old dont study Chapter 25 Muscle Relaxants Flashcards by Shaniya Capre

What is muscle spasms?

-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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What is muscle spastsicity?

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

Lioresal

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

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

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

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

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

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What are contras of Baclofen(Lioresal)?

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

People who have seizure disorders, it can exacerbate seizures

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

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

Dantrium

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

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

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

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What is the pharmacokinetics of Dantrolene((dantrium )?

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

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What is anesthetic?

-Drugs used to cause partial or complete loss of sensation

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What is general anesthetic?

CNS depressant would lead to loss of sensation

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What is local anesthesia?

Loss of sensation in specific area without systemic effect

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What does general anesthesia do?

-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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What is balanced anesthesia?

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

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What do pre-op meds do?

Decrease secretions, prevent bradycardia

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What is sedative hypnotics?

-relax pt
-Decrease SNS stimulation

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What is Anti-emtic ?

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

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What does antihistamines do as anesthesia?

-dry secretions
-decrease chance of getting allergic reactions

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What does opiod help with?

Analgesic and sedation

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What is several different types of anesthetic agents used ?

-Barbiturates
-Non barbiturates
-Gas anesthetics
-Volatole anesthetics

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**General anesthetic What is a type of barbiturates?

Methohexital(Brevital)

What does methohexital(Brevital) do for the body?

Causes CNS depression

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

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

What are pharmacokinetics methohexital(brevital)

Rapid acting (10-30 secs) short recovery

What are adverse affects of methohexital (Brevital)

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

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

Pregnancy

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

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

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

Versed

What does Midazolam(versed) do for the body?

Acts in RAS and limbic system

What is the midazolam(versed) used for?

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

What are adverse effects of Midazolam(Versed)

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

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

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

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

over sedation with concurrent meds

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

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

What is pharmacokinetics with Nitrous Oxide?

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

What is adverse effects of nitrous oxide?

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

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

-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

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

It turns liquids unstable at room temperature, release gas

What are adverse effects of Desflurane (Suprane)

Respiratory reactions

What are cautions when desflurane (Suprane)?

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

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

-Temporarily interrupts conduction of nerve impulses

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

-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

What are adverse affects of lidocaine

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

What are cautions to have with lidocaine?

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

What do the nerves do to result in muscle contraction?

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

What neurotransmitter is required for this process to occur?

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

What interferes with muscle function?

Neuromuscular blocking agents -Non-depolarizing -Depolarizing

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

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

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

-Apart of general anesthesia -Mechanical ventilation

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

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

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

-Paralysis of muscle -Decreased respiratory rate and apena

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

-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

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

-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

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

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

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

-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

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

-Adjunct to general anesthsia -Mechanical ventilation -Intubations

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

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

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

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

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

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