Neuromuscular Blockers - Revision history

Bara at 18:32, 25 January 2011

2011-01-25T18:32:26Z

2011-01-25T16:59:30Z

Monitoring after NMBA Administration

2011-01-25T16:58:39Z

2011-01-25T16:57:18Z

2011-01-25T16:52:15Z

2011-01-25T16:49:56Z

2011-01-25T16:23:58Z

2009-09-01T15:10:40Z

2009-09-01T15:07:00Z

Drugs in this Class

2009-09-01T15:05:20Z

Drugs in this Class

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 ==Non-Depolarising Neuromuscular Blockers==
-'''Non-depolarising agents''' are competitive neuromuscular blocking agents. Unlike [[Depolarising Neuromuscular Blockers|depolarising agents]] there are a number of different drugs available for use. They should not be used on concious patients.
+'''Non-depolarising agents''' are competitive neuromuscular blocking agents. Unlike depolarising agents there are a number of different drugs available for use. They should not be used on concious patients.
 ===Mechanism of Action===

← Older revision		Revision as of 16:59, 25 January 2011
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	==Monitoring after NMBA Administration==		==Monitoring after NMBA Administration==
−	NMBAs act on all skeletal muscles, which includes respiratory muscles. This means that it is essential to have facilities to provide controlled ventilation. Muscles have different sensitivities for NMBAs, with the diaphragm being particularly resistant making it the last to be paralysed and the first to recover. However, laryngeal tissues appear to be relatively sensitive, meaning it may take longer for these tissues to recover after administation. This makes patients at risk of ''upper airway obstruction'' after the endotracheal tube has been removed.	+	[[Dissociative Agents\|NMBAs]] act on all skeletal muscles, which includes respiratory muscles. This means that it is essential to have facilities to provide controlled ventilation. Muscles have different sensitivities for NMBAs, with the diaphragm being particularly resistant making it the last to be paralysed and the first to recover. However, laryngeal tissues appear to be relatively sensitive, meaning it may take longer for these tissues to recover after administation. This makes patients at risk of ''upper airway obstruction'' after the endotracheal tube has been removed.

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 Muscle relaxation is part of a ''balanced anaesthetic technique''. Most anaesthetic agents produce a mild-moderate amount of muscle relaxation and often this is not sufficient. Increased muscle relaxation can be produced by increasing anaesthetic depth, the use of local anaesthetic techniques, or the use of centrally or peripherally acting muscle relaxants. However, it is important to realise that muscle relaxants have no anaesthetic or analgesic effect themselves and so should never be used alone.
-'''Neuromuscular blocking agents'''(NMBA) are peripherally acting muscle relaxants. They can be classified as [[Neuromuscular Blockers#Depolarising Neuromuscular Blockers|'''depolarising''']] or '''non-depolarising''' depending on whether they are competitive or not.
+'''Neuromuscular blocking agents'''(NMBA) are peripherally acting muscle relaxants. They can be classified as [[Neuromuscular Blockers#Depolarising Neuromuscular Blockers|'''depolarising''']] or [[Neuromuscular Blockers#Non-Depolarising Neuromuscular Blockers|'''non-depolarising''']] depending on whether they are competitive or not.
 ==Neuromuscular Transmission==
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 *Replacement of dislocations and fractures.
 *Intraocular procedures.
 ==Depolarising Neuromuscular Blockers==
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 ===Clinical Uses===
 Suxamethaonium is used to aid endotracheal intubation of cats.
 ==Non-Depolarising Neuromuscular Blockers==

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 Suxamethaonium is used to aid endotracheal intubation of cats.
-==Drugs in this Class==
+===Contraindications and Side Effects===
-*[[Depolarising Neuromuscular Blockers|Depolarising Agents]]
+*Response to these drugs may be altered by underlying neurological conditions that are present in patients e.g. myasthenia gravis patients have a reduced number of ACh receptors and so are more sensitive where as patients with denervating diseases are less sensitive as there are increased numbers of ACh receptors.
-**Suxamethonium
+*Patients with hepatic or renal disease may have prolonged recovery time after the administration of vecuronium or pancuronium due to hepatic metabolism and renal excretion impairment.
 [[Category:Anaesthetic Drugs]]

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 Muscle relaxation is part of a ''balanced anaesthetic technique''. Most anaesthetic agents produce a mild-moderate amount of muscle relaxation and often this is not sufficient. Increased muscle relaxation can be produced by increasing anaesthetic depth, the use of local anaesthetic techniques, or the use of centrally or peripherally acting muscle relaxants. However, it is important to realise that muscle relaxants have no anaesthetic or analgesic effect themselves and so should never be used alone.
-'''Neuromuscular blocking agents'''(NMBA) are peripherally acting muscle relaxants. They can be classified as '''depolarising''' or '''non-depolarising''' depending on whether they are competitive or not.
+'''Neuromuscular blocking agents'''(NMBA) are peripherally acting muscle relaxants. They can be classified as [[Neuromuscular Blockers#Depolarising Neuromuscular Blockers|'''depolarising''']] or '''non-depolarising''' depending on whether they are competitive or not.
 ==Neuromuscular Transmission==
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 *Replacement of dislocations and fractures.
 *Intraocular procedures.
 ==Drugs in this Class==

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 <br>
 Muscle relaxation is part of a ''balanced anaesthetic technique''. Most anaesthetic agents produce a mild-moderate amount of muscle relaxation and often this is not sufficient. Increased muscle relaxation can be produced by increasing anaesthetic depth, the use of local anaesthetic techniques, or the use of centrally or peripherally acting muscle relaxants. However, it is important to realise that muscle relaxants have no anaesthetic or analgesic effect themselves and so should never be used alone.
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 **Vecuronium
 **Pancuronium

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 **Suxamethonium
-*[[Non-depolarising Neuromuscular Blockers|Non-Depolarising Agents]]
+*[[Non-Depolarising Neuromuscular Blockers|Non-Depolarising Agents]]
 **Atracrium
 **Cis-atracurium