Question Set One:NMJ blockers

Anesthesia Pharmacology Chapter 18: Neuromuscular Blocking Drug Practice Questions

isoquinoline derivative:
1. pancuronium (Pavulon)
2. pipecuronium (Arduan)
3. atracurium (Tracrium)
4. gallamine (Flaxedil)
5. vecuronium (Norcuron)
Spasticity characteristics:
1. muscle weakness
2. increased flexor muscle spasm
3. increase in tonic stretch reflexes
4. B & C
5. A, B & C
Clinical condition associated with spasticity:
1. hypertension
2. stroke
3. multiple sclerosis
4. B & C
5. A, B & C
Clinical spasticity -- mechanisms
1. reflex arc involvement
2. higher center involvement
3. both
4. neither
Reduction in spasticity due to drug action:
1. alteration in stretch reflex arc
2. reduced excitation-contraction coupling at the muscle
3. both
4. neither
Example(s) of anti-spasmolytic drugs:
1. baclofen (Lioresal)
2. metaxalone (Skelaxin)
3. tizanidine (Zanaflex)
4. orphenadrine (Norflex)
5. all the above
Baclofen (Lioresal) pharmacology:
1. more sedating then diazepam (Valium)
2. parenteral administration required
3. adverse effect: increased seizure activity in patients with epilepsy
4. B & C
5. A & C
Concerning intrathecal baclofen (Lioresal):
1. Generally favored Route of Administration
2. peripheral symptoms common
3. major disadvantage is the maintenance of integrity of delivery catheter
4. tolerance does not develop
5. Significant improvement of the quality of life is not seen
Tizanidine (Zanaflex) pharmacology:
1. advantages for patients with spasticity (several types)
2. facilitates nociceptor transmission in dorsal horn
3. significantly more efficacious compared to diazepam (Valium)
4. adverse effects: hypertension
Spasmolytic:: acts by interfering with muscle fiber excitation-coupling mechanism.
1. baclofen (Lioresal)
2. dantrolene (Dantrium)
3. tizanidine (Zanaflex)
Clinical uses: dantrolene (Dantrium) --
1. spasmolytic
2. malignant hyperthermia
3. both
4. neither
Drugs for acute, local spasm:
1. carisoprodol (Soma, Rela)
2. chlorphenesin (Maolate)
3. methocarbamol (Robaxin)
4. orphenadrine (Norflex)
5. all the above