UPRVUNL - 2021
Pharmacology
Easy
In the standard form of modified ECT, the short-acting muscle relaxant used is?
Appeared in: UPRVUNL - 2021
Explanation
- Succinylcholine is the standard muscle relaxant for modified ECT due to its specific pharmacological properties.
- It is a depolarizing neuromuscular blocker with a rapid onset of action (30-60 seconds), which is crucial for the timely progression of the procedure.
- Its duration of action is very short (5-10 minutes), allowing for quick recovery and return of spontaneous respiration after the brief seizure, enhancing patient safety.
- The primary purpose is to modify the motor component of the seizure to prevent musculoskeletal injuries like fractures, which were a common complication of unmodified ECT.
Why Other Options Were Wrong
- Option B: Pancuronium bromide is a long-acting non-depolarizing muscle relaxant. Its effects last for 60-90 minutes, which would cause prolonged paralysis and require extended respiratory support, making it unsuitable for a short procedure like ECT.
- Option C: Atropine is an anticholinergic agent, not a muscle relaxant. Its role in ECT is as a premedication to reduce oral and respiratory secretions (preventing aspiration) and to block vagal nerve reflexes that can cause bradycardia.
- Option D: Thiopental is a short-acting barbiturate anesthetic. It is used to induce unconsciousness (general anesthesia) just before the muscle relaxant is administered. It does not cause muscle relaxation itself.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pharmacology of Modified Electroconvulsive Therapy (ECT) as background academic context rather than a clinical decision trigger.
- A nurse's primary responsibility during ECT is patient safety, which includes ensuring that emergency airway equipment (Ambu bag, suction, oxygen) is immediately available and functional before succinylcholine is given, as it paralyzes the respiratory muscles.
- The nurse must monitor the patient's vital signs, oxygen saturation, and the return of spontaneous respirations post-procedure.
- What if? If a patient has a known history of pseudocholinesterase deficiency or malignant hyperthermia, succinylcholine is contraindicated. In such cases, a non-depolarizing muscle relaxant like atracurium or rocuronium would be used instead, and the nurse must be aware of the different duration and reversal requirements.
How to Approach the Question
- First, identify the core of the question: it asks for a specific type of drug ('short-acting muscle relaxant') used in a specific procedure ('modified ECT').
- Recall the standard medication protocol for modified ECT, which involves three main classes: an anticholinergic, an anesthetic, and a muscle relaxant.
- Evaluate each option based on its drug class and function.
- Eliminate options that do not fit the 'muscle relaxant' category. Atropine is an anticholinergic, and Thiopental is an anesthetic.
- Differentiate between the remaining muscle relaxants. Compare Succinylcholine and Pancuronium based on their duration of action. The question specifies 'short-acting', which points directly to Succinylcholine as the correct choice for the brief ECT procedure.
Concept Tested & Keywords
- Concept Tested: Pharmacology of Modified Electroconvulsive Therapy (ECT)
- Stem keywords: modified ECT, short-acting muscle relaxant
- Lead-in keywords: used is
- Negative lead-in flag: false
Question ID
Q_clZk2v68on-TN5ViMMiA
Reference Book
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 11193-11195
E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 2304-2306
Practise the full UPRVUNL - 2021
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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