Skeletal Muscle Relaxants Flashcards
What are the 2 types of Neuromuscular Blocking agents?
Non-Depolarizing
Depolarizing
What is the Depolarizing Neuromuscular Blocking Agent?
Succinylcholine
Besides Succinylcholine, the rest of the Neuromuscular Blocking Agents are ____
Non-depolarizing
The Isoquinolone Derivatives that are Neuromuscular Blocking end in what?
–Curium or Curarine
The Steroid Derivatives that are Neuromuscular Blocking Agents end in what?
–Nium
What are 3 long acting Neuromuscular Blocking Agents?
Doxacurium
Pancuronium
Piperuronium
Do Neuromuscular Blockers have CNS activity?
No – just interfere with transmission at NMJ
The Non-depolarizing Neuromuscular Blocking Agents MOA
Prevent access of Ach to its receptor and block depolarization
The Depolarizing Neuromuscular Blockage Agent MOA
Blockade that results from excess of a depolarizing agent
What are 3 possible adverse effects of Neuromuscular Blocking Agents?
Hypotension
Tachycardia
Histamine release – bronchospasm
Which Neuromuscular Blocking Agents have less Histamine release?
Steroids – nium
What drug class is used to reverse the NMJ Blockade?
Cholinesterase (-)’s +/- Anticholinergics
What drug class is used to reverse the NMJ Blockade?
Cholinesterase (-)’s +/- Anticholinergic Agents
What are the 2 phases of Succinylcholine’s MOA?
Phase 1 Depolarizing Block
Phase 2 Desensitizing Block
How does Phase 1 Depolarizing Block work with Succinylcholine?
Longer Ach effects at NMJ which causes the membranes to be depolarized and unresponsive
What is the manifestation of Phase 1 Depolarizing Block of Succinylcholine?
Flaccid paralysis with lack of repolarization
How does Phase 2 Desensitizing Block work with Succinylcholine?
Depolarization decreases with continued exposure and then receptors become desensitized
What are 2 Anti-muscarinic Agents? (Anticholinergics)
Atropine
Glycopyrrolate
What is 1 Cholinesterase Reactivator?
Pralidoxime
What is 1 Cholinesterase Reactivator?
Pralidoxime
What can Pralidoxime do?
(Cholinesterase Reactivator)
= Reverse organophosphates sensory changes
If you were to choose a Cholinesterase (-) to reverse a pharmacologic paralysis, which one would you choose?
Neostigmine
If you were to choose a Cholinesterase (-) to reverse a pharmacologic paralysis, which one would you choose?
Neostigmine
What 3 Cholinesterase (-)’s can be used to treat Myasthenia Gravis?
Neostigmine
Pyridostigmine
Ambenonium
What 3 Cholinesterase (-)’s can treat Myasthenia Gravis?
Neostigmine
Pyridostigmine
Ambenonium
Muscle Relaxants are known as?
Spasmolytic Agents
Generally, what do Spasmolytic Agents do?
Provide relief from discomfort and pain of muscle spasms
What are 2 Centrally Acting Muscle Relaxants that you need to know?
Carisoprodol
Cyclobenzaprine
What are 2 Centrally Acting Spasmolytic Agents that you need to know?
Carisoprodol
Cyclobenzaprine
What are the adverse effects of Carisoprodol?
Addictive potential with anxiolytic effects
Which Centrally acting muscle relaxant has an addictive potential with anxiolytic effects?
Carisoprodol
What is an adverse effect of Cyclobenazprine?
Drowsiness
Which Centrally acting muscle relaxant can cause drowsiness?
Cyclobenzaprine
What are 2 Non-Centrally acting muscle relaxants?
Dantrolene
Botulinum Toxin
What are 4 drugs for Multiple Sclerosis?
Glucocorticoids
Glatiramer Acetate
IFN-beta-1a/1b
Mitoxantrone
What are 4 drugs for Multiple Sclerosis?
Glucocorticoids
Glatiramer Acetate
IFN-beta-1a/1b
Mitoxantrone
What is Glatiramer Acetate made of?
4 AA polymers that are similar to myelin basic protein
What is the MOA for Glatiramer Acetate?
(+) T Suppressor Cells specific for myelin antigen
Where do IFN-beta-1a/1b drugs act?
BBB
What is the MOA for IFN-beta-1a/1b?
Interfere with T cell adhesion by binding VLA-4 or by (-) expression of MMP on T cells
What is the MOA for Mitoxantrone?
Intercalates into DNA to cause cross-links and strand breaks
Which drug for MS can intercalate into DNA and cause cross-links and strand breaks?
Mitoxantrone
Which drug for MS can interfere with T cell adhesion by binding VLA-4 or by (-) expression of MMP on T cells?
IFN-beta-1a/1b
Which drug for MS (+) T suppressor cells specific for myelin antigen?
Glatiramer Acetate
