Which of the following is a muscle relaxant?

Appeared in: BCCL kharkhanda Staff Nurse - 2015

Explanation

Pancuronium bromide is classified as a non-depolarizing neuromuscular blocking agent, which is a type of peripherally acting skeletal muscle relaxant.
Its primary mechanism involves competitively antagonizing acetylcholine receptors at the neuromuscular junction, which prevents muscle contraction.
Clinically, it is administered intravenously as an adjunct to general anesthesia to achieve muscle paralysis, facilitating procedures like tracheal intubation and surgery.

Option A: Thiopentone is an ultra-short-acting barbiturate. Its primary role is to induce general anesthesia rapidly due to its high lipid solubility and rapid entry into the brain. It does not have primary muscle relaxant properties.
Option B: Ketamine is a dissociative anesthetic. It produces a state of anesthesia characterized by analgesia, amnesia, and catalepsy, but it is not classified as a primary muscle relaxant.
Option C: Epontol (Propanidid) is an ultra-short-acting intravenous anesthetic. Its use has been largely discontinued due to a high incidence of hypersensitivity reactions. Its function was to induce anesthesia, not to provide muscle relaxation.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pharmacological classification of anesthetic and adjuvant drugs as background academic context rather than a clinical decision trigger.
The primary nursing responsibility when a patient receives a neuromuscular blocker like pancuronium is to manage the airway and breathing, as these drugs cause paralysis of the respiratory muscles, leading to apnea.
Nurses must be prepared to administer reversal agents, such as neostigmine combined with glycopyrrolate, to counteract the paralysis once the surgical procedure is complete.
A peripheral nerve stimulator is used to monitor the depth of the blockade, ensuring the patient is adequately relaxed but not overly paralyzed, which helps in titrating the dose and timing the reversal.

How to Approach the Question

First, identify the key term in the question stem, which is 'muscle relaxant'.
This is a factual recall question requiring knowledge of drug classifications in pharmacology.
Systematically review each option and categorize it based on its primary drug class and function.
Thiopentone is a barbiturate anesthetic.
Ketamine is a dissociative anesthetic.
Epontol is an older intravenous anesthetic.

Concept Tested & Keywords

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E6 Pharmacology KD Tripathi Essentials 9e Part 2 pp. 28-30, 27-29, 33-35

Practise the full BCCL kharkhanda Staff Nurse - 2015

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