Skeletal Muscle Relaxants

Question 1

non-depolarising neuromuscular blocker
(long-acting)
SE: respiratory paralysis, ganglion block, histamine release (moderate), recurarization
relatively CI in myocardial ischemia

Answer 1

tubocurarine

Question 2

what can reverse the effects of tubocurarine, atracurium, vecuronium, pancuronium, and mivacurium?

Answer 2

neostigmine

Question 3

short-acting non-depolarising neuromuscular blocker
SE: respiratory paralysis, histamine release
metabolised by pseudocholinsterase
short DOA (10-20 mins)

Answer 3

mivacurium

Question 4

intermediate non-depolarising neuromuscular blocker
SE: respiratory paralysis, apnea
undergoes HOFFMAN ELIMINATION

Answer 4

atracurium

cisatracurium

Question 5

intermediate-acting non-depolarising neuromuscular blocker
SE: respiratory paralysis
undergoes elimination in bile
muscle relaxation is potentiated by inhaled anesthetics, aminoglycosides, and quinidine

Answer 5

vecuronium

Question 6

long-acting non-depolarising neuromuscular blocker
moderate block on cardiac muscarinic receptors
for euthanasia, lethal injection, strychnine poisoning
SE: respiratory paralysis, apnea, tachycardia, hypertension, recurarization

Answer 6

pancuronium

Question 7

drugs that comprise lethal injection

Answer 7

5g thiopental
100 mg pancuronium
100 mEq potassium chloride

Question 8

phases of depolarisation blockade

Answer 8

phase I (depolarisation): transient fasciculations followed by flaccid paralysis
phase II (desensitisation)

Question 9

depolarising neuromuscular blocker
agonist at Ach-Na receptors
SE: post-op muscle pain, hyperkalemia, aspiration, malignant hyperthermia
metabolised by pseudocholinesterase (plasma)

Answer 9

succinylcholine

Question 10

interaction between succinylcholine and which inhaled anesthetic produces malignant hyperthermia of up to 41C sec to protein denaturation?

Answer 10

halothane

Question 11

treatment for malignant hyperthermia?

Answer 11

rapid cooling and administration of dantrolene

Question 12

early sign of malignant hyperthermia?

Answer 12

trismus

Question 13

intermediate-acting non-depolarising neuromuscular blocker
SE: respiratory paralysis, hypersensitivity
for intubation

Answer 13

rocuronium

Question 14

novel reversal agent for rocuronium?

forms complex to incativate

Answer 14

sugammadex

Question 15

centrally-acting spasmolytic
GABA-B agonist
for severe spasticity

Answer 15

baclofen

Question 16

centrally-acting spasmolytic
inhibition of muscle stretch reflex
for acute spasm sec to muscle injury
strong anti-muscarinic effects

Answer 16

cyclobenzaprine

chlorphenesin, methocarbamol, orphenadrine

Question 17

centrally-acting spasmolytic
GABA agonist
for chornic and acute spasm

Answer 17

diazepam

Question 18

centrally-acting spasmolytic

alpha2-adrenoreceptor agonist in spinal cord

Answer 18

tizanidine

Question 19

direct-acting muscle relaxant

for malignant hyperthermia

Answer 19

dantrolene