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Unit 1 Pharm II > Nicotinic antagonists > Flashcards

Nicotinic antagonists Flashcards

1
Q

nondepolarizing competitive antagonists MOA

A

hold the Nm receptor closed, preventing Na+ flow and depolarization–> no muscle contraction

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2
Q

effect of nondepolarizing blockers can be overcome with

A

ACh, as they are competitive antagonists

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3
Q

the only depolarizing blocker

A

succinylcholine

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4
Q

succinylcholine MOA

A

holds Nm open, continual flow of Na+ causes continual, longer than normal depolarization, which causes Nm to desensitize to subsequent ACh stimulation

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5
Q

neuromuscular blocking agents DO NOT

A

produce unconsciousness or anesthesia because they do not enter the brain

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6
Q

due to their high degree of ionization

A

neuromuscular blocking agents are NOT absorbed orally and do NOT enter CNS. IV ONLY.

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7
Q

nondepolarzing blockers interfere with the mobilization of ACh from the nerve terminal by

A

blocking pre-junctional sodium channels

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8
Q

endplate potential _______ when a nondepolarizing blocker is taken

A

decreases, an action potential can no longer be generated –> lack of muscle contraction (paralysis)

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9
Q

pharmacologic reversal for nondepolarizing blockers

A

cholinesterase inhibitors (increase ACh which can outcompete blockers)

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10
Q

muscles that are affected first by nondepolarizing blockers

A

small muscles followed by larger muscles

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11
Q

muscles that are affected last by nondepolarizing blockers

A

diaphragm, intercostal muscles

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12
Q

onset of action and recovery from succinylcholine are ________, so it’s used for

A

rapid

short procedures

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13
Q

succinylcholine’s action is terminated by

A

plama pseudocholinesterase

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14
Q

dibucaine

A

a local anesthetic that causes inhibition of AChE

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15
Q

abnormal dibucaine number

A

20%: abnormal cholinesterase acitivity, succinylcholine with last way too long

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16
Q

normal dibucaine number

A

80%: cholinesterase functions normally and succinylcholine will be short acting

17
Q

delay recover from succinylcholine

A

cholinesterase inhibitors

18
Q

succinycholine contraindications

A

soft tissue damage, burns, non-traumatic rhabdomyolisis, spinal cord injuries, muscular dystrophy, <8 years old

19
Q

inhaled anesthetic

A

halothane

20
Q

halothane is notorious for

A

malignant hyperthermia (also succ can cause)

21
Q

malignant hyperthermia from succinylcholine/halothane treatment

A

dantrolene

22
Q

patients who are at higher risk of too much K+ released by succinylcholine

A

burns, nerve degeneration, head trauma, peritoneal infection, kidney disease

23
Q

prolonged release of potassium by succinylcholine + risk factor can cause

A

cardiac arrest, life threatening esp in CHF

24
Q

malignant hyperthermia by succinylcholine/halothan MOA

A

uncontrolled release of Ca++ from sarcoplasmic reticulum –> muscle rigidity and high temperature

25
Q

ventilation use of neuromuscular blocking agents

A

paralyze diaphragm so a ventilator can be used. intubation, bronchoscopy.

26
Q

surgery use of neuromuscular blocking agents

A

paralysis, relax muscles for surgery

27
Q

orthopedic use of neuromuscular blocking agents

A

allow manipulation of bones

28
Q

other random ass use of neuromuscular blocking agents

A

decrease convulsions/muscle spasms (fine) in ECT (idk).

29
Q

ganglion blockers are considered

A

nondepolarizing competitivie antagonists

30
Q

2 ganglion blockers

A

hexamethonium
mecamylamine
(not used clinically)

31
Q

effects of ganglion blockers

A

fire PNS and SNS so it depends on the dominant tone of the organ

32
Q

ganglion blocker effects in eye

A

PNS blocked: cycloplegia, mydriasis

33
Q

ganglion blocker effects on blood vessels

A

SNS blocked: vasodilation causes drop in BP, orthostatic hypotension

34
Q

ganglion blocker effects on heart

A

SNS blocked: contractility reduced

PNS blocked: decrease in vagal tone causes tachycardia

35
Q

GU ganglion blocker effects

A

PNS blocked: urinary retention, esp. BPH

36
Q

sex ganglion blocker effects

A

PNS blocked: erectile dysfunction

SNS blocked: reduced ejaculation

37
Q

ganglion blocker effects on body temp

A

SNS blocked: can’t sweat

maintain body heat through vasodilation

38
Q

ganglion blocker effects if combined with autonomic drugs

A

normal/exaggerated effects on target organ receptors which are not blocked
Feedback and reflexes are decreased/abolished

Unit 1 Pharm II (18 decks)

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