Term
| What is the major, stereotypical neuromuscular blocking agent (NMBA)? |
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Definition
-Tubocurarnine
-It is long acting |
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Term
| What is a short acting NMBA? |
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Definition
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Term
| What kind of receptor is at the neuromuscular junction? |
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Definition
| -Nicotinic II receptor (type I is for the first neuron junction for sensory, autonomics, and everything but NMJs in general) |
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Term
| What two types of NMBA are there? |
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Definition
-Nondepolarizing and depolarizing
-The nondepolarizing antagonize the NAch receptor
-Depolarizing blockers just keep the end plate depolarized |
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Term
| What are some nondepolarizing agents (6)? |
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Definition
1. **Tubocurarine
2. Metocurine
3. Atracurium
4. Gallamine
5. Pancuronium
6. Vecuronium
-Tubocurarine is also a ganglionic blocker (of Nic I)
-Blocks sympathetic nervous system |
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Term
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Definition
1. **Succinylcholine
2. Decamethonium
-Neither have much ganglion blocking effect (Nic I)
-Can result in hyperkalemia |
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Term
| What blocks both muscular and ganglion nicotinic receptor? What is it's action? What are it's side effects? |
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Definition
-TUBOCURARINE TUBOCURARINE TUBOCURARINE!!!!
-It *competitively inhibits at **nicotinic receptors
-Can cause *hypotension, bronchospasm, edema, and histamine release |
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Term
| What are the effects of the SNS? What if they are inhibited? |
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Definition
-Constricts blood vessels; hypotension
-Speeds heart; bradycardia
-Dilates pupil; miosis (constricted)
-Activates sweat glands; anhydrous
-Decreases peristalsis; diarrhea
-These are all symptoms you could expect when inadvertently blocking off sympathetic outflow (at the ganglia) |
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Term
| What is the action of succinylcholine? What do we use it for? Toxicity? |
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Definition
-It is an **agonist at nicotinic receptors; stimulates at first, but then you get prolonged *flaccid paralysis
-Use it for the initial placement of a tracheal tube
-Only last about five mins
-Can cause arrhythmias, hyperkalemia, and *malignant hyperthermia (in genetically susceptible) |
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Term
| What if tubocurarine and succinylcholine are used together? |
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Definition
| -They have an antagonistic effect |
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Term
| Give three antispasmodic drugs and actions? |
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Definition
1. Baclofen; GABAb agonist (inhibitory)
2. Diazepam; Enhances CNS GABA action
3. Botox; Prevents ACh release |
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Term
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Definition
1. Pyridostigmine
2. Neostigmine
-Both inhibit AChEsterase
-Overdose may cause *cholinergic crisis (too much causes a depolarizing block) |
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