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Pharamcology > Skeletal Muscle Relaxants > Flashcards

Skeletal Muscle Relaxants Flashcards

1
Q

What is malignant hyperthermia

A

Hyperthermia that results from massive release of calcium from Sarcoplasmic reticulum. Leads to uncontrolled contraction and stimulation of metabolism in skeletal muscles.

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2
Q

Which enzyme Metabolizes succinylcholine

A

Cholinesterase in the liver and plasma but it is resistant to acetylcholinesterase

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3
Q

What is the mechanism of action of succinyl choline

A

Depolarize is the neuromuscular junction. Continuous depolarization results in muscle relaxation and paralysis. In phase two there is repolarization

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4
Q

What are the effects of continuous infusion of succinyl choline

A

Continuous depolarization changes into gradual repolarization with resistance (sensitization) to depolarization

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5
Q

Why does Cisatracurium replace atracurium?

A

Because cisatracurium metabolite is less toxic (laudanosine)

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6
Q

Which drugs are metabolized by the liver

A
  1. Rocuronium
  2. Vecuronium
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7
Q

Which drug is used to reverse neuromuscular blockade in rocuronium and vecuronium

A

Sugammadex

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8
Q

Cholinesterase inhibitors can be used to reverse the effects of the blocker succinylcholine in which phase

A

Phase 2

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9
Q

What are the toxicities of neuromuscular blockers

A
  1. Respiratory paralysis
  2. Autonomic affects and histamine release
  3. Special effects of succinylcholine ( Hyperkalemia, peripheral nerve dysfunction, muscle dystrophy)
  4. Increase intragastric pressure
  5. Malignant hyperthermia
    
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10
Q

Patients who are deficient in pseudo esterases have which toxic effect toward succinylcholine

A

Prolonged apnoea

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11
Q

Which drugs cause histamine release

A
  1. Tubocurarine
  2. Mivacurium
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12
Q

How is malignant hyperthermia caused including succinylcholine

A

Interaction of succinylcholine with inhaled anaesthetics

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13
Q

Which drugs prolong the relaxant action of neuromuscular blockers

A
  1. Aminoglycosides antibiotics
  2. antiarrhythmic drugs
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14
Q

Which patients are more sensitive to non-depolarizing blockers

A

Patients with
1. myasthenia gravis
2. severe burns
3. upper motor neuron disease
4. renal failure

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15
Q

Which drugs block cardiac muscarinic receptors

A
  1. Pancuronium
  2. Rocuronium 
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16
Q

Which drug is able to reduce pain caused by severe spasms

A

Botulinum toxin

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17
Q

Which spasmolytic drugs act in the spinal cord

A
  1. Diazepam
  2. baclofen
  3. tizanidine
18
Q

Which drug acts as a GABA(B)  agonist And causes membrane hyper polarization

A

Baclofen

19
Q

Which spasmolytic drug is in alpha-2 agonist that acts in the spinal cord

A

Tizanidine

20
Q

Which Spasmolytic drug act in the skeletal muscle cell to reduce the release of activator calcium from SR. What receptor Channel does it act on.

A

Dantrolene On Ryanodine receptor Channel

21
Q

Which drugs cause malignant hyperthermia

A

Succinyl choline
tobocurarine

22
Q

What drug is given to treat malignant hyperthermia and how does it act. 

A

Dantrolene
blocks calcium release

23
Q

What are the adverse effects/toxicities of spasmolytic drugs

A
  1. Diazepam - sedation
  2. tolerance
  3. tizanidine - asthenia, drowsiness, dry mouth, hypotension
  4. dantrolene - muscle weakness
24
Q

Which drugs are used for acute muscle spasms

A
  1. Cyclobenzaprine
  2. Maraxalone
  3. Methocarbamol
  4. Orphenadrine
25
Q

Which Spasmolytic drug used for acute muscle spasms may cause confusion and visual hallucinations

A

Cyclobenzaprine

26
Q

What are the adverse effects of succinylcholine

A
  1. Muscle pain
  2. hyperkalaemia
  3. increased intra-gastric and intraocular pressure
27
Q

Name non-depolarizing skeletal muscle relaxants

A
  1. Tubocurarine
  2. Atracurium
  3. Cisatracurium
  4. Mivacurium
  5. Rocuronium
  6. Vecuronium
28
Q

What are the adverse effects of cyclobenzaprine

A
  1. M Block
  2. sedation
  3. confusion
  4. ocular effects
29
Q

What is the second name for Succinyl choline

A

Suxamethonium

30
Q

Name two drug that is a depolarizing blocker

A

Succinyl choline
decamethonium 

31
Q

Which drug acts directly on the skeletal muscle

A

Dantrolene

32
Q

Which drugs act on the CNS

A
  1. Diazepam
  2. methocarbamol
  3. chlorzoxazone
  4. tizanidine
  5. baclofen
  6. gabapentin
  7. Thiocochicoside
33
Q

What happens when non-depolarizing blockers are used with antibiotics

A

Aminoglycosides inhibit release of acetylcholine
tetracycline and clindamycin also have effects

34
Q

What is the effect of using loop diuretics or thiazides with non-depolarizing Blockers

A

Hypo kalaemia caused by loop diuretics/thiazides may potentiate the effect of non-depolarizing blockers

35
Q

What happens when succinyl choline and Thiopentone Are used together

A

IV
Precipitation when mixed in the same syringe

36
Q

Which Group of drugs enhances the effect of non-depolarizing blockers

A

General anaesthetics and fluorinated anaesthetics

37
Q

What are the factors affecting the actions of neuromuscular blockers

A
  1. pH changes
  2. hypothermia
  3. myasthenia gravis
  4. aminoglycoside antibiotics
  5. inhalation anaesthetics
38
Q

Why is a true been administered before neuromuscular blockers

A

To block the Muscarinic effects of anti-cholinesterase

39
Q

Which drugs are used to reduce the effect of tubocurarine 

A

Endorphonium
Neostigmine

40
Q

Which drug is the most non-depolarizing neuromuscular blocking agent which can be used as an alternative to succinylcholine for tracheal intubation

A

Rocuronium

Pharamcology (15 decks)

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