Section 2e Neuromuscular Nicotinic Blockers

Question 1

Do Depolarizing blockers depolarize the cell?

Answer 1

only in the initial stage

Question 2

Which blocker is competitive to the nicotinic receptor

Answer 2

Nondepolarizing blocker

Question 3

Which blocker is resistant to AChE?

Answer 3

Depolarizing blockers

Question 4

What is an example of a depolarizing blocker?

Answer 4

Succinylcholine

Question 5

What is an example of Nondepolarizing blocker?

Answer 5

Tubocurarine

Question 6

Which blocker acts as an agonist and which an antagonists between the two blockers

Answer 6

agonist = depolarizing
antagonists = nondepolarizing

Question 7

What does fasciculations mean?

Answer 7

twitching of the muscle (such as during the depolarizing phase of the depolarizing blockers)

Question 8

What happens during phase 2 of depolarizing neuromuscular blocking drugs

Answer 8

Succinylcholine stays on the receptor and blocks the end-plate depolarization - desensitizing the effects of ACh

Question 9

How long is the duration of action for Succinylcholine?

Answer 9

short muscle faciculations then a few minutes of paralysis (extremely short)

Question 10

What can degrade Succinylcholine?

Answer 10

Butyrylcholinesterase (psuedocholinesterase)

Question 11

What is dangerous adverse effect of succinylcholine in burn patients?

Answer 11

hyperkalemia

Question 12

what are the major 4 adverse effects of succinylcholine?

Answer 12

hyperkalemia, bradycardia, malignant hyperthermia, apnea

Question 13

What is probably reason behind the adverse effect apnea for succinylcholine?

Answer 13

patients with a deficiency in pseudocholinesterase = may need ventilation until drug is cleared from the body

Question 14

What are the two groups of nondepolarizing blockers?

Answer 14

Benzylisoquinolinium (-acurium and tubocurarine) and Aminosteroid (-onium) compounds

Question 15

What is the order/on set of action for neuromuscular blocking agents? (opposite for recovery)

Answer 15

smaller muscles –> larger muscles (on set of action)

Question 16

How does the duration of action compare between Tubocurarine and Succinylcholine?

Answer 16

tubocurarine is much longer

Question 17

What are the 2 major uses of Tubocurarine?

Answer 17

1. adjuvant drug in anesthesia to relax muscles during surgery
2. facilitate intubation during orthopedic surgery

Question 18

What are side effects of Tubocurarine and the reasoning behind it?

Answer 18

hypotension and compensatory tachycardia due to marked histamine release

Question 19

Is Tubocurarine used more or sythetic durgs?

Answer 19

sythetic drugs because they have lesser side effects

Question 20

What is the duration of action for d-tubocuratine and pancuronium?

Answer 20

very long lasting

Question 21

What is the duration of action for vecuronium, Atracurium, and rocuronium?

Answer 21

intermediate duration

Question 22

What is the duration of action for mivacurium?

Answer 22

rapidly degraded (thus really short duration)

Question 23

Which nondepolarizing agents cause histamine release?

Answer 23

Tubocurarine, atracurium and mivacurium

Question 24

Which drug blocks muscarinic receptors in the heart, resulting in tachycardia?

Answer 24

Pancuronium

Question 25

Which drugs have active metabolites that cause side effects?

Answer 25

Atracurium –> laudanosine
Pancuronium –> 3-hydroxy metabolite
Vecuronium –> 3-deacetylvecuronium

Question 26

Which will have more side effects when messed with, nicotinic or muscarinic receptors?

Answer 26

nicotinic receptors

Question 27

if it deals with heart rate what is it called?

Answer 27

chronotropy

Question 28

if it deals with blood velocity what is it called?

Answer 28

dromotropy

Question 29

if it deals with contractility (force) what is it called?

Answer 29

iontropy

Question 30

if it deals with myocyte relaxation what is it called?

Answer 30

lusitropy