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Pharm-Chpt 28

Pharmacology

QuestionAnswer
2 categories of neuromuscular junction blockers nondepolarizing and depolarizing
Nondepolarizing neuromuscular junction blockers act as? where? act as antagonist to ACh at neuromuscular junction
Nondepolarizing neuromuscular junction blockers prevent? prevent depolarization of muscle cells
Depolarizing neuromuscular junction blockers act as? act as ACh agonist
Depolarizing neuromuscular junction blockers stimulate? stimulate muscle cell
Depolarizing neuromuscular junction blockers prevent? prevent cell from repolarizing
Neuromuscular junction blockers cause? then have to? cause paralysis-- so perform surgery and facilitate mechanical ventilation
Nondepolarizing NMJB similar in structure to? similar in structure to ACh
Nondepolarizing NMJB occupy? occupy muscular cholinergic receptor site
Nondepolarizing NMJB-- ACh cannot react with receptor at cholinergic receptor site.T/F True
Nondepolarizing NMJB- no what? (2) no activation of muscle cells and no contraction
Not broken down by cholinesterase. Nondepolarizing NMJB
Longer lasting than ACh Nondepolarizing NMJB
Prototype for Nondepolarizing NMJ Blockers Pancuronium(Pavulon)
Pavulon indication as an adjunct to gen. asthetics to induce skeletal muscle relaxation; to reduce the intensity of muscle contractions in electroconvulsive therapy, to facilitate teh care of patients undergoing mechanical ventilation
Adverse reactions of Pavulon respiratory depression, apnea, broncospasm, cardiac arrhythmias
Neuromuscular junction blocking agents are structurally similar to? structurally similar to ACh
Neuromuscular junction blocking agents compete with? compete with ACh for muscle ACh receptor sites
Is hydrophilic. Neuromuscular junction blocking agents
Hydrophilic means? does not cross blood brain barrier
Neuromuscular junction blocking agents are adjunct to? adjunct to general ansthesia
Neuromuscular junction blocking agents facilitate? facilitate intubation and electroconvulsive therapy
Neuromuscular junction blockers prevent? prevent resistance to ventilator
Caution for neuromuscular junction blocking agents malignant hyperthermia(patient/family), genetic or disease related low cholinesterase(cirrhosis and malnutrition)
Adverse reactions of neuromuscular junction blocking agents respiratory depression, bronchospasm, GI slowdown, fear related to helplessness, inability to communicate
Prototype for depolarizing NMJ Blocker Succinylcholine(Anectine, Quelicin)
Indication of Succinylcholine as an adjunct to gen. anesthesia, to facillitate endotracheal intubation, to induce skeletal muscle relaxation during surgery or mechanical ventilation
Adverse effects of Succinylcholine muscle pain, relatd to contraction of the muscles as a first reaction, respiratory depression,apnea
Nursing implication for Neuromuscular junction blocking agents(part 1) -assess for HX of malignant hyperthermia(dantolene available, cooling measures) -have cholinesterase inhibitor available(reduce excessive neuromuscular blockade caused by nondepolarizing neuromusuclar junction blockers
Nursing implication for neuromuscular junction blocking agents(part 2) monitor closely, provide comfort measures
Created by: mhruska
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