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Questions – Skeletal Muscle Relaxants

by Pravin Shukle, MD
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    Let's try a question. Mitch don't twitch. Mitch is a patient who was given a muscle relaxant. During administration, the patient had a slight drop in blood pressure and a slight increase in heart rate. The patient did not have any twitching during induction. Question. Which of the agents was likely used as a muscle relaxant? Would it be succinylcholine? Would it be pancuronium? Would it be tubocurarine? Would it be baclofen? Or would it be dantrolene? The best answer here is pancuronium. Technically, you could say C, D and E are okay as well. Let's take a look at the explanation. So, succinylcholine is a depolarizing agent. The patient will often twitch during that first phase of injection. Once the first phase is finished, they don't twitch anymore. They are not reversed by acetylcholinesterase inhibitors. Tubocurarine is an old drug. It was used back in the 1900. It's not really used much anymore. It has a similar action to pancuronium though. Baclofen is a great drug but it's an antispasmodic. It has an action at the spinal cord. Now dantrolene, once again, used in malignant hyperthermia, it is not commonly used outside of that use. Now, remember pancuronium can block muscurinic cholinergic receptors in the heart, causing tachycardia. And it may drop the blood pressure initially. But really, these are minimal effects. I've used pancuronium many times and I've never had worrisome drops in my experience, and I've never had worrisome in rise in heart rate. There is small changes but they are not big. So, the answer here is going to be pancuronium. Let's go on to a different question. Mitch won't twitch now. So, Mitch is a patient who was given a muscle relaxant. During administration, the patient had a slight drop in blood pressure and a...

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    The lecture Questions – Skeletal Muscle Relaxants by Pravin Shukle, MD is from the course CNS - Pharmacology.


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     Pravin Shukle, MD

    Pravin Shukle, MD


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