Name the 2 neuromuscular blockers with intermediate duration of action
Name the 2 neuromuscular blockers with short duration of action
Duration of action (in min) of tubocurarine:
Duration of action (in min) of pancurorium:
Duration of action (in min) of pipercuronium:
Duration of action (in min) of cisatracurium:
Duration of action (in min) of vecuronium
Duration of action (in min) of atracurium:
Duration of action (in min) of mivacurium:
Duration of action (in min) of rocuronium:
Duration of action (in min) of succinylcholine
less than 8
Why is the duration of action of succinylcholine so much less than nondepolarizing blocking agents?
Rapid hydrolysis by butyrylcholinesterase and pseudocholinesterase (in liver and plasma respectively) AND most is diffused away from end plate (only small percentage reach NMJ)
Nondepolarizing drugs have rapid distribution phase and slow elimination phase
What is the prototypic drug for depolarizing blocking agents?
What is the prototypic drug for nondepolarizing blocking agents?
In which order are muscles paralyzed when given nondepolarizing blockers? In which order do they recover?
Paralysis: Facial, foot and hand mm --> abdomen, trunk, paraspinous --> diaphragm
Recovery: Diaphragm --> abdomen, trunk, paraspinous --> facial, foot, hand
Which nonpolarizing NM blocker produces hypotension as a result of systemic histamine release and ganglionic blockade?
What can be given before administering tubocurarine in order to attenuate hypotension?
Which nondepolarizing NM blocker causes moderate increase in heart rate and smaller increase in cardiac output with little or no change in systemic vascular resistance?
Increase in HR and CO associated with pancuronium is due to what?
Primarily caused by vagolytic action
Secondarily due to release of NE from adrenergic nn., as well as a blockade of neuronal uptake of NE
Which NM blocker causes caridac arrhythmias when administered with halothane anesthesia?
How does succinylcholine cause cardiac arrhythmias?
Stimualtes nicotinic receptors at sympathetic and PS ganglia and muscarinic receptors in the heart (SA node)
Cardiac arrhythmias associated with succinylcholine can be attenuated by administration of which type of drug?
Pts with burns, nerve damage or NM disease, closed head injury or other trauma can respond to succinylcholine by releasing ________ into the blood, which may result in ____________.
Myalgias are a common complain of heavily muscle pts who receive large doses of _________. The pain is thought to be secondary to the unsynchronized contractions of adjacent muscle fibers just before the onset of paralysis.
What are the 4 drug interactions you need to consider when prescribing muscle relaxants?
Local anesthetics and antiarrhythmic drugs
Other nondepolarizing NM blocking drugs
List the 3 side effects of administering anesthetics + muscle relaxants