Pharmacology notes

Apr 15th, 2015
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SKELETAL MUSCLE RELAXANTS:INTRODUCTIONDrugs that affect skeletal muscle function are of two very different therapeutic groups:1) Neuromuscular blockers;These drugs are used during surgical procedures and in intensive care units toproduce muscle paralysis for patients requiring ventilatory assistance.2) Spasmolytics;These are drugs used to reduce spasticity in a variety of neurologic conditions. Neuromuscular blocking drugs interfere with transmission at theneuromuscular end plate and lack central nervous system activity. Thesecompounds are used primarily as adjuncts during general anesthesia tofacilitate tracheal intubation and optimize surgical conditions while ensuringadequate ventilation. Drugs in the spasmolytic group have traditionally been called "centrally acting"muscle relaxants and are used primarily to treat chronic back pain andfibromyalgic conditions.NEUROMUSCULAR BLOCKING DRUGSHistoryDuring the 16th century, European explorers found that natives in the Amazon Basinof South America used curare, an arrow poison, to produce death by skeletal muscleparalysis. The active compound, d-tubocurarine, and its modern synthetic derivativeshave had a significant influence on the practice of anesthesia and surgery and haveproved useful in defining normal neuromuscular physiologic mechanisms.Normal Neuromuscular Function The mechanism of neuromuscular transmission at the motor end plate is similarto that described for preganglionic c

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