Neuromuscular junction blocking agents for Pharmacology and Physiological Functioning II academic year 2020 PDF

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Neuromuscular junction blocking agents for Pharmacology and Physiological Functioning II academic year 2020...

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Neuromuscular junction blocking agents A neuromuscular junction is the point at which motor neurons communicates with skeletal muscle fibers  Balance of excitatory and inhibitory impulses = muscle tone  NMJ blockers prevent stimulation at muscle cell and cause paralysis without CNS depression  There are two groups of neuromuscular junctions blocking agents o Nondepolarizing - antagonists to ACH at the NMJ- these prevent depol of muscle cells – ANYTHING THAT ENDS IN CURIUM OR ONIUM o Depolarizing - these are agonists to ACH at NMJ – SUCCINYLCHOLINE  Stimulate muscle cells  Prevents repolarization  The first NMJ blocker (CURARE) was used as poision on the tips of arrows o Rocuronium is used for flaccid muscles  These are used when muscle paralysis is required or desired o Might be adjunct to general anesthesia o Intubation, endoscopies  These compete with ACH FOR RECEPTOR SITES AND DON’T GET BROKEN DOWN BY ACETYLESTERASE  They do not cross the BBB and are metabolized in the serum  They are c/I in allergies and MG (BEC it blocks ACH receptors), renal dysfunction, and malignant hyperthermia o They can cause a risk for aspiration due to blocking muscle contraction  THEY HAVE D/HERB INTERACTIONS WITH VALERIAN ROOT, MELATONIN, AND KAVA DEPOLARIZING NEUROMUSCULAR JUNCTION BLOCKERS (SUCCINYLCHOLINE)  This attaches to ACH receptor site which causes prolonged depolarization – muscle contraction then paralysis  These get broken down by cholinesterase but not immediately  ALASKIN ESKIMOS HAVE LONGER PARALYSIS D/T LOW SERUM CHOLINESTERASE  These are c/I in patients with o Fractures o Narrow angle glaucoma o Eye injuries  They can have prolonged paralysis that will result in respiratory depression or malignant hyperthermia  Always monitor vitals and pulse ox  Turn and reposition patient – protect airway – give them pre admin education bc theyre not going to be able to move ...