Muscle Relaxants / Reversals

Question 1

Succinylcholine Dose + Concentration + Trade Name

Answer 1

Anectine

Conc: 20 mg/ml

Dose: 1 - 1.5 mg/kg

Question 2

Cisatricurium Dose + Concentration + Trade Name

Answer 2

Nimbex

Conc: 2 mg/ml

Dose 0.1 mg/kg

Question 3

Vecuronium Dose + Concentration + Trade Name

Answer 3

Norcuron

Conc: 1 mg/ml

Dose 0.1 mg/kg –> IDEAL BW

Question 4

Rocuronium Dose + Concentration + Trade Name

Answer 4

Zemuron

Conc: 10 mg/ml

Dosed on IDEAL BW
Dose 0.6 mg/kg
RSI 1.2 mg/kg

Question 5

Pancuronium Dose + Concentration + Trade Name

Answer 5

Pavulon

Conc: 2 mg/ml

Dose 0.1 mg/kg –> IDEAL BW

Question 6

Neostigmine Dose

Answer 6

0.04 - 0.07 mg/kg
Max 5 mg

Question 7

Sugammadex Dose + Trade Name

Answer 7

2 - 16 mg/kg

Bridion

Question 8

Glycopyrrolate Dose + Trade Name

Answer 8

Robinul

0.2 mg per mg of Neostigmine
Max 1 mg

Question 9

Succinylcholine MOA

Answer 9

Depolarizing neuromuscular blocking agent

Increases Na conductance via nACh
Can cause an increase in K by 0.5 mEq/dL

Cause Fasciculations

Question 10

Non-Depolarizing NMB MOA

Answer 10

Binds at 2 nACH to prevent depolarization

Question 11

Neostigmine MOA

Answer 11

Anticholinesterase inhibitors
Increases ACh for nACh receptors
Competetive w NDMB

Question 12

Sugammadex MOA

Answer 12

Encapsulates steroidal NMBD
Only works for Roc, Vec, Panc
Binds to free drug in plasma

Question 13

Glycopyrrolate MOA

Answer 13

Blocks ACh at muscarinic receptor
Blocks SLUDGE-MB (miosis,
bradycardia)

Question 14

Succinylcholine Onset

Answer 14

30 - 60 sec

Question 15

Succinylcholine Duration

Answer 15

5 - 10 min

Question 16

Cisatricurium Onset

Answer 16

2 - 3 min

Question 17

Cisatricurium Duration

Answer 17

40 - 75 min

Question 18

Vecuronium Onset

Answer 18

2 - 3 min

Question 19

Vecuronium Duration

Answer 19

45 - 90 minutes

Question 20

Rocuronium Onset

Answer 20

2 - 3 mins for normal dose

1.5 min for RSI dose

Question 21

Rocuronium Duration

Answer 21

35 - 75 min per TexWes Guide

Question 22

Pancuronium Onset

Answer 22

2 - 3 min

Question 23

Pancuronium Duration

Answer 23

60 - 120 mins

Question 24

Succinylcholine Pharmacodynamics

Answer 24

Metabolism: plasma esterases

Question 25

Cisatricurium Pharmacodynamics

Answer 25

Benzylisoquinolinium Metabolism: Hoffman Elimination BETTER FOR LIVER & KIDNEY PATIENTS

Question 26

Vecuronium Pharmacodynamics

Answer 26

Aminosteroid Metabolism: 20% Renal & 80% Liver/Biliary

Question 27

Rocuronium Pharmacodynamics

Answer 27

Aminosteroid Metabolism: Unchanged in Bile 70% & Renal 30%

Question 28

Pancuronium Pharmacodynamics

Answer 28

Aminosteroid Metabolism: 80% unchanged in urine 20% hepatic Increased HR, MAP and CO r/t vagal blockade on SA node

Question 29

Suggamadex Onset

Answer 29

1 - 4 min

Question 30

Suggamadex Duration

Answer 30

1.5 - 3 hr

Question 31

Neostigmine Onset

Answer 31

5 - 10 min

Question 32

Neostigmine Duration

Answer 32

60 min

Question 33

Roc E 1/2 time

Answer 33

1 hr

Question 34

Vec E 1/2 time

Answer 34

1 hr

Question 35

Panc E 1/2 time:

Answer 35

2 hr

Question 36

Succinylcholine E 1/2 time

Answer 36

< 1 min