Test 2- NMD

Question 1

NMD

Answer 1

interrupt transmission of nerve impulses at the neuromuscular junction; this results in complete paralysis of striated muscles while consciousness is retained

Question 2

Do NMD provide analgesia?

Answer 2

NO!

Question 3

When would you use NMB

Answer 3

open eye sx;

Question 4

What are the contraindications to using NMB?

Answer 4

conscious experience of complete muscle paralysis is EXTREMELY DISTRESSING even without pain?

Question 5

Min requirement for NMB

Answer 5

use mechanical ventilation, monitor,

Question 6

can you use NMB as the sole agent for a procedure?

Answer 6

NO NEVER!

Question 7

depolarizing NMB act as

Answer 7

act as an against

Question 8

Non-depolarizing NMB

Answer 8

act as competitive anatgonist

Question 9

Order of muscle relaxation

Answer 9

ocular muscles are the most sensitive, diaphragm is the most resistant

Question 10

What drugs potentiate the NMB effect?

Answer 10

inhalation anesthetics

Question 11

Factors that influence the depth of the NMB effect?

Answer 11

hypothermia, electrolyte abnormalities, age,

Question 12

Are NMB water or lipid soluble?

Answer 12

water- thus they don’t cross lipid barriers, i.e. BBB

Question 13

What is a SE of NMB

Answer 13

Histamine release; more likely to be caused by Atrium- causes bronchoconstriction, CV- vasodilation, negative iontropy, tachycardia- treat with epinephrine

Question 14

Example of Depolarizing NMBD

Answer 14

succinylcholine

Question 15

Examples of non-depolarizing

Answer 15

atracurium, cisatracurium, rocuronuium, vecuronium

Question 16

Succinylcholine

Answer 16

used in clinics; fast onset and short duration Phase 1 block=prevents neuromuscular transmission; Phase 2= non-polarizing block; not preferred for vet med

Question 17

Do we prefer non-polarizing or polarizing NMB in vet med?

Answer 17

Non-polarizing because they have less adverse effects

Question 18

Atracurium

Answer 18

Laudanosine is the major metabolite and it decreases the seizure threshold; can cause histamine release at high doses

Question 19

Cisatracurium

Answer 19

Laudanosine production is less and doesn’t cause histamine release

Question 20

Rocuronium

Answer 20

excellent NMB;

Question 21

Sugammadex

Answer 21

antagonist for rocuronium; chelating agent

Question 22

stimulation patterns used to test NMB

Answer 22

• single twitch, and train of four