Neuromuscular Relaxants

Question 1

Pancuronium

Answer 1

Indication - Adjuvant in surgical anesthesia, sp. abdominal wall relaxation and orthopedic procedures
Mechanism of Action - Non-depolarizing blockade of muscle nicotinic receptors
Elimination - Primarily renal excretion

Question 2

D-tubocurarine

Answer 2

Indication - Prototype (only used in lethal injection
Mechanism of action - Non-depolarizing blockade of muscle nicotinic receptors
Elimination - Liver clearance and renal elimination

Question 3

Rocuronium

Answer 3

Indication - Intubation, muscle relaxation during surgery or ventilation
Mechanism of action - Non-depolarizing blockade of muscle nicotinic receptors
Elimination - Liver

Question 4

Mivacurium

Answer 4

Indication - Intubation, muscle relaxation during surgery or ventilation in pts w/renal failure
Mechanism of action - Non-depolarizing blockade of muscle nicotinic receptors
Elimination - Plasma cholinesterase

Question 5

Vecuronium

Answer 5

Indication - Adjuvant in surgical anesthesia, sp. abdominal wall relaxation and orthopedic procedures
Mechanism of action - Non-depolarizing blockade of muscle nicotinic receptors
Elimination - Liver metabolism and clearance, renal elimination

Question 6

Baclofen

Answer 6

Indication - Muscle spasticity associated w/MS or spinal cord injury
Mechanism of action - Inhibits neurotransmitter release from skeletal muscle sensory afferent

Question 7

Diazepam

Answer 7

Indication - Muscle spasm due to local injury (inflammation), muscle spasticity due to loss of descending inhibitory input, e.g. cerebral palsy
Mechanism of action - Benzodiazepine receptor agonist

Question 8

Tizanidine

Answer 8

Indication - Muscle spasticity due to spinal cord injury or MS
Mechanism of action - Centrally acting alpha2 agonist

Question 9

Dantrolene

Answer 9

Indication - Muscle spasm, malignant hyperthermia

Mechanism of action - Uncouples excitation, contraction of skeletal muscle (blocks ryanodine receptor)