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SEARCH RESULTS FOR: non-depolarizing-neuromuscular-blocks-ndnmbs

non-depolarizing-neuromuscular-blocks-ndnmbs

Authors: Sunny Fong Reviewers: Joseph Tropiano Billy Sun Melinda Davis, MD Non-Depolarizing Neuromuscular Blockers (NDNMBs) Eg. pancuronium, rocuronium, atracurium, vecuronium Abbreviations NDNMBs — Non-Depolarizing Neuromuscular Blockers ACh — Acetylcholine Quick Facts 1° Indication = Skeletal muscle paralysis to facilitate tracheal intubation, and used during indicated surgeries or mechanical ventilation Route of Administration = IV Metabolism & Excretion = Redistribution, hepatic clearance/renal excretion (extent varies greatly by drug). NOT degraded by acetylcholinesterase or pseudocholinesterase See Acetylcholinesterase Inhibitors slide for reversal of NDN M Bs Competitive antagonism at post-synaptic nicotinic receptors on muscles Competitive antagonism at the pre-synaptic nicotinic receptors on neurons Vagolytic effect (esp. pancuronium) Anaphylactic/ anaphylactoid reactions 4, Binding sites for ACh at post-synaptic nicotinic receptors on muscles 4, Binding sites for ACh at pre-synaptic nicotinic receptors on neurons Blockage of vagal muscarinic receptors in sinoatrial nodes IgE antibodies attach to ammonium ion components of NDNMBs Non-immunologic mast cell degranulation (esp. atracurium) 4, Muscle cell depolarization 4, Positive feedback for continued ACh ► release in response to high frequency stimulation Skeletal muscle paralysis Tetanic fade, Train-of-Four fade 4, —• Parasympathetic Tachycardia effects on heart Release of histamine from mast cells and basophils Bronchospasm Hypotension Legend: Pathophysiology Mechanism Sign/Symptom/Lab Finding Complications I Published March 3, 2018 on www.thecalgaryguide.com 0€3,0 BY NC SA

non-depolarizing-neuromuscular-blocks-ndnmbs

Authors: Sunny Fong Reviewers: Joseph Tropiano Billy Sun Melinda Davis, MD Non-Depolarizing Neuromuscular Blockers (NDNMBs) Eg. pancuronium, rocuronium, atracurium, vecuronium Abbreviations NDNMBs — Non-Depolarizing Neuromuscular Blockers ACh — Acetylcholine Quick Facts 1° Indication = Skeletal muscle paralysis to facilitate tracheal intubation, and used during indicated surgeries or mechanical ventilation Route of Administration = IV Metabolism & Excretion = Redistribution, hepatic clearance/renal excretion (extent varies greatly by drug). NOT degraded by acetylcholinesterase or pseudocholinesterase See Acetylcholinesterase Inhibitors slide for reversal of NDN M Bs Competitive antagonism at post-synaptic nicotinic receptors on muscles Competitive antagonism at the pre-synaptic nicotinic receptors on neurons Vagolytic effect (esp. pancuronium) Anaphylactic/ anaphylactoid reactions 4, Binding sites for ACh at post-synaptic nicotinic receptors on muscles 4, Binding sites for ACh at pre-synaptic nicotinic receptors on neurons Blockage of vagal muscarinic receptors in sinoatrial nodes IgE antibodies attach to ammonium ion components of NDNMBs Non-immunologic mast cell degranulation (esp. atracurium) 4, Muscle cell depolarization 4, Positive feedback for continued ACh ► release in response to high frequency stimulation Skeletal muscle paralysis Tetanic fade, Train-of-Four fade 4, —• Parasympathetic Tachycardia effects on heart Release of histamine from mast cells and basophils Bronchospasm Hypotension Legend: Pathophysiology Mechanism Sign/Symptom/Lab Finding Complications I Published March 3, 2018 on www.thecalgaryguide.com 0€3,0 BY NC SA

nicht-depolarisierende-muskelrelaxanzien

Nicht-Depolarisierende Muskelrelaxanzien Z.B. Pancuronium, Rocuronium, Atracurium, Vecuronium