ch. 43: antinicotinic drugs
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| MOA of antinicotinic drugs? | block cholinergic (i.e. Ach) transmission between motor nerve endings and ndicotinic receptors on neuromuscular junctions of skeletal muscle. they are strucutral analogs of Ach and act as either antagonists (nondepolarizing type) or agonists (depolarizing
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| general effects of antinicotinic drugs? | produce complete muscle relaxation (paralysis),
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| primary use for antinicotinic drugs?? | surgery
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| non depolarizing (competitive) blocker. thereffore, it prevents Ach binding. it affects the small, rapid muscles first, then the larger ones, then the limbs, neck, trunk, then intercostal muscles, then diaphragm last. | tobocurarine
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| antidoetes of tobocurarine? | cholinesterase inhibitors such as neostigmine or edophonium, dpeneding on the degree of overdose and/or symptamology
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| also a non depolarizing antinicotinic drug. causes less histamine release than tobocurarine, so it has a more favorable side effect profile. | pancuronium
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| major ADR of pancuronium? | vagolysis (with resultant dangers tachycardia(
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| depolarizing nicotinic blocker. acts like Ach binding at the Ach receptors. however, it persits at the receptor. therefore, it initially causes fasciculations due to muscle stimulation, then, with its persistnce at the receptor, flaccid paralysis occurs. | succinylcholine
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| primary use of succinylcholine? | rapid endotracheal intubation, electroconvulsive shock therapy, surgery. can cause many side effect,s including significant apnea, and in genetically susceptible patients, ther is a risk for malignant hyperthermia,
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| succinylchoine can cause malignant hyperthermia especially if used with what? | the anesthetic halothane.
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| what happens in malignant hyperthermia? | calciu mis released voluminously from the sarcoplasmic reticulum of muscle cells. this causes muscles to become rigid. the rigidity results in hyperpyrexia because muscles generate heat. it is a life threatening disorder.
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| treatment for malignant hyperthermia? | dantrole
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| MOA of dantorlene? | blocks caklcium release form the sarcoplasmic reticulum
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| one must use cuation when using antinicotinic drugs with what other clas? | drugs that enhance neuromuscular block (halothane, aminoglycosides, CCB. halothane is a strong enhances of all neuromuscular blockade agents. aminoglycosides inhibit Ach release.
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