Skeletal Muscle Relaxants Flashcards
Only depolarizing skeletal muscle relaxant in use
Succinylcholine
side effects of Succinylcholine
Malignant Hyperthermia
Sustained Paralysis
Hyperkalemia
Cardiac Abnormalities
Increased IOP and gastric pressure
Abdominal Fasciculations
Increased Risk of Aspiration
Succinylcholine Antidote
Dantrolene
Explain the mechanism of action for Succinylcholine
- Drug binds to Nicotinic Receptors in skeletal muscle, causing persistent depolarization at the motor end plate
- Persistent depolarization creates a depolarized block, yielding unresponsiveness to subsequent nerve impulses
- Unresponsiveness yields flaccid paralysis
Explain the difference in depolarizing vs nondepolarizing NMJ Blockade
- Depolarizing blockade has 2 phases. The first has a diminished but constant train of 4, while the second has a diminishing fade of 4
- Non-depolarizing blockade just fades
What causes prolonged paralysis in succinylcholine administrations
Atypical cholinesterases
Explain the mechanism of action for Non-depolarizing skeletal muscle relaxants
- They act as competetive agonists of ACh at nicotinic receptors in skeletal muscle
- Stimulate the release of Mast Cells
- Blocks Autonomic galgia
Most common side effects of Non-depolarizing NMJ blockers
Bronchospasm
Hypotension
Tachycardia
Non-depolarizing drug antidote
Neostigmine
short action non-depolarizing drug
Mivacurium
what is enzymatic hemolysis
enzyme breakdown via water
- Mivacurium
- Atracurium
- Cistatracurium
Intermediate-acting non-depolarizing drugs
Rocuronium
Atracirium
Cistatracurium
Vecruronium
Benefits of Rocuronium
does not cause histamine release
alternative to succinylcholine
What drug antagonizes rocuronium and vecuronium
Suggamadex
Which non-depolarizing drugs are ideal for patients with hepatic insufficiency
Atracurium
Cistatracurium
