NMBA dosing, MOA, etc. Flashcards Preview

Pharm 512 Drugs > NMBA dosing, MOA, etc. > Flashcards

Flashcards in NMBA dosing, MOA, etc. Deck (34):
1

What type of drug is Succinylcholine?

D-NMBD:
Ultra short-acting

2

What is the MOA and metabolism of Succinylcholine?

ACh receptor agonist, continuous endplate depolarization;
↑ effects/duration: atypical pseudoChE, hypothermia, reduced ChE activity (liver dz, malnutrition, burns, PG, geriatrics)
CI: Pediatrics (< 8-14yo, unless E)
Metabolism: Pseudo/
Plasmacholinesterases

3

What is the induction and maintenance dose of Succinylcholine?


Induction dose: 1 mg/kg
Maintenance dose: 0.5-10mg/min

4

What is the half-life of Succinylcholine?

47 sec

5

What are the side effects/contraindications for Succinylcholine?


Hyperkalemia (↑0.5 mEq/L avoid in renal/burns, fasciculation/myalgia, muscular d/o, and atypical pseudocholinesterase pts, ↑ICP/IOP, tachycardia, and bradycardia w/ repeat doses, risk of MH

6

What type of drug is Atracurium?

ND-NMBD: Intermediate-acting

7

What is the MOA and metabolism of Atracurium?

Benzylisoquinoline nAChR antagonist.
Metabolism: Hoffman elimination. Non-specific esterase hydrolysis

8

What is the induction and maintenance dose of Atracurium?

Induction dose: 0.5 mg/kg
Maintenance dose: Intial: 0.25mg/kg
Repeat: 0.1mg/kg

9

What is the half-life of Atracurium?

20 min

10

What are the side effects/contraindications of Atracurium?

Skin flushing, moderate histamine release, hypotension, tachycardia

11

What type of drug is Cisatracurium?

ND-NMBA
Intermediate-acting

12

What is the MOA and metabolism of Cisatracurium?

Benzylisoquinoline relaxant, nAChR antagonist.
Metabolism: Hoffman elimination. Non-specific esterase hydrolysis.

13

What are the induction and maintenance doses of Cisatracurium?


Induction dose: 0.1 mg/kg
Maintenance dose: none

14

What NMBA is safe for kidney and liver patients and why?

Cis
Safe for kidney patients (and liver) d/t hoffman elimination

15

What is the half-life of Cisatracurium?

22 min

16

What are the side effects/contraindications of Cisatracurium?

Bronchospasm, bradycardia, hypotension (<1%)

17

What type of drug is Vecuronium?

ND-NMBA Intermediate-acting

18

What is the MOA and metabolism of Vecuronium?

Aminosteroid. nAChR antagonist.
Metabolism: Hepatic and renal

19

What are the induction and maintenance doses of Vecuronium?

Induction dose:
0.1 mg/kg
Maintenance dose: Inital: 0.04mg/kg
Repeat: 0.01 mg/kg

20

What is the half-life of Vecuronium?

30-80 min

21

What type of drug is Rocuronium?

ND-NMBA Intermediate-acting

22

What is the MOA and metabolism of Rocuronium?

Aminosteroid. nAChR antagonist. Metabolism: Hepatic and biliary

23

What is the induction and maintenance dose of Rocuronium?


Induction dose: 0.6-1.2 mg/kg
RSI: 1.0-1.2mg/kg
Maintenance dose: 0.15 mg/kg

24

What is the half-life of Rocuronium?

1.5-
2.5 hr

25

What are the side effects/contraindications of Rocuronium?


No histamine effects, does not cause CV effects

26

What type of drug is Pancuronium?

ND-NMBA
Long-acting

27

What is the MOA and metabolism of Pancuronium?

Aminosteroid nAChR antagonist.
Metabolism: Liver 10-20%

28

What is the induction and maintenance dose of Pancuronium?

Induction dose: 0.08-1.8 mg/kg
0.1mg/kg
Maintenance dose: Initial: 0.04mg/kg
Repeat: 0.01mg/kg

29

What is the half-life of Pancuronium?

2 hr

30

What are the side effects/contraindications of Pancuronium?

Tachycardia, HTN; slightly vagolytic (blocks cardiac muscarinic effect)

31

Would you reverse someone with no twitches?

No

32

What dose of Neostigmine would you give if your patient had 1-3 twitches?

0.05 mg/kg

33

What dose of Neostigmine would you give if your patient had 4 twitches with fade?

0.04 mg/kg

34

What dose of Neostigmine would you give if your patient had 4 twitches with no fade?

0.015-0.025 mg/kg