Competitive vs. Depolarizing NMBs (Nursing)

00:00 Now, there are 2 groups of NBPs. We've got 2 types. They are competitive or non-depolarizing neuromuscular blockers and depolarizing neuromuscular blockers. That's just the way they work a little bit more of their mechanism of action, but they have a different effect on your patient. So, let's compare them. I always like to use a chart format because it helps me see the information more clearly. So, as far as onset of paralysis, both competitive and depolarizing are rapid. They both happen quickly. Now, the peak for the competitive or the non-depolarizing takes about 20 to 45 minutes for that to really hit, and then it will decline after that. For the depolarizing, it peaks at a minute, and it fades after 4 to 10. So, with the depolarizing, they don't last as long. They kick in quicker for their peak effect, but they also wear off faster.

00:56 Now, with the competitive, recovery will be complete in 1 hour, and with the depolarizing, it's ultra short-acting. So look, the peak is gone after 4 to 10 minutes. It's going to wear off much quicker. So, that's why we use competitive or non-depolarizing neuromuscular blockers for longer procedures, not the depolarizing ones. Okay, now that was a lot of information. No worries. I would recommend that you pause the video, stop over and review that again, make sure I would write in non-depolarizing above the column where it says competitive and then I'd just spend some time laying that foundation of information down, so that's clear before you move on. Then, restart the video again and join us. So, let's look at some drug names of both the competitive neuromuscular blockers and the depolarizing neuromuscular blockers. I'll just let you know there's a lot more competitive ones than there are depolarizing ones. So, for the competitive, you've got atracurium. Look what these end in.

02:02 Look at those last words. You've got i-u-m at the end of each one of these. So, that's one clue to help you remember what these are. Now, the depolarizing example we have is succinylcholine.

02:15 You'll hear them call that succs a lot of times. So, I know it kind of sounds weird to say that in a medical setting, but a lot of times people refer to succinylcholine as succs.