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Pharm-1-Muscle-Relaxers

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hpaul2's version from 2017-04-03 15:38

Section

General & CNS Effects
Question Answer
What are the 4 pillars of anesthesia & what do they meanMental (unconscious), motoric (unable to move), sensible (unaware), autonomic stability
What are the 5 ways to induce muscle relaxationgeneral or local anesthetics, Nm blockers, centrally acting Rx, Rx with muscle relaxant properties
What are the 2 therapeutic targets for muscular relaxation in the CNSGABA receptors, α2 receptors
Which muscle relaxant targets the CNSguaifenesin
What drugs influence muscle relaxant effectsneuromuscular agents, cholinesterase inhibitors, amino glycoside antibiotics
In which species are NM blockers used and in which species is guaifenesin usedNM blocker- dogs/horses, guaifenesin - horses, cattle, pigs
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Guaifenesin
Question Answer
When/how/why is guaifenesin usedinduction/maintenance of anesthesia in horses used in ‘triple drip’ with ketamine & α2 agonist
Where does guaifenesin actinternuncial neurons (spinal cord, brainstem, subcortical areas)
What are the effects of guaifenesin on the CNSdepresses impulse neurotransmission, sedation, muscle relaxation
What are the effects of guaifenesin on the cardiovascular systeminitial BP ↓, normal HR & contractile force
What are the effects of guaifenesin on the respiratory system↑ RR
What are the effects of guaifenesin on the musculoskeletal systemsk mm relaxation, relax laryngeal/pharyngeal muscles, recumbency
What might be seen with high doses of guaifenesinrespiratory depression, paradoxical muscle rigidity, hemolysis in cows
Describe the gender difference in guaifenesinlonger 1/2 life in males (85 vs 60 min.)
What drug should never be used with guaifenesinphysostigmine
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PNS Effects
Question Answer
What is the therapeutic target for muscular relaxation in the PNSthe neuromuscular junction
What is the target of neuromuscular-blocking drugsinterference w/ Ach
Where can Ach receptors be affectedpresynaptically & postsynaptically
How can Ach be affected presynapticallyinhibit synthesis or inhibit release
How can Ach be affected postsynaptciallyinteract with postsynaptic actions of Ach (non-depolarizing blockers & depolarizing blockers)
What does a non-depolarizing blocker doPre- & postsynaptic Ach nicotinic receptor competative antagonists
What does a depolarizing blocker dopostsynapctic Ach nicotinic receptor agonists
Which species are sensitive to neuromuscular blockerssheep
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Non-depolarizing Blocking Agents
Question Answer
What are the 2 non-depolarizing blockers found in naturecurare (plant) & α-bungarotoxin (snake)
What are the synthetic curaresgallamine, pancuronium, vecuronium, atracurarium (VAPan' plant water + galileo because curare is a really old drug)
What is the mode of action of non-depolarizing blockerscompetitive antagonist of Ach nicotinic receptor (stabilizes receptors so not easily affected)
What are the two types of non-depolarizing blockersbenzyl-iso-quinolium derivatives & amino-steroids
How do benzyl-iso-quinolium derivatives workhistamine release
How do amino-steroids workvagolytic properties
What are the 4 benzyl-iso-quinolium derivativestubocurarine, atracurium, doxacurium, mivacurium
What are the 4 amino-steroidspancuronium, pipecuronium, rocuronium, vecuronium
Which non-depolarizing blockers are long actingtubocurarine, doxacurium, pancuronium, pipecuronium (turbo, oxys, panic, pipe-bomb)
Which non-depolarizing blockers are short actingmivacurium (mini-van)
Which non-depolarizing blockers are intermediate actingatracurium, rocuronium, vecuronium
What are the side-effects of tubocurarinehypotension, bronchoconstriction
What are the side-effects of atracurium, doxacurium, & mivacuriumtransient hypotension
What are the side-effects of pancuronium & pipecuroniumtachycardia, no hypotension
What are the side-effects of rocuroniumprolonged paralysis
What are the side-effects of vecuroniumfew side-effects
What drugs can counteract non-depolarizing blockersanicholinesterase drugs
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Depolarizing Blocking Agents
Question Answer
How do depolarizing blockers worksimulate postsynaptic membrane (initial fasciculations) → stays permeable to Na/K → no way for Ach to cause depolarization
What are the 2 depolarizing blockersdecamethonium, suxamethonium
Which depolarizing blocker is long acting and which is short actingdecamethonium - long, suxamethonium short
What are the side effects of suxamethoniumbradycardia, ↑ intra-ocular pressure, prolonged paralysis, malignant hyperthermia
What are some contra-indications for suxamethoniumpatients with muscle denervation, neonates, liver disease
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