Neuromuscular Blockade

Question 1

What is the brand name for doxacurium?

Answer 1

Nuromax

Question 2

What is the ED95 for doxacurium (Nuromax)?

Answer 2

0.03 mg/kg

Question 3

What is the intubating dose for doxacurium (Nuromax)?

Answer 3

0.05-0.08 mg/kg

Question 4

What is the onset for doxacurium (Nuromax)?

Answer 4

4-5 minutes

Question 5

What is the duration of doxacurium (Nuromax)?

Answer 5

60-90 minutes (dose dependent = dd)

Question 6

What is an advantage of doxacurium (Nuromax)?

Answer 6

No CV effects

Question 7

Metabolism of doxacurium (Nuromax)?

Answer 7

Renal > hepatic

Question 8

What is the brand name for pipecuronium?

Answer 8

Arduan

Question 9

What is the ED95 for pipecuronium (Arduan)?

Answer 9

0.05 mg/kg

Question 10

What is the intubating dose of pipecuronium (Arduan)?

Answer 10

0.085 mg/kg

Question 11

What is the onset of pipecuronium (Arduan)?

Answer 11

3-5 minutes

Question 12

What is the duration of pipecuronium (Arduan)?

Answer 12

60-90 minutes (dd)

Question 13

Pipecuronium (Arduan) metabolism?

Answer 13

Renal > hepatic

Question 14

What are the advantages of pipecuronium (Arduan)?

Answer 14

NO CV effects, NO histamine

Question 15

What is the brand name for pancuronium?

Answer 15

Pavulon

Question 16

What is the ED95 for pancuronium (Pavulon)?

Answer 16

0.07 mg/kg

Question 17

What is the intubating dose for pancuronium (Pavulon)?

Answer 17

0.1 mg/kg

Question 18

What is the onset of pancuronium (Pavulon)?

Answer 18

3-5 minutes

Question 19

What is the duration of pancuronium (Pavulon)?

Answer 19

60-90 minutes

Question 20

Metabolism of pancuronium (Pavulon)?

Answer 20

Renal > hepatic

Question 21

What to remember about pancuronium (Pavulon)?

Answer 21

Vagolytic side effects

Question 22

What is the brand name for vecuronium?

Answer 22

Norcuron

Question 23

What is the ED95 for vecuronium (Norcuron)?

Answer 23

0.05 mg/kg

Question 24

What is the intubating dose for vecuronium (Norcuron)?

Answer 24

0.1 mg/kg

Question 25

What is the onset for vecuronium (Norcuron)?

Answer 25

2.3 minutes

Question 26

What is the duration for vecuronium (Norcuron)?

Answer 26

45-60 minutes (dd)

Question 27

Metabolism of vecuronium (Norcuron)?

Answer 27

Hepatic > renal (both in first 24 hours)

Question 28

What should you remember about vecuronium (Norcuron)?

Answer 28

NOT vagolytic, NO histamine release, but CAN inhibit catabolism of histamine; a powder that must be reconstituted

Question 29

What is the brand name of mivacurium?

Answer 29

Mivacron

Question 30

What is the ED95 of mivacurium (Mivacron)?

Answer 30

0.08 mg/kg

Question 31

What is the intubating dose of mivacurium (Mivacron)?

Answer 31

0.15-0.2 mg/kg

Question 32

What is the onset of mivacurium (Mivacron)?

Answer 32

1.5-3 minutes

Question 33

What is the duration of mivacurium (Mivacron)?

Answer 33

10-20 minutes (dd)

Question 34

Metabolism of mivacurium (Mivacron)?

Answer 34

Plasma cholinesterase

Question 35

What should you remember about mivacurium (Mivacron)?

Answer 35

Prolonged action with atypical pseudocholinesterase or deficiency; anticholinesterases may prolong; causes HISTAMINE RELEASE

Question 36

What is the brand name of cisatracurium?

Answer 36

Nimbex

Question 37

What is the ED95 of cisatracurium (Nimbex)?

Answer 37

0.05 mg/kg

Question 38

What is the intubating dose of cisatracurium (Nimbex)?

Answer 38

0.2 mg/kg

Question 39

What is the onset of cisatracurium (Nimbex)?

Answer 39

2-3 minutes

Question 40

What is the duration of cisatracurium (Nimbex)?

Answer 40

20-35 minutes

Question 41

Cisatracurium (Nimbex) metabolism?

Answer 41

Hofmann elimination (organ independent)

Question 42

What should you remember about cisatracurium (Nimbex)?

Answer 42

Less of metabolite laudanosine produced than in atracurium since there is only one metabolism pathway (1/5?), NO histamine release

Question 43

What is the brand name for atracurium?

Answer 43

Tracrium

Question 44

What is the ED95 for atracurium (Tracrium)?

Answer 44

0.2 mg/kg

Question 45

What is the intubating dose for atracurium (Tracrium)?

Answer 45

0.5 mg/kg

Question 46

What is the onset for atracurium (Tracrium)?

Answer 46

2-3 minutes

Question 47

What is the duration of atracurium (Tracrium)?

Answer 47

20-35 min (dd)

Question 48

Metabolism of atracurium (Tracrium)?

Answer 48

Hofmann elimination, nonspecific plasma esterase (organ independent)

Question 49

What should you remember about atracurium (Tracrium)?

Answer 49

Causes HISTAMINE RELEASE; laudanosine is a metabolite which has to be eliminated by kidneys; drug must be refrigerated

Question 50

What is the brand name of rocuronium?

Answer 50

Zemuron

Question 51

What is the ED95 of rocuronium (Zemuron)?

Answer 51

0.3 mg/kg

Question 52

What is the intubating dose of rocuronium (Zemuron)?

Answer 52

0.6 mg/kg (dd)

Question 53

What is the onset of rocuronium (Zemuron)?

Answer 53

1-2 minutes

Question 54

What is the duration of rocuronium (Zemuron)?

Answer 54

20-35 minutes

Question 55

Metabolism of rocuronium (Zemuron)?

Answer 55

Hepatic > renal

Question 56

What should you remember about rocuronium (Zemuron)?

Answer 56

Used for rapid sequence induction (RSI), priming dose does not improve onset

Question 57

What is the brand name for succinylcholine?

Answer 57

Anectine

Question 58

What is the ED95 for succinylcholine (Anectine)?

Answer 58

0.3 mg/kg

Question 59

What is the intubating dose for succinylcholine (Anectine)?

Answer 59

1-1.5 mg/kg IV OR 4-5 mg/kg IM

Question 60

What is the onset of succinylcholine (Anectine)?

Answer 60

45-90 seconds

Question 61

What is the duration of succinylchoine (Anectine)?

Answer 61

5-10 minutes

Question 62

What is the infusion concentration for succinycholine?

Answer 62

1 gm/500 mL and titrate to effect

Question 63

Metabolism of succinylcholine (Anectine)?

Answer 63

Plasma cholinesterase

Question 64

What should you remember about succinylcholine (Anectine)?

Answer 64

Used for RSI, difficult airway; MH trigger; causes hyperkalemia; usually phase I block (can be pushed into phase II); atypical plasma cholinesterase prolongs duration (hetero 30 min - dibucaine 40-60; homo >3 hours - dibucaine 20); causes myalgia (can be prevented with defasciculating dose of nondepolarizing NMB)