Pharmacology of Neuromuscular Blocking Agents Flashcards

1
Q

What is the MOA of depolarizing neuromuscular blockers?

A

Initially depolarize the cell, followed by persisted occupation of the receptor site that delays repolarization

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2
Q

What is the MOA of Dantrolene?

A

Direct-acting skeletal muscle relaxant

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3
Q

What ADRs are associated with depolarizing neuromuscular blockers?

A

Muscle twitching, hyperkalemia, respiratory depression, increased ocular pressure, hypertension, tachycardia, arrhythmias, salivation

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4
Q

What is the active metabolite of succinylcholine?

A

Succinylmonocholine

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5
Q

What are the uses of Dantrolene?

A

Treatment of chronic muscle spasticity and malignant hyperthermia

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6
Q

What is the major ADR associated with Dantrolene?

A

Hepatotoxicity

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7
Q

What types of muscle fibers (slow/fast) are more susceptible to the effects of direct-acting skeletal muscle relaxants?

A

Fast-twitch muscle fibers

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8
Q

What are the steroid derivative non-depolarizing neuromuscular blockers?

A

Vecuronium, Rocuronium

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9
Q

When are non-depolarizing neuromuscular blockers contraindicated?

A

During overdose with depolarizing blockers - receptor sites will be blocked and OD effects will be prolonged

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10
Q

This drug may be administered via IV during surgery to treat malignant hyperthermia.

A

Dantrolene

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11
Q

What neuromuscular blocker is commonly used in emergency situations to facilitate intubation?

A

Succinylcholine

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12
Q

What are the two types of neuromuscular blockers?

A

Depolarizing & Non-depolarizing

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13
Q

What drug can be administered an an antidote for non-depolarizing neuromuscular blockers?

A

Sugammadex

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14
Q

What are the isoquinolone derivatives?

A

Tubocurarine, Cisatracurium

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15
Q

What are the contraindications for use of a depolarizing neuromuscular blocker?

A

History of malignant hyperthermia, narrow-angle glaucoma

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16
Q

What is the MOA of Succinylcholine?

A

Depolarizing neuromuscular blocker

17
Q

True/False. Neuromuscular blockers penetrate the BBB.

A

False. They cannot penetrate the BBB, thus there is little CNS effect

18
Q

How can an overdose by a non-depolarizing neuromuscular blocker be treated?

A

Mechanical respiration, vasopressors, cholinesterase inhibitors

19
Q

What non-depolarizing neuromuscular blockers are most likely to increase histamine release?

A

Isoquinolone derivatives

20
Q

Cholinergic drugs and corticosteroids have what effect on neuromuscular blockers?

A

Reduce pharmacological effectiveness

21
Q

What is the MOA of direct-acting skeletal muscle relaxants?

A

Act directly on skeletal muscle fibers to decrease Ca2+ release

22
Q

Malignant hyperthermia is a serious ADR associated with what class of neuromuscular blockers?

A

Depolarizing blockers

23
Q

What is the MOA of non-depolarizing neuromuscular blockers?

A

Competitively bind to post-synaptic ACh cholinergic receptors

24
Q

What type of neuromuscular blocker produces flaccid paralysis?

A

Non-depolarizing blockers

25
Q

What are the primary uses of neuromuscular blockers?

A

Facilitate intubation, improve respiration with mechanical respirators

26
Q

Blocking of receptors by neuromuscular blockers beings (peripherally/centrally).

A

Peripherally. At low doses, rapidly contracting small muscles are first blocked and moves centrally. Recovery occurs in the reverse order, starting with the diaphragm and intercostal muscles.

27
Q

What is the MOA of sugammadex?

A

Encapsulates drug to prevent receptor binding