Lesson 11 - Anaesthetics. Muscle relaxants.

Activities in the class


Activity 1 - General anaesthesia

Divide the following substances into appropriate pharmacotherapeutic groups. Discuss briefly mechanisms of actions and indications of substances in the category called „other“:

Pharmacotherapeutic groups

  1. Sedatives, hypnotics
  2. Parasympatholytics
  3. Analgesics - anodynes
  4. NSAIDs
  5. General anaesthetics
  6. Antidotes
  7. Antihistamines
  8. Laxatives
  9. Antiemetics
  10. Muscle relaxants
  11. Other

Drug list

  • adrenaline
  • atropine
  • celecoxib
  • domperidone
  • fentanyl
  • flumazenil
  • isoflurane
  • ketamine
  • ASA
  • lidocaine
  • metoclopramide
  • morphine
  • naloxone
  • naltrexone
  • nitrous oxide
  • procaine
  • promethazine
  • propofol
  • remifentanil
  • rocuronium
  • suxamethonium

Assign substances from the previous activity to the particular phases of general anaesthesia:

Phases

Premedication prior to diagnostic or surgical procedure
Induction and maintenance of GA
Termination of GA
Adjuvant drugs from other pharmacological groups 

Discuss reasons for your drug choice and describe the pharmacological profiles of these drugs (indication, pharmacokinetics, adverse effects, contraindications, drug-drug interactions)


Activity 2 - Local anaesthetics

Cardiotoxicity of LA

  • Explain the principles of cardiotoxic effects in local anaesthetic drugs.
  • Describe the most prominent symptoms of cardiovascular toxicity.
  • Suggest therapeutic possibilities.
  • Give examples of local anaesthetic drugs with a high risk of cardiotoxicity.

Neurotoxicity of LA

  • Explain the principles of neurotoxic effects in local anaesthetic drugs.
  • Describe the most prominent symptoms of CNS toxicity.
  • Suggest therapeutic possibilities.
  • Give examples of local anaesthetic drugs with a high risk of neurotoxicity.

Allergic reactions induced by LA

  • Explain the principles of allergenic properties in local anaesthetic drugs (LA).
  • Describe the most prominent symptoms of the aforementioned effects.
  • Suggest therapeutic possibilities.
  • Give examples of local anaesthetic drugs associated with a high risk of allergic reactions.

Methaemoglobinaemia induced by LA

  • Explain the principles of possible adverse effects of LA on haemoglobin functioning.
  • Describe the most prominent symptoms of these effects.
  • Suggest therapeutic possibilities.
  • Give examples of local anaesthetic drugs associated with a high risk of haemoglobin disorders.


Activity 3 - Muscle relaxants

  • Revise your knowledge of pharmacology of the central and peripheral muscle relaxants.
  • Discuss your homework task (see the section Getting ready for the practical class).
  • Summarize the basic pharmacology of drugs with muscle-relaxing properties (their MoA, pharmacokinetics, adverse effects, etc.). 


Game "Guess what drug I am"

voluntary activity

  • Select a drug.
  • Perform a mute scene "Guess what a drug I am" - other students will ask questions and make notes to remember answers. 
  • Guess what drug was chosen.

 Note: The student, who pretends to be a drug, can only provide answers YES or NO.

Questions of students - related to the drug mechanism of action, its administration route, adverse effects, use, pharmacokinetics, drug-drug interactions, etc. 

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