Skeletal Muscle Relaxants Flashcards
How are you going to remember the non-depolarizing NM blockers????
CAT-MD are the isoquinolones, PIPE, PAN, R, V are the steriod non-depolarizing NM blockers.
How do the non-depolarizing NM blockers work???
Non-depolarizing drugs act as an Acetylcholine Receptor antagonist. Competes with ACh for the receptor at the neuro-muscular junction.
How do polarizing (aka succinylcholine) cause a neruomuscular blockade?
Succinylcholine first binds to the ACh receptor and causes a brief activation (seen clinically as twitching in the chest, muscle spasms, ect.), then what it dose is inactivates/closes the receptor so that when ACH binds, it can not produce effect.
When are non-polarizing NM blokers used?
Prior o ECT, ICU when patients have inceased muscle tone (when on a ventilator) this will reducemuscle tone and peripheral oxygen use, Intubation Tubes, INcracranial procedures, *****USED TO DECREASE THE DEPTH OF SYSTEMIC ANESTHETIC DURING SURGERY< AKA YOU DONT HAVE TO PUCH ANESTHESIA CLOSE TO COMA.
What are the toxicitie involved with non-depolarizing NM blockers???
Can cause release of histamine, causing hypotension, seizures, Cardiac arrhythmias (block M2 receptors - Atracurium and Pancuronium).
What drugs ehance the NM blockade?
Myasthenia graves, local anesthetics, inhalational anesthetics, Aminogylcosides,
How would you reverse a Neuromuscular blockade??
You want to give them NEOstigmine (neo makes you move!!) and/or pyridostigmine (to get rid of muscle contractions).
How are the steriodal NM blockers metabolized.. what implications dose this have???
STeroids are metabolized by the liver. They have a rather long half life.
Succinylcholine toxicities
Intraocular pressure, intragastric pressure, hyperkalemia in those with severe burns, head trauma, etc. and MUSCLE PAIN.
What are the contraindication of giving succinylcholine??
DO not give with inhaled, halogenated anesthetics dantrolene. will cause malignant hyperthermia!!!! Can cause cardiac arrhythmias.
Baclofen -uses, MOA, and toxicites
Baclofen is used as an antispasmodic… it binds GABA-B receptors ad increases K+ channels (allowing an eflux of K+ will cause the cell to become hyperpolarized and can’t contract)… it is used to treat back spasms, MS muscle contraction, cerebral palsy, stroke, and spinal injury. Can cause orthostatic hypotension, dizziness, fatigue, depression.
Diazepam
Bezo drug.. binds GABA A increasing Cl- ion influx, hyperpolarizing cell…Can be used as an ati-spasmodic,
Dantrolene
Binds to Ca2+ receptor and intereferes with Ca2+ release from SR. HEPATOTOXICITY with chronic use. Useful in patients with malignant hyperthermia.
Botulinum Toxin
Prevents the secretion of the NT by inhibiting exocytosis. Flaccid! USED IN STRABISMUS< MUSCLES SUFFERING FROM REPETITIVE USE.
