Non-Depolarizers Flashcards
NDNMBs act by
Combining with nicotinic cholinergic receptors without activation of ion channels
Tetanus and TOF give what data
Pre-junctional data
Single twitch response gives what data
Post-junctional
TOF fade aka
Wedensky inhibition
Wedensky inhibition is
Continuous refractory state preventing repolarization
NDNMB and volatile agents
NDNMB enhanced by volatile agents
Aminoglycosides and NDNMB fx
Enhance (Gent) via decreased prejx release of Ach and decreased post-jx sensitivity to Ach
Quinidine and NMB fx
Increases NDNMB and depolarizer function
2 categories of NDNMB
Aminosteroids (Roc and Vec)
Benzylisoquinoliniums (Nimbex)
3 characteristics of NMBs
Highly ionized
Water soluble at physiologic pH
Poorly lipid soluble
Plasma clearance, Vd, elimination 1/2 times influenced by (3)
Age
Volatile anesthetics
Hepatic/renal disease
Train of Four fade aka
Wedensky inhibition
LA effect on NDNMBs
Small dose- enhance
Large dose- block NM transmission
Effect of Dilantin on NMB
Increase depth of NMB
Ephedrine effect on NMB
Increases onset of NDNMB
Magnesium effect on NMB
Decrease onset and increase duration of action
Respiratory acidosis and NDNMB
Augments NDNMB
With severe hepatic dysfunction avoid
Use
Avoid Roc and Vec
Use Cistatracurium
Roc and Vec are metabolized by
Liver
Paraplegia/quadriplegia and NDNMB
Increased sensitivity
Burns and NDNMB
Greater than 30% BSA burn get NDNMB resistance
Hypokalemia and NDNMB
Smaller dose needed of NDNMD
Greater anticholinesterase needed for reversal
