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ganglion blockers

clinical neuro 3

hypertensive emergencies trimethaphan
dissecting aortic aneurysm trimethaphan
adjunct to nicotine patch mecamylamine
CNS adverse effects tremor, chorea, mental disturbances
CNS effects esp common with mecamylamine
Eye adverse effects cycloplegia, blurred vision
CV adverse effects dec BV tone, severe orthostatic hypotension, tachycardia
GI adverse effects dec motility, constipation
GU adverse effects (in men) urinary retention, ED, impaired ejaculation
effects on sweating decreased
depolarizer succinylcholine
short-acting non-depolarizer nivacurium
long-acting non-depolarizer pancuronium, doxacurium
intermediate-acting non-depolarizer atracurium, cisatracurium, rocuronium, vecuronium
effect of advanced age on non-depolarizers prolongs duration of action by decreasing clearance
cisatracurium non-depolarizer, isoquinoline family
MOA of non-depolarizers in small doses compete w/Ach at nicotinic receptor
MOA of non-depolarizers in large doses enter pore of channel and dec sensitivity to neostigmine/edrophonium
GI absorption of non-depolarizers poor
non-depolarizers & BBB can't cross
increased response to non-depolarizers when also taking inhaled anesthetics, aminoglycoside antibiotics, tetracyclines, Ca++ channel blockers
atracurium metabolism hydrolyzed by plasma esterase
cisatracurium isomer of atracurium; undergoes hoffman degradation
DOC for pts w/impaired renal/hepatic functions cisatracurium
releases histamine at high doses atracurium
minimal CV/resp effects intermediate-acting non-depolarizers
MOA of sugammadex reverses actions of steroid blockers by forming water-soluble complexes with drug and removing it from NMJ
initial fasciulations with subsequent paralysis depolarizers
no antidote, irreversible effect depolarizers
could produce apnea depolarizers
contraindications of succinylcholine unhealed skeletal m injury (ie - severe burn/trauma)
less commonly used in peds due to hyperkalemia risk succinylcholine
may cause post-op myalgia succinylcholine
risk of malignant hyperthermia succinylcholine
can be reversed by anticholinesterase agents non-depolarizers
increase tetanic fade non-depolarizers
Created by: drhermy