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Pharmacology > old dont study Chapter 25 Muscle Relaxants > Flashcards

old dont study Chapter 25 Muscle Relaxants Flashcards

1
Q

What is muscle spasms?

A

-Often results from injury to the musculoskeletal
-Caused by the flood of sensory impulses coming to the spinal cord from the injured area
- It is involuntary

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2
Q

What is muscle spastsicity?

A

-Results of damage to neurons within the CNS not peripheral structures
-Spasticity can lead to muscle spasms
-Can be due to an increase in excitatory influences or a decrease in inhibitory influences within the CNS

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3
Q

**Centrally Acting Skeletal Muscle relaxants
What is Baclofen brand name?

A

Lioresal

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4
Q

**Centrally Acting Skeletal Muscle relaxants
What are the therapeutic actions with baclofen( Lioresal).
What does it do in the body

A

-Interfere with reflexes in the CNS causing the spasm, not peripheral structure
-causes cns depression

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5
Q

**Centrally acting skeletal muscle relaxants
How does baclofen (Lioresal) help a person?

A

-Alleviation of signs and symptoms of spasticity
-Used in spinal cord injuries or neuromuscular diseases in conjunction with rest,PT
-It works centrally in the CNS and will cause CNS depression

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6
Q

**Centrally acting skeletal muscle relaxants
What are adverse effects baclofen (Lioresal)

A

-Related to CNS depression- sleepiness, weakness, confusion, HA
-Hypotension
-Gi including naseau and vomiting

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7
Q

What are contras of Baclofen(Lioresal)?

A

-People who have rheumatic disease shouldn’t be on it because it won’t help them with the peripheral structures and it wont work because it targets their CNS
-Should not be given to someone who needs to walk, sit, grab things

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8
Q

What should you be cautious of when taking baclofen(Lioresal)?

A

People who have seizure disorders, it can exacerbate seizures

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9
Q

What are drug interactions that will mess with baclofen(Lioresal)

A

-Taking other Cns medication and taking alcohol
-DO not take with alcohol.
-If you stop this medication immediately it can cause psychosis or hallucinations make sure to stop this medication slowly

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10
Q

**Direct Acting skeletal muscle relaxants
What is dantrolene brand name?

A

Dantrium

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11
Q

**Direct Acting skeletal muscle relaxants
How does Dantrolene(Dantrium) work in the body?

A

-Inhibits release of calcium from muscle fibers which prevents muscle conractions
-Affects the peripheral muscle contraction by entering muscle and preventing contractions
-This medication inhibits calcium since calcium is inhibited then muscle contractions are inhibited

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12
Q

**Direct Acting skeletal muscle relaxants
Why would Dantrolene((dantrium ) be given?

A

-Treatment of spasticity associated with neuromuscular disease
-Malignant hyperthermia,
-This works directly @ the sit of the muscle

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13
Q

What is the pharmacokinetics of Dantrolene((dantrium )?

A

-Crosses the placenta and enters the breastmilk so do not give to anyone breast feeding or nurturing

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14
Q

What is anesthetic?

A

-Drugs used to cause partial or complete loss of sensation

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15
Q

What is general anesthetic?

A

CNS depressant would lead to loss of sensation

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16
Q

What is local anesthesia?

A

Loss of sensation in specific area without systemic effect

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17
Q

What does general anesthesia do?

A

-Block of physical reflexes that may interfere without surgery and you din’t want them to move
-amnesia which causes the inability to recal

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18
Q

What is balanced anesthesia?

A

Drug combined to produce the best effect with minimal amount of medication

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19
Q

What do pre-op meds do?

A

Decrease secretions, prevent bradycardia

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20
Q

What is sedative hypnotics?

A

-relax pt
-Decrease SNS stimulation

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21
Q

What is Anti-emtic ?

A

As GI slows it can cause N/V. NO eating before surgery

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22
Q

What does antihistamines do as anesthesia?

A

-dry secretions
-decrease chance of getting allergic reactions

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23
Q

What does opiod help with?

A

Analgesic and sedation

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24
Q

What is several different types of anesthetic agents used ?

A

-Barbiturates
-Non barbiturates
-Gas anesthetics
-Volatole anesthetics

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25
Q

**General anesthetic
What is a type of barbiturates?

A

Methohexital(Brevital)

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26
Q

What does methohexital(Brevital) do for the body?

A

Causes CNS depression

27
Q

What are good affects that come from methohexital(Brevital)?

A

-Induce rapid anesthesia.
-They do not relieve pain they will only cause loss of consciousness

28
Q

What are pharmacokinetics methohexital(brevital)

A

Rapid acting (10-30 secs) short recovery

29
Q

What are adverse affects of methohexital (Brevital)

A

r/t supression if CNS
supressing GI system which can cause post op n/v

30
Q

What are contras/cautions when taking Methohexital(Brevital)?

A

Pregnancy

31
Q

What are drug to drug interactions to look out for Methohexital(Brevital)

A

-Synergistic with other CNS suppressants
-Decrease effectiveness of other medications
like anticoagulation, beta blockers, oral contraceptives

32
Q

**General Anesthetic agents non- Barbiturates
What is midazolam also called?

A

Versed

33
Q

What does Midazolam(versed) do for the body?

A

Acts in RAS and limbic system

34
Q

What is the midazolam(versed) used for?

A

-Ptent amnesiac
-Utilized for diagnostic procedures are well as surgery

35
Q

What are adverse effects of Midazolam(Versed)

A

-R/T CNS suppression
-Respiratory suppression
-N/V

36
Q

What are cautions you should you have with Midazolam(Versed)?

