skeletal muscle relaxants

Question 1

general characteristics about Ach receptor

Answer 1

requires 2 ACh. is ligand gated with five subunits opens to cause sodium channel to open and thus depolarization. muscle relaxants prevent depolarization.

Question 2

nonpolarizing muscle relaxants

Answer 2

nicotinic antagonists (tubocurarine type). are reversible with AChEi. they cause progressive paralysis (face, limbs, respiration).

Question 3

what do the nondepolarizing muscle relaxants not effect

Answer 3

CNS or cardiac or SM.

Question 4

atracurium

Answer 4

nondepolarizing agent. rapid recovery. safe for liver and renal impairment. it does spontaneously inactivate to laudanosine which can cause seizures.

Question 5

mivacurium

Answer 5

nondepolarizing agent. very short duration, metabolized by plasma cholinesterase.

Question 6

depolarizing muscle relaxants

Answer 6

noncompetitive. nicotinic agonists. irreversible by AChEi.

Question 7

phase I of depolarizing muscle relaxants

Answer 7

depolarization with fasciculations. AChEi would make this phase worse.

Question 8

phase II of depolarizing muscle relaxants

Answer 8

desinsitization. AChEi would not touch this phase,

Question 9

what is the depolarizing agent

Answer 9

succinylcholine

Question 10

what are the cautions for using depolarizing agent

Answer 10

malignant hyperthermia, hyperkalemia would worsen.

Question 11

what are the characteristics of malignant hyperthermia

Answer 11

life threatening. muscle ridigity, hyperthermia, hypertension, acidosis, hyperkalemia. ryanodine receptor or L-type calcium channel genetic predominance.

Question 12

treatment for malignant hyperthermia

Answer 12

dantrolene: acts directly on muscle to decrease contractility