NMBs
- Created by: Caroline Malik
- Created on: 19-11-19 17:55
View mindmap
- NMBs
- Depolarising
- Succinylcholine Suxamethonium
- Two ach molecules back to back
- causes initial depolarisation => fasiculation
- muscle then flaccidly paralysed
- non competitive neuromuscular blockade
- no fade produced
- binds to alpha receptors longer than usual ach molecule
- plasma/pseudocholinesterases responsible for breakdown
- Problems with sux
- muscle fasiculatins
- muscle pain/soreness
- inreased IOP, ICP, intra-abdominal pressure
- increased serum potassium
- malignant hyperthermia trigger
- occasional histamine release
- Succinylcholine Suxamethonium
- Non depolarising
- large polar molecules with N+ atom
- this binds to alpha sub unit
- competes with ach for NAchR
- needs to block 75% of receptors to create a block
- fade present
- needs to block 75% of receptors to create a block
- competes with ach for NAchR
- this binds to alpha sub unit
- Amino steroid
- Pancuronium
- tachycardia
- hypertension
- long half life
- Untitled
- 80% renal excretion
- Untitled
- long half life
- hypertension
- tachycardia
- Vecuronium
- dry powder
- can store 24 hrs
- 20% renal excretion rest is hepatic
- can store 24 hrs
- dry powder
- Rocuronium
- fastest onset
- stable 3 mnths
- more CV effects
- less hepatic metabolism (more billary excretion)
- diabetic dogs need increased doses
- less hepatic metabolism (more billary excretion)
- more CV effects
- stable 3 mnths
- fastest onset
- Parchycurare molecule
- tend not to cause histimine release
- liver metabolises
- more likely to have active metabolites
- liver metabolises
- tend not to cause histimine release
- Pancuronium
- Benzylisoquinoliniums
- leptocurares
- may cause histamine release
- tend to be degraded by hydrolysis and plasma enterases
- may cause histamine release
- Atracurium
- contains 10 isomers
- causes histamine release
- must be kept in the fridge
- 10% excreted urine, 40% Hoffmanns degradation, 50% plasma hydrolysis
- Laudenosine
- 10% excreted urine, 40% Hoffmanns degradation, 50% plasma hydrolysis
- must be kept in the fridge
- causes histamine release
- contains 10 isomers
- Cisatracurium
- 1 of the active isomers of atracurium
- cis - cis
- more potent
- much less histamine release
- more cleared by Hoffmanns degradation
- much less histamine release
- more potent
- cis - cis
- 1 of the active isomers of atracurium
- Mivacurium
- 3 isomers, 2 of which active
- wrong shape for Hoffmanns degradation
- ester hydrolysis by plasma cholinesterase
- histamine release
- no other cardiac effects
- histamine release
- ester hydrolysis by plasma cholinesterase
- wrong shape for Hoffmanns degradation
- 3 isomers, 2 of which active
- leptocurares
- large polar molecules with N+ atom
- effects on anaesthesia
- cant monitor
- respiratory parameters
- eye position or palpebral reflex
- jaw tone
- movement
- can monitor
- heart rate
- blood pressure
- lacrimation
- salivation
- diaphragmatic twitches
- how to monitor
- peripheral nerve stimulator
- sends electrical stimulus over nerve which supplies a motor muscle unit
- positive goes proximal
- small animals
- facial
- ulnar
- peroneal
- equine
- facial
- peroneal
- sends electrical stimulus over nerve which supplies a motor muscle unit
- monitoring reflexes returning
- peripheral nerve stimulator
- cant monitor
- Depolarising
Comments
No comments have yet been made