Muscle relaxants

Question 1

How do you pretreat brady from succs with peds?

Answer 1

Atropine 0.02mg/kg

Question 2

How do you pretreat fasciculation’s from succs?

Answer 2

Defasiculating dose:
Roc 0.06-0.1

Question 3

If you give a defasiculating dose of roc, then what will your succs dose be?

Answer 3

1.5-2.0mg/kg

Question 4

How much can sucs increase your K levels by?

Answer 4

0.5-1.0 mEq/L

Question 5

How can you prevent myalgias from succs?

Answer 5

Defasiculating dose
NSAIDs

Question 6

What’s the onset time after adm sucs for the pt to have myalgias

Answer 6

24-48hrs

Question 7

How long can myalgias last?

Answer 7

2-7 days

Question 8

How can you prevent an increase in ICP that occurs with sucs adm?

Answer 8

Defasiculating dose
Lidocaine adm
Hyperventilation

Question 9

DO NOT adm sucs to …. (muscle and electrolytes)

Answer 9

MH
Third degree burns
Severe muscle trauma
Muscle wasting
Hyper K
Muscular dystrophy
Rhabdo

Question 10

DO NOT adm sucs to …. (CNS, patients, and diseases)

Answer 10

Spinal chord injury
Sepsis
Atypical P-AchE
Allergy
CHILDREN

Question 11

If you’re administering atracurium, how can you decrease the histamine release?

Answer 11

Pretreat with antihistamines

Push med slowly

Question 12

What does prostacyclin do to the plt plug?

Answer 12

prevents it from forming

Question 13

Do you increase or decrease your NDMR with a burn patient?

Answer 13

Increase!

Question 14

Which electrolyte imbalances augment NDMRs?

Answer 14

HyperMg
HypoCa
HypoK

Question 15

You have a neonate your going to arm a NDMR. What are you doing with the dose?

Answer 15

Nothing
unless its atrocurium (then 1/2 it)

Question 16

Things to remember about atrocurium

Answer 16

Histamine release- BRONCHOSPASM
Drop in SVR and increase in CI
Decrease neonate dose in 1/2
High Laudinsoine toxicity

Question 17

What patients will have an prolonged DOA of roc?

Answer 17

hepatic failure
pregancy
elderly
obese

Question 18

Who will you increase your roc dose?

Answer 18

patients with liver diseas

Question 19

Who will have an increased DOA with vec?

Answer 19

Renal failure patients
AIDs
Elderly
Post partum
Obese

Question 20

What drugs will precipitate with Thiopental increasing risk of PE?

Answer 20

Atrocurium
Cisatrocurium
Vecuronium

Question 21

What does pancuronium do to CV?

Answer 21

increase HR, MAP, CO
Blocks muscarinic receptors of the SA node
Increases catacholamine release

Question 22

What does vec do to the CV?

Answer 22

typically no effects
minimal increase in HR and BP

Question 23

What does roc do to the CV?

Answer 23

nothing really

Question 24

What pt population will you decrease your neostigmine dose with?

Answer 24

Elderly and peds

Question 25

What is the Neostigmine:glyco ration?

Answer 25

1: 0.2mg

Question 26

Does glyco cross the BBB?

Answer 26

Yes

Question 27

What else is neostigmine used to treat?

Answer 27

MG, paralytic ileus, and bladder atony

Question 28

What are the chemical strucures of the anticholinesterases?

Answer 28

Quatranary ammonium