A

-Have intubation equipment ready?
-Monitor closely for respiratory suppression

37
Q

What are drug to drug interactions with midazolam(Versed)?

A

over sedation with concurrent meds

38
Q

**General Anesthetic Agents: Anesthetic gases
What does nitrous oxide do for the body?

A

-When inhaled it goes to the bronchi, capillaries, blood system, and brain
-Causes CNS depression

39
Q

What is pharmacokinetics with Nitrous Oxide?

A

-Weakest and least toxic of gases
-Rapids onset (1-2 min)

40
Q

What is adverse effects of nitrous oxide?

A

Acute sinus, middle-ear pain, abd. They like to put pressure in the area. Gases can accumulate and make cause bowel compression

41
Q

What are cautions you should have when going under anesthesia with nitrous oxide?

A

-Pregnancy
-If pt is breastfeeding they should wait atleast 4 hours before they pump because they is a risk of it crossing onto the baby
-This blocks oxygen uptake so be sure to watch oxygen and 02 stat

42
Q

**General Anesthetic agents: Volatile Liquids
What is therapeutic actions desflurane (Suprane)?

A

It turns liquids unstable at room temperature, release gas

43
Q

What are adverse effects of Desflurane (Suprane)

A

Respiratory reactions

44
Q

What are cautions when desflurane (Suprane)?

A

-If you have respiratory problems you should be careful
-And be careful with pregnancy/lactation

45
Q

**Location Anesthetics
What does lidocaine(Dilocaine,Lidoderm) do to the body?

A

-Temporarily interrupts conduction of nerve impulses

46
Q

What is the point of lidocaine(Dilocaine,Lidoderm) ?

A

-Peripheral nerve block, spinal anesthesia, local pain relief
-Blocks sodium. If sodium is blocked from coming in that action potential is blocked, the pain messages thats suppose to get sent gets blocked

47
Q

What are adverse affects of lidocaine

A

blocking of sensations, which can cause a fall safety risk
-Important to look for skin breakdown because they cab’t feel

48
Q

What are cautions to have with lidocaine?

A

-Allergy
-Heart block
-Monitor for systemic effects
like CNS, cardiac arrhythmias
like critical that effects be limited to specific area of the body

49
Q

What do the nerves do to result in muscle contraction?

A

Nerve communicate with skeletal muscle fibers at Neuromuscular junction which ends in muscle contraction

50
Q

What neurotransmitter is required for this process to occur?

A

Acetylcholine (ACh) is neurotransmitter required for this process to occur
Releasing calcium so the muscles can contract

51
Q

What interferes with muscle function?

A

Neuromuscular blocking agents
-Non-depolarizing
-Depolarizing

52
Q

**Nondepolarizing Neuromuscular Junction Blockers
rocuronium (Zemuron)
pancuronium (Pavulon)
What are the the therapeutic actions for these

A

Antagonist to acetylecohaline and neuromuscular junction
-If acetyolcohine has nothing to communicate with it is blocked from sending the messages to release calcium, that leads to blocking muscle movement
-Does not allow depolarization(contraction of muscle

53
Q

What Is the point of rocuronium (Zemuron)
pancuronium (Pavulon)?

A

-Apart of general anesthesia
-Mechanical ventilation

54
Q

What are pharmacokinetics of rocuronium (Zemuron)
pancuronium (Pavulon)

A

-Metabolized in serum by cholinesterase
-If pt has low levels of cholinesterase drug will last linger

55
Q

What are adverse effects of rocuronium (Zemuron), pancuronium (Pavulon)?

A

-Paralysis of muscle
-Decreased respiratory rate and apena

56
Q

What are contras against rocuronium (Zemuron), pancuronium (Pavulon)?

A

-Renal/ hepatic disease because body won’t be able to excrete or metabolize properly
-Myasthenia gravis it will aggravate disease. It is an autoimmune disease where the body attacks receptors and if its blocked it will get worse

57
Q

What should you look out for when giving rocuronium (Zemuron)
pancuronium (Pavulon)?

A

-Look out for pt with malignant hyperthermia
Histamine release, so know if they have family history or if pt had it before
-It can cause histamine release which can cause inflammatory problems

58
Q

What are drug to drug interactions to look out for with rocuronium (Zemuron)
pancuronium (Pavulon)?

A

Aminoglycosides, CCB’s increases blockade effects it can increase blocking effects of the drug

59
Q

**Depolarizing Neuromuscular junction blocker
What does **succinylcholine (Anectine, Quelicin) do for the body?

A

-ACh agonist, attaches to ACh site causing prolonged depolarization (contraction), then flaccid paralysis

Agnosist to acetolycholine, meaning it will cause same affect
-Calcium will come rushing in since it will cause intial contractions
-It causes paralysis because it keeps the tubules open, those muscles can’t respond to any new stimuli. Keeping the whole process in depolarization, muscles can’t move

60
Q

What is intubations for **succinylcholine (Anectine, Quelicin)

A

-Adjunct to general anesthsia
-Mechanical ventilation
-Intubations

61
Q

What is pharmakinetics of **succinylcholine (Anectine, Quelicin)? / what does the body do the drugs ?

A

-Metabolize in serum by cholinesterase
-Rapid onset, short duration

62
Q

What are adverse affects of **succinylcholine (Anectine, Quelicin)?

A

-Same as Neuromuscular junction blockers
-Muscle pain
r/t paralysis of muscles
Decreased resp, apnea

63
Q

What are cautions you should have when taking **succinylcholine (Anectine, Quelicin)?

A

-Same as NMJ blockers
-Low plasma cholinesterase
h/o malignant hyperthermia
Histamine release

Pharmacology (39 decks)

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