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Pharmacology
Depolarizing Muscle Relaxants
6
Medical
Graduate
03/10/2010

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Cards

Term
succinylcholine
Definition
  • only DMR
  • stops Na channel from closing at NMJ
  • rigidity?
  • metabolized by plasma ChE to succinylmonocholine, only 1-10% of SUX will reach target
  • 2-4 minutes, ultra short, rapid onset
  • never give MR without ventilation, sedative/hypnotic, and analgesic!
  • TOF, no fading with DMR
Term
Adverse Effects
Definition

fasciculations

myalgia (most common complaint)

increased pressure

bradycardia (use atropine)

bronchospasm

hyperkalemia

masseter muscle spasm -->

malignant hyperthermia

esp in children

 

to be removed from market

Term
malignant hyperthermia
Definition

higher metabolic rate

cooked from the inside

opens ryanodine receptor

try to cool down patient -- close ryanodie receptor with dantrolene

triggered by: sux, halothane, most anesthetics

Term
Atypical ChE
Definition
duration: sux, remi, miva, cocaine
Term
dibucaine test
Definition
dibucaine inhibits plasma ChE to about 80%
Term
monitoring
Definition
  1. ECG, bp, o2 sat on all patients
  2. IV line
  3. oxygen mask to replace nitrogen in lung with oxygen to preempt hypoxia
  4. put patient to sleep (propofol)
  5. analgesic (fentanil)
  6. bag ventilate
  7. MR (sux)
  8. ET tube
  9. check tube position (CO2 meter or esophageal detector device)
  10. NDMR
  11. after procedure, reverse NDMR if necessary (stigmine + atropine)
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