

example of depolarizing block

Answer 6

succinylcholine

Question 7

what are some other druing that can influence neuromuscular blockade?

Answer 7

• antibiotics
• calcium channel blockers
• local anesthetics
• inhalation anesthetics
• anticholinesterase (organophosphates)

Question 8

what are some adverse effects of succinylcholine (depolarizing)?

Answer 8

• hyperkalemia
• muscle soreness
• histamine release
• bradycardia or tachycardia
• hypotension
• malignant hyperthermia (halothane)
• -deficiency/abnormal plasmacholinesterases

Question 9

when is succinycholine contraindicated?

Answer 9

• organophosphates
• glaucoma
• liver disease
• chronic anemia