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Flashcards in Muscle Relaxers PCOL Sharpe Deck (55)
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1

The drug Sugammadex will inactivate Non-depolarizing neuromuscular blockers by binding to them and forming an inactive complex. Which of these drugs listed will be inactivated if taken with sugammadex. (Select All)(Hint it only affects Steroid-derivative Non-depolarizing neuromuscular blockers)

A. Rocuronium

B. Atricurium

C. Pancuronium

D. Vecuronium

E. Tubocurarine

A, C, D

2

Diazepam, Tizanidine and Baclofen act ____ and Dantrolene acts ____ at the muscle,

A. Centrally, Peripherally

B. Peripherally, Centrally

A

3

T/F The common side effects of spasmolytics include sedation and muscle weakness

T

4

T/F Medications that are meant to activate the Neuromuscular nicotnic receptors are generally able to pass the BBB

F

Medications that are meant to activate the neuromuscular recetpors are only needed in the periphery so they do not need to be able to pass the BBB. If they were designed to do that as well they would also cause more side effects

5

What is the mechanism of action of Succinylcholine?

A. Hyperpolarizes the motor end plate via nAChR, similar to ACh

B. Depolarizes the motor end plate via nAChR, similar to ACh

C. Antagonizes the motor end plate by blocking the nAChR

D. Inhibits AChE and elevates levels of ACh, causing continued depolarization and leading to paralysis 

B

6

Which of these Non-Depolarizing Neuromuscular blockers is a steroid derivative? (Select All)

A. Pancuronium 

B. Atracurium

C. Cisatricurium

D. Rocuronium

E. Vecuronium

A, D, E

Remember: the agents that end in Curonium are steroid derivatives

7

When treating with paralytics where can these drugs be therapeutically active? 

A. nAChR

B. ACh degredation (AChE- acetylcholinesterase)

C. Motor neuron

D. All of the above

A

8

Succinylcholine acts as an _____ at the nAChR on the motor-end plate and is an example of a ______ neuromuscular blocker.

A. Antagonist, Depolarizing

B. Agonist, Non-Depolarizing

C. Antagonist, Non-Depolarizing 

D. Agonist, Depolarizing

D

9

Look up Treatment of acute spasmolytic conditions to see the centrally acting agents such as carisprodol, chlorzoxazone, cyclobenazaprine, Metaxolone, methovarbamol, orphenadrine.

10

What are the side effects of diazepam?

A. Hypotension

B. Dizziness/drowsiness

C. Abuse

D. Rebound/withdrawal

E. All of the above

E

11

When muscarinic receptors are activated by acetylcholine all of the following effects can be seen EXCEPT:

A. Bradycardia and Vasodilation

B. Salivation and Emesis (Vomiting)

C. Lacrimation (tears) and Urination

D. Diaphoresis (sweating)

E. Tachycardia (elevated heart rate)

 

 

E

12

Which of thes spasmolytic medications are considered GABA agonists? (Select All)

A. Diazepam

B. Tizanidine

C. Dantrolene

D. Baclofen

A,D

13

T/F Dantrolene is the ONLY spasmolytic that acts peripherally at  the muscle and the other spasmolytics act centrally

T

14

What class of drugs can be given to reverse Neuromuscular blockade?

A. Alpha Agonists

B. Cholinesterase inhibitors 

C. Beta Agonists

D. Non-depolarizing neuromuscular blockers

B

Giving a cholinesterase inhibitor will cause less ACh to be broken down and thus cause an increase chance of stimulating the receptor and causing muscle contractions.

15

T/F Paralytic agents should be used as an Adjuvant to anesthesia and should never be used alone.

T

This is because the agents onlly paralyze they do not numb.

16

What is the mecahnism of action of Diazepam?

A Binds to AChE at the neuromuscular junction and inhibits its activity

B. Allosterically binds to the GABA-A receptor in order to increase GABA activity at GABA-A receptors and lets chloride into the cell, causing it to hyperpolarize.

