Skeletal Muscle Relaxants

Question 1

Blockade that results in neuromuscular paralysis from persistent depolarization, non-competitive antagonist

Answer 1

Depolarizing Blockade

Question 2

Blockade that results in neuromuscular paralysis from pharmacologic antagonism, competitive antagonist

Answer 2

Non-depolarizing Blockade

Question 3

Drugs eliminated in ______ have shorter action than kidney elimination

Answer 3

bile

Question 4

Non-depolarizing Neuromuscular Block with the most rapid onset time

Answer 4

Rocuronium

Question 5

Long acting neuromuscular blocker
SE: Respiratory paralysis, Ganglion block, Histamine release, Recurarization
Relatively contraindicated in myocardial ischemia

Answer 5

Tubocurarine, Non-depolarizing

Question 6

Drug that reverses effects of Tubocurarine, Mivacurium, Atracurium

Answer 6

Neostigmine (Cholinesterase Inhibitor)

Question 7

Short acting neuromuscular blocker
DOC for Myesthenia Gravis
SE: Respiratory paralysis, Moderate histamine release
Metabolized by pseudocholinesterase

Answer 7

Mivacurium, Non-depolarizing

Question 8

Intermediate acting neuromuscular blocker
SE: Respiratory paralysis, histamine release, bronchospasm, seizures
Undergoes rapid spontaneous breakdown

Answer 8

Atracurium, Nondepolarizing

Cistracurium - less adverse effects

Question 9

Neuromuscular blocker that undergoes Hoffmann Elimination

Answer 9

Atracurium

Cistracurium

Question 10

Intermediate acting neuromuscular blocker
SE: Respiratory paralysis
Undergoes elimination in BILE
Muscle relaxation is potentiated by inhaled anesthetics, aminoglycosides, and quinidine

Answer 10

Vecuronium, Nondepolarizing

Question 11

Intermediate acting neuromuscular blocker
SE: HYPERSENSITIVITY, Respiratory paralysis
Effects reversed by Neostigmine and novel drug SUGAMMADEX

Answer 11

Rocuronium, Nondepolarizing

Question 12

Long acting neuromuscular blocker
Moderately blocks cardiac muscarinic receptors
Drug for euthanasia, lethal injection, Strychnine poisoning
SE: Respiratory paralysis, apnea, tachycardia, hypertension, recurarization
Reversed with Neostigmine

Answer 12

Pancuronium, Nondepolarizing

Question 13

MOA of Strychnine

Answer 13

Glycine inhibitor
Similar to tetanus
Known convulsant

Question 14

Drugs for Lethal Injection

Answer 14

Sedative: Thiopental (5g)
Relaxant: Pancuronium (100mg)
Arrhythmic: Potassium Chloride (100 mEq)

Question 15

Identify Phase of Depolarizing Blockade: Transient fasciculations followed by flaccid paralysis

Answer 15

Phase I (Depolarization)

Question 16

Identify PHase of Depolarizing Blockade:

Membrane repolarizes but receptor is desensitized to effects of ACh

Answer 16

Phase II (Depolarization)

Question 17

Agonist at ACh-N receptors causing initial twitch then persistent depolarization
SE: Muscle pain, hyperkalemia, aspiration, malignant hyperthermia
Metabolized by pseudocholinesterase

Answer 17

Succinylcholine, Depolarizing

Question 18

Interaction of Succinylcholine (possibly Tubocurarine) with inhaled anesthetics (Halothane) resulting in massive Calcium release from SR
Sx: Trismus

Answer 18

Malignant Hyperthermia

Question 19

Tx of Malignant Hyperthermia

Answer 19

DOC Dantrolene

Rapid cooling of px