neuromuscular blockade

1. Skeletal
muscle
relaxants

2. Skeletal muscle relaxants
Centrally acting Peripherally acting
Neuromuscular
Blocking drugs
Directly acting
drugs

3. Succinylcholine
D-tubocurarine
Vecuronium
Rocuronium
Pancuronium
Doxacurium
Atracurium
Depolarizing
Blockers
Nondepolarizing/
Competitive
Blockers
Neuromuscular
blockers
Directly acting
Dantrolene
Quinine
Centrally acting
Diazepam, Baclofen,
Tizanidine, Chlorzoxazone,
Mephensin

4. Uses of centrally acting SMRs
• Acute muscle spasm - Sprain, ligament tear,
dislocation
• Backache, torticollis, neuralgias
• Tetanus
• Spastic neurological diseases -
cerebral palsy, multiple sclerosis, spinal injuries
• Electroconvulsive therapy
• Orthopedic manipulations
• Anxiety and tension

5. Adverse effects of centrally acting SMRs
• Drowsiness
• Mental confusion
• Hallucinations
• Ataxia
• Weakness
• Night-time insomnia

6. Therapeutic uses of peripherally acting SMRs
• Adjuvant to general anaesthesia – abdominal and
thoracic surgery
• Orthopedic manipulations
• Endotracheal intubation and endoscopies
(laryngoscopy, bronchoscopy etc.)
• Convulsions and trauma from electroconvulsive
therapy
• Assisted ventilation
• Severe cases of tetanus and status epilepticus
• Malignant hyperthermia, cerebral palsy, multiple
sclerosis, hemiplegia, paraplegia - dantrolene

7. Therapeutic uses of peripherally acting SMRs
• Adjuvant to general anaesthesia – abdominal and
thoracic surgery
• Orthopedic manipulations
• Endotracheal intubation and endoscopies
(laryngoscopy, bronchoscopy etc.)
• Convulsions and trauma from electroconvulsive
therapy
• Assisted ventilation
• Severe cases of tetanus and status epilepticus
• Malignant hyperthermia, cerebral palsy, multiple
sclerosis, hemiplegia, paraplegia - dantrolene