Term
Neuromuscular Blocking Agents (NMBAs)
Overview of Muscle Contraction |
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Definition
-Ach released from synaptic cleft
-binds to receptor on motor eend plate
-depolarization of muscle fibers
-Acetylcholinesterase limits binding |
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Term
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Definition
-Depolarizing
-Non-depolarizing |
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Term
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Definition
PHARMACOLOGY: Depolarizing
--binds to Ach Receptor
--Causes persistent depolarization of neuromuscular end plate
--Muscle weakness
--Meabolism terminates activity |
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Term
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Definition
PHARMOKINETICS
ONSET: 1-1.5 minutes
DURATION: 5-10 minutes
METABOLISM: plasma pseudocholinesterases
DOSE: 1-1.5 mg/kg
USE: Intubation |
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Term
Succinylcholine
ADVERSE EFFECTS |
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Definition
-Hyperkalemia-0.501.0 meq/l
-muscle fasiculations
-Increased intracranial pressure
-Increased intraoccular pressure
-bradycardia or tachycardia
-malignant hyperthermia |
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Term
Succinylcholine
ODRER OF PARALYSIS |
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Definition
-Eyes, face, neck
-Extremeties
-Abdomen
-intercostals, glottis
-Diaphragm |
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Term
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Definition
Pharmacology
-compete with Ach for postsynaptic receptors on the motor end plate |
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Term
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Definition
-AGENTS
-Vecuronium (norcuron)
-Pancuronium (pavulon)
-Atracurium (tracrium) |
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Term
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Definition
Facilitate intubation
-Synchronize mechanical ventilation
-Prevent extubation
-Decrease ICP
-Reduce metabolic Demands |
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Term
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Definition
Pharmokinetics
ONSET 3-5 minutes
DURATION: 60-90 minutes
Elimination: liver, kidney |
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Term
Pancuronium (Pavulon)
DOSING |
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Definition
Loading Dose: 0.06 mg/kg
Infusion rate: 0.06-0.1 mg/kg/hr
ADVERSE EFFECTS
Tachycardia
HTN |
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Term
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Definition
PHARMOKINETICS
ONSET: 3-5minutes DURATION: 20-30min
ELIMINATION: 75% liver 25%kidney
DOSING:
Loading Dose: 0.08-1.0mg/kg
-in conjunction w/succinylcholine: .05-.06mg/kg
-Infusion Rate: 1mcg/kg/min 20min post intubation dose |
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Term
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Definition
PHARMOINETICS
ONSET: 3-5 minutes
DURATION: 20-35 minutes
ELIMINATION: enzymatic degradation |
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Term
Atricurium (Tracrium)
DOSING |
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Definition
Loading Dose: 0.3-0.5 mg/kg
INFUSION RATE: 0.4-1.0 mg/kg/hr
ADVERSE EFECTS:
Active metabolite-laudosine
-dependent on renal elimination
-Histamine release |
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Term
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Definition
-Renal Failure
-Drug Interactions
-Steroid configuration
-Elderly
-Duration of infusion |
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Term
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Definition
POTENTIATES BLOCKADE: Aminoglycerides, Anesthetics, Magnesium, Lithium, Verapamil
INHIBITS Blockade: Carbamazepine, Phenytoin, Theophylline, Corticosteroids, Rantidine |
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Term
| NMBAs: Patient Care Issues |
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Definition
-Pain Anxiety
-Immobility
--DVT
--Decubitus formation
-Corneal Abrasions |
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