Term
| Which receptor do the neruomuscular blocking agents work at? |
|
Definition
|
|
Term
| What are the two general classes of neuromuscular blocking agents? |
|
Definition
Nondepolarizing competative blockers
Depolarizing blockers |
|
|
Term
| What are the drugs that fall into the two classes of blocking agents? |
|
Definition
non-depolarizing: d-TC (d-tubocurarine)
depolarizing: succinylcholine |
|
|
Term
| Which of the classes is short lived? |
|
Definition
|
|
Term
| Why is succinylcholine short lived? |
|
Definition
| because it is metabolized by plasma cholinesterase |
|
|
Term
| Where is d-TC metabolized? |
|
Definition
|
|
Term
| What does d-TC cause the muscle to do? |
|
Definition
|
|
Term
| What does succinylcholine initial cause the muscle to do? |
|
Definition
|
|
Term
| Which muscles are effected first by the neuromuscular blocking agents? |
|
Definition
| the highly innervated muscles (eyes, fingers) first then the limbs, diaphram, intercostal muscles |
|
|
Term
| Which muscles come back to normal first after stopping the neuromuscular blocking agent? |
|
Definition
|
|
Term
| How are the neuromuscular agents administered and how long until they act? |
|
Definition
| administered IV and take effect within 1-3 minutes |
|
|
Term
| How long does d-TC and Succinylcholine last? |
|
Definition
d-TC about 30 mins
Sux less than 5 mins |
|
|
Term
| What are the uses for d-TC? (4) |
|
Definition
ET intubation
Electric shock therapy
vent
with anesthia |
|
|
Term
| What are the uses for Sux? (2) |
|
Definition
intubation
short procedures |
|
|
Term
| What are the adverse effects of d-TC? (2) |
|
Definition
prolonged weakness
histamine release |
|
|
Term
| What does the induced histamine release by d-TC cause? (3) |
|
Definition
hypotension
increased bronchial secretion
bronchoconstriction |
|
|
Term
| What are the adverse effects of Sux? (4) |
|
Definition
people with genetic polymorphism w/o full plasma cholinesterase activity will have longer apnea
watch for patients with malignant hypothermia
intense skeletal muscle contractions
hyperkalemia |
|
|
Term
| What type of patients is SUX contraindicated in? (2) |
|
Definition
those with malignant hypothermia
skeletal muscle problems |
|
|
Term
Why can Sux lead to hyperkalemia?
What will the hyperkalemia lead to? |
|
Definition
because of intense muscle contractions, potassium leaks out of cell
leads to heart arrhythmia |
|
|
Term
| What is the treatment for malignent hyperthermia induced by Sux? (3) |
|
Definition
stop the Sux
ice the patient
give Na-Dantrolene |
|
|
Term
| What are the signs of malignant hyperthermia? (2) |
|
Definition
muscle rigidity
increased temperature as much as 43 degrees |
|
|
Term
| How is malignant hyperthermia determined? |
|
Definition
|
|
Term
| What other condition studied in this module is associated with malignant hyperthermia? |
|
Definition
| central core disease (a congenital myopathy) |
|
|
Term
| What drug interaction with the d-TC will cause a decrease in the d-TC effect? |
|
Definition
|
|
Term
| How can d-TC be reversed? |
|
Definition
|
|
Term
| Why when Sux is administered with an anti-achE does the effect of Sux go up? |
|
Definition
the anti-achE effects both plasma cholinesterase and the achE in the neuro junction
the Sux is broken down by the plasma cholinesterase
therefore wiht less cholinesterase the Sux will not be inactivated and there will be more around |
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