anesthetics and muscle relaxants

generic: etomidate

brand: amidate

• general anesthetic

→ induction of anesthesia

generic: propofol

brand: diprivan

• general anesthetic/sedative

→ induction & ICU maintenance

generic: dexmedetomidine

brand: precedex

• sedative

→ procedural/ICU sedation

generic: succinylcholine

brand: anectine

• neuromuscular blocker

→ RSI/short paralysis

generic: rocuronium

brand: zemuron

• neuromuscular blocker

→ intubation paralysis

generic: cisatracurium

brand: nimbex

• neuromuscular blocker

→ intubation paralysis

generic: baclofen

brand: lioresal

• skeletal muscle relaxant

→ muscle spasm/spasticity

generic: carisoprodol

brand: soma

• skeletal muscle relaxant

→ muscle spasm/spasticity

generic: cyclobenzaprine

brand: flexeril

• skeletal muscle relaxant

→ muscle spasm/spasticity

generic: methocarbamol

brand: robaxin

• skeletal muscle relaxant

→ muscle spasm/spasticity

generic: metaxalone

brand: skelaxin

• skeletal muscle relaxant

→ muscle spasm/spasticity

generic: tizanidine

brand: zanaflex

• skeletal muscle relaxant

→ muscle spasm/spasticity

general anesthetics (etomidate, propofol) cause…

loss of consciousness

dexmedetomidine provides…

lighter sedation/calmness

neuromuscular blockers (NMBS) cause…

flaccid paralysis for airway control

skeletal muscle relaxants act centrally to…

break muscle-spasm pain cycle

common side effects include

drowsiness, dizziness, hypotension, bradycardia

serious risks include

• respiratory depression/apnea (propofol, all NMBs)

• severe hypotension and bradycardia with sedatives

• hepatotoxicity (tizanidine, metaxalone)

  • seizures on abrupt baclofen/carisoprodol withdrawal; serotonin syndrome & QT prolongation (cyclobenzaprine)

interactions & contra-indications

• additive CNS/respiratory depression w/ alcohol, opioids, benzodiazepines (all)

• egg/soy allergy caution for propofol

• patients must be sedated to loss of consciousness and must be receiving airway support for neuromuscular blockers