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NU 624

Exam 2 - Neuromuscular Blocking Drugs

Succinylcholine is a [depolarizing/nondepolarizing] neuromuscular blocker. Depolarizing
Name 4 different intermediate acting nondepolarizing NMBDs. Vecuronium, atracurium, rocuronium, mivacurium
Name 6 different long-acting nondepolarizing NMBDs. d-tubocurarine, doxacurium, pancuronium, pipercuronium, metocurine, gallium
NMBDs have a similar structure to what neurotransmitter? acetylcholine
Succinylcholine is consisted of two molecules of ____________________ that are linked together by _____________________ groups. acetylcholine, acetate methyl
What chemical group helps to link 2 acetylcholine molecules together to form succinylcholine? acetate methyl
Describe the structure of succinylcholine and what does this shape allow it to do? Long, slender, flexible -- allows it to bind to and activate cholinergic receptors on skeletal muscle
Where are cholinergic receptors found? Skeletal muscle
What do nondepolarizing agents structurally look like? Bulky and rigid
True/False: Nondepolarizing NMBDs do not have any molecular similarity to acetylcholine. False - they do contain portions that are similar to acetylcholine
What type of chemical group do NMBDs contain? Is it positively or negatively charged? Quaternary ammonium. Positive charge.
How many quaternary ammonium groups do NMBDs generally have in their structure? One or more
How is a quaternary ammonium formed? Attachment of 4 carbon atoms to a nitrogen atom
Pancuronium has a quaternary ammonium group and is classified as a/an _____________. Aminosteroid
Pancuronium is an aminosteroid [with/without] hormonal activity. without
NMBDs (are/are not) able to cross lipid membranes. Are not
Why are NMBDs not able to cross lipid membranes? Contain quaternary amines, which do not cross biologic membranes
What part of NMBDs resembles acetylcholine? The positive charge on the quaternary ammonium mimics the quaternary nitrogen of acetylcholine
What is the charge of the cholinergic receptor on a skeletal muscle cell? Negative
What is the reason for the attraction of NMBDs to cholinergic receptors of skeletal muscle? The positive charge on the quaternary ammonium of the NMBDs is attracted to the negatively charged cholinergic receptor of skeletal muscle.
Why are NMBDs able to affect muscle cells of other types of muscles besides skeletal muscles? Lack of specificity
Where else in the body are the charged quaternary ammonium of NMBDs able to attach themselves? cardiac and nervous systems
How is the specificity of a NMBD for an autonomic versus neuromuscular junction determined? By the length of the carbon chain that separates the positively charged ammonium groups
How many positively charged ammonium groups does vecuronium have? Pancuronium? Vec=1, Panc=2
How many positively charged ammonium groups do most NMBDs have? 2
The presence of 2 ammonium groups is called ______________. Bisquaternary
Name 2 mono-quaternary NMBDs. Vecuronium, d-tubocurarine
Name 4 bisquaternary NMBDs. Atracurium, cisatracurium, succinylcholine, doxacurium
Name 1 triquaternary NMBD. Gallamine
How many distinct forms do NMBDs have? What is one distinct form? 2, steroidal.
How is the steroidal structure of NMBDs composed? 3 six-sided rings (benzene) and 1 five-membered ring
Name the 4 steroidal NMBDs. Pancuronium, vecuronium, rocuronium, pipercuronium
Why does succinylcholine have a short duration of action? It is quickly broken down by hydrolysis via plasma cholinesterase
What two products are formed from the breakdown of succinylcholine by plasma cholinesterase? Succinylmonocholine, choline
The byproducts of succinylcholine metabolism is further broken down into what two products? Succinic acid and choline
The metabolites of succinylcholine are (active/inactive). Inactive
How is mivacurium metabolized and eliminated? Metabolized by plasma cholinesterase, eliminated in the bile and urine
How is rocuronium eliminated? Deacetylation via the liver
How does atracurium get eliminated? Hoffman elimination in the plasma and tissues
What two variables does Hoffman elimination depend on? pH and temperature
Which NMBD undergoes elimination by a three compartment model? Vecuronium
How does pancuronium undergo elimination? Triphasic elimination via the kidneys through glomerular filtration.
Created by: philip.truong