Neuromuscular Relaxants Flashcards by Ryan Hutten

Succinylcholine mechanism of action

Depolarization blockade of muscle nicotinic receptors

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Succinylcholine indication

Tracheal intubation

Electroconvulsive therapy

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Effect of cholinesterase inhibitors on succinylcholine blockade within 4-8 min

Augmented blockade

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Side effects of succinylcholine

Non-analgesic
Apnea
Muscle pain
Arrhythmia, hypertension and bradycardia
Hyperkalemia
Malignant hyperthermia

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Pancuronium mechanism of action

Non-depolarizing blockade of muscle nicotinic receptors

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Pancuronium indication

Adjuvant in surgical anesthesia
Abdominal wall relaxtion
Orthopedic procedures

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D-tubocurarine mechanism of action

Non-depolarizing blockade of muscle nicotinic receptors

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D-tubocurarine indication

Prototype drug

Only used in lethal injection

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Rocuronium mechanism of action

Non-depolarizing blockade of muscle nicotinic receptors

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Rocuronium indication

Intubation

Muscle relaxation during surgery or ventilation

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Mivacurium mechanism of action

Non-depolarizing blockade of muscle nicotinic receptors

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Mivacurium indication

Intubation

Muscle relaxation during surgery or ventilation in patients with RENAL FAILURE

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Vecuronium mechanism of action

Non-depolarizing blockade of muscle nicotinic receptors

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Vecuronium indication

Adjuvant in surgical anesthesia

Abdominal wall relaxation, orthopedic procedures

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Which non-depolarizing NMJ blockade drug would you use in a patient with liver failure?

Pancurium, because it is primarily eliminated by the kidney

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Baclofen mechanism of action

GABA B agonist

Inhibits neurotransmitter release from skeletal muscle sensory afferent

Baclofen indication

Muscle spasticity associated with MS or spinal cord injury

Baclofen side effects

Drowsiness

Diazepam mechanism of action

Benzodiazepine receptor agonist

“GABA mediated presynaptic inhibition”

Diazepam indication

Muscle spasm due to local injury

Muscle spasticity due to loss of inhibitory input (cerebral palsy)

Tizanidine mechanism of action

centrally acting α2 agonist

“TWOz-α-nidine”

Tizanidine indication

Muscle spasticity due to spinal cord injury or MS

Side effect of benzodiazepines

Drowsiness

Tizanidine side effects

Drowsiness, hypotension

Dantrolene mechanism of action

Uncouples excitation contraction of skeletal muscle by blocking ryanodine receptors

Dantrolene indication

Muscle spasm | Malignant hyperthermia

Dantrolene side effects

Muscle weakness | Sedation

What are the two classes of neuromuscular blockers?

1) Non-depolarizing agents (curare type) | 2) Depolarizing agents (succinylcholine)

How do you reverse the effect of non-depolarizing muscle relaxants?

Administer neostigmine (AChE inhibitor to increase [ACh] in synapses) and Glycopyrrolate (to minimize the muscarinic effects of neostigmine)