Pharma Halo-halo 2 Flashcards
Examples of nondepolarizing neuromuscular blockers
Tubocurarine Pancuronium Atracurium Vecuronium (Cholinergic antagonists at nicotinic sites)
Long-acting nondepolarizing nm blocker
Tubocurarine
Pancuronium
Short-acting nondepolarizing nm blocker
Mivacurium
Rocuronium, most rapid?? 📌
Remarks on pancuronium
Additionally has moderate block on cardiac muscarnic receptors
Also used for euthanasia, lethal injection, strychnine poisoning
NMBs considered DOC for hemodynamically compromised patients
Cisatracurium
Vecuronium
Rocuronium
(Less chances for histamine release causing hypotension)
Remarks on atracurium / cisatracurium
Both undergo HOFFMAN ELIMINATION (rapid spontaneous breakdown) yielding LAUDANOSINE (seizure causing)
Both also are ideal for hepatic patients
Reversal agents for ND-NMB
Neostigmine
*Sugammadex for rocuronium (lesser extent for vecuronium, pancuronium)
Nmb of choice for rapid sequence induction
Succinylcholine
📌 what’s the alternative if may MH?
S/e of succinylcholine
Hyperkalemia (0.5 mEq/L increase)
Increased intragastric pressure leading to regurgitation (aspiration)
Increased intraocular pressure
Malignant hyperthermia
Centrally acting spasmolytic drugs
Baclofen
Orphenadrine (+para = NORGESIC)
Diazepam
Tinazidine (a2 agonist in the spinal cord)
Classmates of orphenadrine
Chlorphenesin
Methocarbamol
Cyclobenzaprine
Direct-acting muscle relaxants
Dantrolene
Eperisone
MOA of dantrolene
Block RyR1 Ca2+ channels in the R of skeletal muscles
Remark on eplerenone
Reduces progression of DM nephropathy and reduces mortality post-MI
Loop diuretics
Furosemide
Torsemide
Bumetanide
Ethacrynic acid
