NMJ Drugs Flashcards
Atracurium
Nondepolarizing NMJ blocker- Isoquinoline derivative
Cisatracurium
Nondepolarizing NMJ blocker- Isoquinoline derivative
Doxacurium
Nondepolarizing NMJ blocker- Isoquinoline derivative
Metocurine
Nondepolarizing NMJ blocker- Isoquinoline derivative
Mivacurium
Nondepolarizing NMJ blocker- Isoquinoline derivative
Tubocurarine
Nondepolarizing NMJ blocker- Isoquinoline derivative
Pancuronium
Nondepolarizing NMJ blocker- steroid derivative
Pipecuronium
Nondepolarizing NMJ blocker- steroid derivative
Rocuronium
Nondepolarizing NMJ blocker- steroid derivative
Vecuronium
Nondepolarizing NMJ blocker- steroid derivative
Succinylcholine
Depolarizing NMJ blocker
AE: hyperkalemia, increased intraoccular pressure
CI: malignant hyperthermia, not with kids <12 (cardiac arrest risk if underlying skeletal muscle myopathy)
Dantrolene
Muscle relaxant(spasmolytic) - inhibits ryanodine receptors(malignant hyperthermia)
Botulinum toxin
Muscle relaxant(spasmolytic) - cleaves SNARE complex
Ambenonium
AChE inhibitor
Donepezile
AChE inhibitor
Echothiophate*
AChE inhibitor
Edrophonium*
AChE inhibitor
Galantamine
AChE inhibitor
Neostigmine*
AChE inhibitor
Physostigmine*
AChE inhibitor
Pyridostigmine*
AChE inhibitor
Rivastigmine
AChE inhibitor
Tacrine
AChE inhibitor
Atropine*
Antimuscarinic compunds
nondepolarizing NM blocking agents
distribute fast, eliminate slow
poor solubility
competitive antagonists at nAChR
how to reverse nondepolarizing NM blocking agents
add acetylcholine or succinylcholine
or cholinesterase inhibitors
neostigmine/pyridostigmine - AChE inhibitors that increse release
What do you give with AChE inhibitors?
Anticholinergic agents - atropine glycopyrrolate
prevent bradycardia, bronchoconstriction
AE of nondepolarizing NM blocking agents
can cause histamine release - wheals, bronchospasm, hypotension, bronchial/salivary secretion
-less with steroids
CV effects of hypotension and tachycardia
What drugs use for rapid sequence intubation
succynilcholine, rocuronium, vecuronium
What drugs for surgical muscle relaxation
pancuronium, atracurium, cisatracurium
Drugs for hepatic/renal insufficiency?
atracurium, cisatracurium