Neuromuscular Drugs

Question 1

What are the clinical uses of neuro muscular drugs?

Answer 1

1. Blocking drugs provides muscle relaxation for therapy

2. Anticholinesterases are used for diagnosis and therapy for myasthenia gravis

Question 2

What are the major comfirmations or states of the skeletal muscle nicotinic acetylcholine receptor?

Answer 2

resting
open
desensitized

Question 3

What is/are the prototype non-depolarizing muscle relaxant(s)?

Answer 3

Vecuronium

Question 4

What reverses the block of the non-depolarizing muscle relaxnats?

Answer 4

Anticholinesterase (Neostigmine)

Question 5

What are the potential adverse side effects of vecuronium?

Answer 5

HypOtension resulting from basophil release of histamine or blockade of autonomic neural transmission

Question 6

What are the pharmacokinetics of Vecuronium? What is it compared to?

Answer 6

Largely eliminated by biliary secretion, ATRACURIUM spontaneously breaks down at physiological pH

Question 7

What do depolarizing muscle relaxants act as? What is an example?

Answer 7

Nicotinic agonists, succinylcholine

Question 8

When is the first depolarizing stage important in the use of SuCH?

Answer 8

When used for tracheal intubation, stage two is not observed because of its slow onset

Question 9

What are some disadvantages of depolarizing blockers?

Answer 9

Muscle soreness of SuCH-induced muscle relaxation
Inability to reverse stage 1 block with anti-cholinesterases
K+ release may be life threatening in burn patients displaying skeletal muscle DENERVATION HYPERSENSITIVITY
SuCH bio transformation is abnormally slow in some people

Question 10

What drug is used for the treatment of malignant hyperthermia and spasticity disorders?

Answer 10

Dantrolene

Question 11

What is the mechanism of Dantrolene?

Answer 11

Relaxes muscles in a unique way by inhibiting Ca+ release from skeletal muscle sarcoplastic reticulum

Question 12

Myasthenia Gravis

Answer 12

Autoimmune loss of muscle nicotinic ACh receptors

Question 13

What are the treatments for Myasthenia Gravis? And how are the utilized?

Answer 13

Neostigmine and Pyridostigmine are used orally and display intermediate durations of action
Endophonium is used for Dx of MG and for adjustment of anti-ChE dose regimen

Question 14

When does myasthenia weakness occur and how does this compare to cholinergic crisis?

Answer 14

myasthenia weakness- when the patient is under medicated with long duration cholinesterase inhibitor
cholinergic crisis when the patient is over medicated