Test 2- NMD Flashcards
NMD
interrupt transmission of nerve impulses at the neuromuscular junction; this results in complete paralysis of striated muscles while consciousness is retained
Do NMD provide analgesia?
NO!
When would you use NMB
open eye sx;
What are the contraindications to using NMB?
conscious experience of complete muscle paralysis is EXTREMELY DISTRESSING even without pain?
Min requirement for NMB
use mechanical ventilation, monitor,
can you use NMB as the sole agent for a procedure?
NO NEVER!
depolarizing NMB act as
act as an against
Non-depolarizing NMB
act as competitive anatgonist
Order of muscle relaxation
ocular muscles are the most sensitive, diaphragm is the most resistant
What drugs potentiate the NMB effect?
inhalation anesthetics
Factors that influence the depth of the NMB effect?
hypothermia, electrolyte abnormalities, age,
Are NMB water or lipid soluble?
water- thus they don’t cross lipid barriers, i.e. BBB
What is a SE of NMB
Histamine release; more likely to be caused by Atrium- causes bronchoconstriction, CV- vasodilation, negative iontropy, tachycardia- treat with epinephrine
Example of Depolarizing NMBD
succinylcholine
Examples of non-depolarizing
atracurium, cisatracurium, rocuronuium, vecuronium
Succinylcholine
used in clinics; fast onset and short duration Phase 1 block=prevents neuromuscular transmission; Phase 2= non-polarizing block; not preferred for vet med
Do we prefer non-polarizing or polarizing NMB in vet med?
Non-polarizing because they have less adverse effects
Atracurium
Laudanosine is the major metabolite and it decreases the seizure threshold; can cause histamine release at high doses
Cisatracurium
Laudanosine production is less and doesn’t cause histamine release
Rocuronium
excellent NMB;
Sugammadex
antagonist for rocuronium; chelating agent
stimulation patterns used to test NMB
- single twitch, and train of four