C. Binds to GABA-B receptors and decrease the motor neuron activity in order to reduce muscualr simulation

D. Binds to Ryanodine in the muscle and prevent it from contracting. 

B

By causing the cell to hyperpolarize it will decrease the ability for the muscle to contract. 

17

All of the following drugs are Non-Depolarizing neuromuscular blockers EXCEPT:

A. Tubocurarine

B. Atracurium

C. Pancuronium

D. Rocuronium

E. Succinylcholine

E

Remember all the Non-depolarizing agents end in either curarine, curium or curonium

18

Which of the following are uses for Paralytic agents? (Select All)

A. Relaxation of muscles for Surgery

B. Acute muscle spasms due to strain/trauma

C. Placement of endotracheal tube

D. Chronic CNS conditions with abnormally high activity in skeletal muscle reflex arcs (Cerebral Palsy, Multiple sclerosis)

E. Better control of artificial ventiliation 

A, C, E

19

An action potential arrives at the motor nerve terminal and causes the influx of ____ which causes the release of the neurotransmitter ____ from the secretory vesicles.

A. Chloride, ACh

B. Calcium, ACh

C. Calcium, NE

D. Chloride, NE

B

20

In reference to Paralytic medications, most are specific to nAChR at the _____ and have very little effect at nAChR at the ____

A. Neuron, Neuromuscular Junction

B. Neuromuscular Junction, Neuron

 

B

21

What are the side effects of Baclofen?

A. Hypotension

B. Dizziness

C. Drowsiness

D. All of the above

D.

Same side effects as diazepam except for the abuse and rebound/withdrawal 

22

Which of these drugs is a Cholinesterase inhibitor? (Select All)

A. Pancuronium

B. Neostigmine 

C. Edrophonium

D. Rocuronium

E. Atracurium

B,C

 

23

When ACh binds to the nAChR on the motor end plate what happens next?

A. Na+ ion influx that causes hyperpolarization

B. Ca+ ion influx that causes depolarization

C. Na+ ion influx that causes depolarization

D. Ca+ ion influx that causes hyperpolarization

C

24

Diazepam is a ____ agonist and Baclofen is a ____ agonist.

A. GABA-A, GABA-B

B. GABA-B, GABA-A

A

25

Cisatracurium is the ___isomer of atracurium and produces ____ Laudanosine (harmful metabolite) and Histamine than Atracurium.

A. Trans, More

B. Trans, Less

C. Cis, More

D. Cis, Less

D

26

What are the adverse effects of Succinylcholine? 

A. Myalgia (Rhabdomyolysis)

B. Increased intragastric pressure

C. Malignant Hyperthermia

D. Hyperkalemia and Histamine release

E. All of the above

E

27

What is the mechanism of action of Tizanidine?

A. Activates Alpha-2 receptors on the motor neuron and decreases glutamate neurotransmitter release

B. Blocks AChE and increases ACh availability

C. Causes hyperpolarization of the muscle cells

D. Inhibits activation of the motor neuron

A

28

Which of the following indications are spasmolytic medications used for? (Select All)

A. Spinal injury

B. Cerebral Palsy

C. Multiple sclerosis and stroke

D. Surgery preparation

E. Placement of endotracheal tube

F. Flexor and acute localized muscle spasms

A, B, C, F

29

Which of the following are uses for Spasmolytics? (Select All)

A. Chronic CNS conditions with abnormally high activity in skeletal muscle reflex arcs (Cerebral Palsy, Multiple sclerosis)\

B. Relaxation of muscles for Surgery

C. Placement of endotracheal tube

D. Better control of artificial ventilation

E. Acute Muscle spasms due to strain/trauma

A, E

30

(Sharpe)During surgery a Paralytic would cause a/an____ in mental function.

A. Increase 

B. Decrease

C. No change

C