a. How do depolarizing neuromuscular junction blocking agentswork? b.What are th

Question

a. How do depolarizing neuromuscular junction blocking agentswork? b.What are the primary uses for neuromuscular junctionblocking agents? c. What are the key adverse effects of neuromuscular junctionblocking agents? d. What patient care considerations must be included fora patient receiving a  neuromuscular junction blockingagents? a. How do depolarizing neuromuscular junction blocking agentswork? b.What are the primary uses for neuromuscular junctionblocking agents? c. What are the key adverse effects of neuromuscular junctionblocking agents? d. What patient care considerations must be included fora patient receiving a  neuromuscular junction blockingagents? a. How do depolarizing neuromuscular junction blocking agentswork? b.What are the primary uses for neuromuscular junctionblocking agents? c. What are the key adverse effects of neuromuscular junctionblocking agents? d. What patient care considerations must be included fora patient receiving a  neuromuscular junction blockingagents?

Explanation / Answer

Depolarizing blocking agents: These agents act bydepolarizing the plasma membrane of the skeletal muscle fiber. Thispersistent depolarization makes the muscle fiber resistant tofurther stimulation by ACh.

            b.What are the primary uses for neuromuscular junction blockingagents?

Clinically, neuromuscular block isused as an adjunct to anesthesia to induce paralysis, so thatsurgery, especially intra-abdominal and intra-thoracic surgeries,can be carried out with fewer complications. Because neuromuscularblock may paralyze muscles required for breathing, mechanicalventilation should be available to maintain adequaterespiration.

Patients are still aware of paineven after full conduction block has occurred; hence, generalanesthetics and/or analgesicsanesthesia awareness. must begiven to prevent

Quaternary ammonium musclerelaxants are quaternary ammonium salts used as drugs for musclerelaxation, most commonly in anasthesia. It is necessary to preventspontaneous movement of muscle during surgical operations. Musclerelaxants inhibit neuron transmission to muscle by blocking thenicotinic acetylcholine receptor. What they have in common and isnecessary for their effect is having quaternary ammonium groups,usually two. Some of them are found in nature and others aresynthesized molecules.

Majoradverse effects of dantrolene include general muscle weakness,dizziness and drowsiness sedation, and occasionally hepatitis.Neuromuscular blocking agents (NMBAs) paralyze skeletalmuscles by blocking the transmission of nerve impulses at themyoneural junction.

Since these drugs may causeparalysis of the diaphragm, mechanical ventilation should be athand to provide respiration.

Additionally, these drugs mayexhibit cardiovascular effects, since they are not fully selectivefor the nicotinic receptor and hence may have effects on muscarinicreceptors. If nicotonic receptors of the autonomic ganglia oradrenal medulla are blocked, these drugs may cause autonomicsymptoms. Additionally, neuromuscular blockers may facilitatehistamineflushing, and tachycardia. release, which causeshypotension,

In depolarizing the musculature,suxamethonium may trigger a transient release of large amounts ofpotassium from muscle fibers. This puts the patient at risk forlife-threatening complications, such as hyperkalemia and cardiacarrhythmias.

Certain drugs such asaminoglycoside antibiotics and polymyxin and some fluoroquinolonesalso have neuromuscular blocking action as their sideeffect.

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