Term
| Succinyl-choline (SUX) mode of action, effect |
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Definition
| prevents Na channel at neuromuscular junction from closing (attaches at both alpha subunits and opens channel but broken down slowly by ACh esterase); paralysis |
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Term
| Percent of succinyl-choline (SUX) metabolized by plasma ChE (BuChE)? metabolism of SUX vs. ACh by AChE at neuromuscular junction? |
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Definition
| 90-99% (only 1-10% reaches target); SUX: 2-7 min (time of action) vs. ACh: milliseconds |
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Term
| TOF? Use? Result with DMR (SUX)? Result with NDMR? |
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Definition
| Train of four impulses to ulnar nerve (causes thumb to adduct in plane perpendicular to palm); used to monitor extent of muscle relaxation; With SUX: amplitude of each response decreases equally; With NDMR: each subsequent response is less than previous response (fades) |
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Term
| Succynl-choline use, onset/half life, side effects |
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Definition
| muscle relaxant portion of anesthesia used for intubation; rapid onset (60 sec) and ultra short acting (3 min: too short for hypoxia to cause brain); fasciculations (muscle twitches) that lead to myalgia (muscle pain) esp. in young females, and increased pressure (intra -cranial, -gastric, -ocular), bradycardia and brochospasm (Cholergic effect/give glycopyrrolate), hyperkalema (squeezes cells; +0.5 mmol/L; higher with muscle disease and burns), masseter muscle spasm (warning sign of -> malignant hyperthermia also caused by halothane (treat with dantrolene and hyperventilate) |
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Term
| Atypical BuChE (plasma ChE) effect, SUX duration if no ChE? test? |
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Definition
| longer duration of SUX and other drugs degraded by esterases (remifentanil: mu opiod agonist; mivacurium: NDMR; cocaine: ester LA; esmolol: beta blocker); SUX 3 min -> 12 hr if no ChE; Dibucaine test (normal: 80% inhibition of ChE; atypical: 20% (homozygotes), 40-60% heterozygotes. |
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Term
| Clopidogrel mode of action? effect? use? metabolism? caveat? brand name? Other similar drug? |
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Definition
| metabolized by liver into active metabolites that bind to P2Y12 receptor of platelets and reduce aggregation; increased blood flow through narrowed vessels; standard of care for MI/CAD (a better asprin); 85% metabolized by plasma ChE, so atypical ChE will cause longer duration/excessive bleeding; brand name: Plavix; Prasugrel |
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