What is order of paralysing muscles as NMJ blockers take effect

What muscle is last

Fast and Large muscles first

Eye->Extremities->Trunk

Diaphram last

Mechanism of Succinyl choline

How are fasciculations prevented

What are the adverse effects?

How is it degraded?

Initial depolarizing block

Desensitization block(blocking ion channel)

Fasciculations: pretreat with non-depolarizing

Adverse

Hyperkalemia-Not to children bc undiagnosed cardiomyopathies

Ocular Pressure-Not to ocular injured patients

Malignant Hyperthermia

Degradation

Plasma cholinesterases(variants, or liver damage can prolong activity)

What are the long-acting NMJ blockers

Which exhibits Heart block?

How are they eliminated?

Which block autonomic ganglia?

Which increase Histamine release?

Doxacuronium

Pancuronium: Heart block

Pipecuronium

Metocurine: Hist release and Autonomic block

Tubocurarine: Hist release and Autonomic block

All are eliminated by the kidney

What are the Intermeadiate-acting NMJ Blockers?

Which have a fast onset?

Which is eliminated by the liver and kidney

Atracurium

Cistracurium

Rocuronium: Fast-onset

Vecuronium: Liver and kidney

What are the short-acting NMJ blockers

How are they degraded?

Mivacurium

Succinylcholine

Degradation: Plasma Esterases

Addition of Neostigmine

Also, Atropine to prevent the overshoot