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Pharmacology for Musculoskeletal

Terms in this set (22)

a. action: competes with acetylcholine (ACh) for ACh-receptor sites resulting in muscle cell depolarization, initial contraction, and flaccid paralysis; ultra-short acting

b. example: succinylcholine (Anectine) 0.3-1.1 mg/kg IV
Black Box Warning - cardiac arrest risk in pediatric clients

c. uses
i. neuromuscular blockade induction and maintenance
ii. rapid sequence intubation

d. adverse effects
i. life-threatening: prolonged paralysis, respiratory depression, apnea, malignant hyperthermia, arrhythmias
ii. most common: postoperative muscle pain, muscle fasciculation, jaw rigidity, elevated intraocular pressure
iii. other: hypersensitivity reaction, anaphylaxis, rhabdomyolysis with hyperkalemia, myoglobinemia

e. contraindications
i. malignant hyperthermia history, myopathy, acute major trauma or burns
ii. acute upper motor neuron injury, angle-closure glaucoma, penetrating eye injury

f. nursing interventions
i. establish baseline data and continually monitor vital signs, ECG, airway, ventilation, and SaO2
ii. establish baseline data and monitor peripheral nerve stimulation, serum electrolytes
iii. remain at bedside during infusion
•keep emergency equipment and drugs at the bedside
•maintain oxygenation and ventilation while client is being treated
iv. administer sedation and analgesia to clients while being treated - client is conscious and alert without sedation
v. fasciculations subside rapidly after initial administration
vi. client teaching
•etiology of muscle pain
•reassurance about drug-induced, temporary paralysis