Which of the following is a muscle relaxant?

Appeared in: SGPGI Nursing Officer-2023

Explanation

Pancuronium bromide is classified as a non-depolarizing (competitive) neuromuscular blocking agent.
Its primary function is to induce skeletal muscle relaxation, which is essential for surgical procedures, including endotracheal intubation and facilitating mechanical ventilation.
It acts by competing with acetylcholine at the nicotinic receptors at the neuromuscular junction, thereby preventing muscle depolarization and contraction.
It is a long-acting agent, making it suitable for procedures that require sustained muscle paralysis.

Option A: Thiopentone is an ultra-short-acting barbiturate used for the induction of general anesthesia. It produces unconsciousness but does not provide significant muscle relaxation or analgesia.
Option B: Ketamine is a dissociative anesthetic. It produces a trance-like state with profound analgesia and amnesia. While it can affect muscle tone, it is not classified as a primary muscle relaxant.
Option C: Epontol (Propanidid) is an ultra-short-acting intravenous anesthetic agent. It is no longer in clinical use due to a high incidence of hypersensitivity reactions. It was used for induction of anesthesia, not as a muscle relaxant.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pharmacological Classification of Anesthetic Adjuvants as background academic context rather than a clinical decision trigger.
Nurses must be able to differentiate between anesthetic agents, analgesics, and muscle relaxants to ensure patient safety during the perioperative period. Administering a muscle relaxant without an anesthetic would result in a paralyzed but conscious and distressed patient.
When administering pancuronium, nurses must monitor for its known side effects, particularly tachycardia and hypertension, and be prepared to manage them.
It is crucial to ensure mechanical ventilation is available and functioning, as pancuronium paralyzes the respiratory muscles, leading to apnea.

How to Approach the Question

First, identify the core of the question, which is to find the 'muscle relaxant' among the given options.
Recall or look up the pharmacological class of each drug listed.
Thiopentone is a barbiturate anesthetic.
Ketamine is a dissociative anesthetic.
Epontol is an older intravenous anesthetic.
Pancuronium is a neuromuscular blocking agent, which is a specific type of muscle relaxant.

Concept Tested & Keywords

QeuUzJvKlfUVeC64iXpX6M

E6 Pharmacology Nurses Shanbhag 3e p. 76-78

E6 Pharmacology KD Tripathi Essentials 9e Part 2 p. 28-30

Practise the full SGPGI Nursing Officer-2023

Attempt every question from this paper in a timed mock, then review the full solution for each one.