Pharm Block 1e

• HTN
• IHD (Ischemic heart disease)
• Arrhythmia
• CCF (congestive cardiac failure)--- only low dose in mild and moderate patients (not sever because at that point herart is dependent on SNS input).
• Glaucoma
• Hyperthyroidism
• Pheochromocytoma
• Migraine Prophylaxis
• Anxiety of manic attacks

Results in Rebound hypertension and angina

Note:Since you give Beta blockers for a long time, the body response by increasing the Beta blocker recepters.

• -Skeletal muscle relaxants
• - Ganglion blockers (block both SNS and PNS)

• adjuvant in general anesthesia (unconciousness, analgesic, and muscle relaxant)
• Brief procedure- reduction of fractures (when there is a muscle spasm)

• Competative (non-depolarizing)
• Non-Competative (depolarising)

Directly acting muscle relaxants

Peripherally at the neuromuscular junction.

• - Pseudocholinesterase
• - Inactivated in plasma by spontanious non-enzymatic degradation (hoffman elimination)

Pancuronium, Pipecuronium Long acting

Rocuronium, Cisatracurium Medium acting

Mivacurium Short acting

Succinylcholine The shortest acting

Succinylcholine

Neostagmine

Causes:

• Muscle pain
• Hyperkalemia
• Malignant Hyperthermia (due to severe muscle spasms)
• and Succinylcholine apnea in pseudocholinesterase deficiency.

• - Flaccid
• -Antagonizes and thus reverse the effects

• -Succinylcholine open Na channels which cause initial twitching and fasciculations followed by desensitization of receptor
• - Fasciculations--> Flaccid Paralysis
• - Exaggerate/ to no effect

• Detrolene
• Depolarization triggered release of calcium from the sarcoplasmic contraction is {ryanodine receptor(RyR) } blocked / reduced.

• •used to reduces spasticity in hemiplegia and cerebral palsy.
• •It is the drug of choice – malignant hyperthermia

• •Chlorzoxazone
• •Diazepam – GABA-A receptor
• •Baclofen – GABA-B receptor – less sedation
• •Tizanidine – central acting alpha-2 agonist--> decrease in Glut