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Neuro Muscular Psych Block 3 > Skeletal Muscle Relaxant Pharm > Flashcards

Skeletal Muscle Relaxant Pharm Flashcards

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1
Q

Nondepolarizing Neuromuscular Blockers

Mechanism of Action, Adverse Effects (4)

A

Competitive nAchR antagonist

Hypotension
Tachycardia
Bronchospasm
Increased secretions

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2
Q

Isoquinolone Nondepolarizing Agents

Examples (5) with Duration of Action

A

Atracurium: intermediate

Cisatracurium: intermediate

Doxacurium: long

Mivacurium: short

Tubocurarine: long

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3
Q

Steroid Nondepolarizing Agents

Examples (4) with Duration of Action

A

Pancuronium: long

Pipecuronium: long

Rocuronium: intermediate

Vecuronium: intermediate

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4
Q

Succinylcholine
Classification, Duration of Action, Adverse Effects (3) Contraindication, Black Box Warning
MOA: Phase 1 (2) Phase 2 (3)

A

Depolarizing Neuromuscular blocker

Ultra-short acting

Cardiac arrhythmias
Hyperkalemia
Increased Intraocular Pressure

Malignant hypertension

Risk of Cardiac arrest

Phase 1:
Activated Achr causing NMJ depolarization
Flaccid paralysis caused by lack of repolarization

Phase 2:
Continued exposure causes decreased depolarization and membrane repolarizes
Receptor acts as if in prolonged closed state
Receptor desensitized

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5
Q

Neuromuscular Blocking Drugs

Indications (4)

A

Surgical relaxation (long acting drugs)
Tracheal intubation (short acting drugs)
Control of ventilation
Treatment of convulsions

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6
Q

Acetylcholinesterase Inhibitors

Examples (10)

A

Ambenonium
Edrophonium

Echothiophate
Donepezil
Tacrine

Galantamine
Neostigmine
Physostigmine
Pyridostigmine
Rivastigmine
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7
Q

Acetylcholinesterase Inhibitors
Succinylcholine Adjunct Uses (2)
Therapeutic Uses (5)
Adverse Effects (2)

A

Phase 1: Augments blockade
Phase 2: Antagonizes blockade

Myasthenia gravis
Reversal of pharmacologic paralysis
Glaucoma
Dementia
Antidote to anticholinergic poisoning
CNS hyperstimulation (lipid soluble agents)
PSNS Effects
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8
Q

Baclofen

Classification, Mechansim of Action (2) Adverse Effects (2)

A

Centrally acting spasmolytic agent

GABA-b agonist
Inhibits excitatory neurotransmitter release

Seizures (in epileptics)
Psych issues

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9
Q

Carisoprodol

Classification, Adverse Effect, Metabolism

A

Centrally acting spasmolytic agent

Addictive

Metabolized by CYP2C19 to anxiolytic meprobamate

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10
Q

Cyclobenzaprine

Classification, Brand Name, Metabolism, Adverse Effects (3)

A

Centrally acting spasmolytic agent

Flexeril

CYP450 metabolized

Drowsiness
Dizziness
Xerostomia

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11
Q

Diazepam

Classification, MOA, Adverse Effects (2)

A

Centrally acting spasmolytic agent

Enhances GABAa receptor activity in presence of GABA

CNS depression
Sedation

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12
Q

Tizanidine

Classification, MOA, Adverse Effects (4)

A

Centrally acting spasmolytic agent

Alpha-2 agonist

Drowsiness
Hypotension
Dry mouth
Muscle weakness

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13
Q

Dantrolene

Classification, MOA (2) Indication, Adverse Effects (3)

A

Non-Centrally acting spasmolytic agent

Inhibits ryanodine receptor
Blocks SR release of Calcium

Malignant Hyperthermia cure

Muscle Weakness
Sedation
Hepatitis

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14
Q

Botulinum Toxin

Classification, MOA (2) Indications (4) Adverse Effect

A

Non-Centrally acting spasmolytic agent

Cleaves VAMP to block vesicular release of Ach

Dystonia (strabismus, blepharospasm)
Primary Axillary Hyperhidrosis
Chronic Migraine
Focal Spasticity

Focal Muscle Weakness

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15
Q

Multiple Sclerosis Treatments

Drugs (4) with Mechanisms of Action (1/2/1/1)

A

Glucocorticoids: immunosuppression

Interferons: Bind VLA-4 on T cells to stop adhesion or stopping MMP expression by T cells

Glatiramer Acetate: induce T cell suppressor cells for myelin proteins

Mitoxantrone: intercalates with DNA causing strand breaks

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16
Q

Myasthenia Gravis

Treatment (3) Drug Interaction With Disease

A

Pyridostigmine
Neostigmine
Ambenonium

Enhances neuromuscular blockade of non-depolarizing agents

17
Q

Anti-Muscarinic Agents

Examples (2) MOA, and Use (2)

A

Atropine
Glycopyrrolate

Muscarinic antagonist

Given with Acetylcholinesterase inhibitors to reverse skeletal muscle paralysis
Decrease Acetylcholinesterase inhibitor side effects

Neuro Muscular Psych Block 3 (7 decks)

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