Which neuromuscular blocker is MOST effectively antagonized by sugammadex?
Sugammadex selectively binds to the ----- nondepolarizing neuromuscular blockers
Rank Sugammadex affinity to the aminosteroid nondepolarizing neuromuscular blockers. Start with the strongest
Rocuronium > Vecuronium > Pancuronium
Sugammadex has ----- on Succinylcholine or the benzylisoquinolines (atracurium, cisatracurium, and mivacurium)
Sugammadex is a gamma-cyclodextrin made of ----- sugars assembled in a ring
Sugammadex is a gamma-cyclodextrin made of eight sugars assembled in a ring. The ring ----- the neuromuscular blocker, rendering it inactive and unable to engage with the nicotinic receptor. It's like Febreze for aminosteroid neuromuscular blockers.
Encapsulating rocuronium ----- the free concentration of the drug in the plasma
Encapsulating rocuronium decreases the free concentration of the drug in the plasma. This augments the ----- between the neuromuscular junction and the plasma, thereby increasing the rate of transfer of rocuronium from the neuromuscular junction towards the plasma
The affinity for rocuronium is strong, but not -----.
The affinity for rocuronium is strong, but not irreversible. It is not understood if pH, temperature, or other factors affect the rate of ----- between Sugammadex and the NMB
Sugammadex ----- interact with neuromuscular receptors and neurotransmitters
Because it does not interact with neuromuscular receptors and neurotransmitters, it has ----- major systemic side effects
How Does Sugammadex Improve Safety? Rocuronium can be used for difficult ----- without the drawbacks of succinylcholine
Sugammadex can reverse a dense neuromuscular block quickly, thus greatly reducing the risk of -----.
Sugammadex allows for a dense block until the very end of the surgical procedure without the concerns of delayed -----. Now those whiny surgeons can have it both ways!
There is a need for a 1:1 molar ratio between sugammadex and muscle relaxant, so the dose is calculated on the degree of -----
If the agent to reverse is Rocuronium or Vecuronium, and you have a TOF 2/4 or better, administer --- mg/kg of Sugammadex
If the agent to reverse is Rocuronium or Vecuronium, and you have a TOF 0/4 + 2 PTC or better, administer --- mg/kg of Sugammadex
You may reverse with Sugammadex --- minutes after administration of 1.2 mg/kg or less of Rocuronium.
You may reverse with Sugammadex 3 minutes after administration of 1.2 mg/kg or less of Rocuronium. Give --- mg/kg of Sugammadex
Rocuronium is primarily excreted by the ----- system
Biliary system (Liver)
Unlike rocuronium, which is primarily excreted by the biliary system, Sugammadex and the Sugammadex-Rocuronium complex are excreted unchanged by the -----.
What if the Patient Needs to Be Re-Paralyzed After Sugammadex? In this case, you have several options: First, you can select a neuromuscular blocker from outside of the ----- class, such as succinylcholine, atracurium, cisatracurium, or mivacurium. You can do this regardless of when sugammadex was administered.
If 16 mg/kg of sugammadex was given within 24 hours of the need for additional muscle relaxant, then this is your ---- option is to give a neuromuscular blocker from outside of the aminosteroid class
Alternatively, if an amount equal to or less than --- mg/kg of sugammadex was administered, you can re-dose rocuronium or vecuronium
If you need to re-administer a muscle relaxant between --- minutes and --- hours of sugammadex administration, you can re administer rocuronium at 1.2 mg/kg
5 minutes and 4hours
If you need to re-administer a muscle-relaxant more than four hours after sugammadex administration then you can administer Rocuronium at --- mg/kg or Vecuronium at --- mg/kg
Rocuronium at 0.6 mg/kg or
Vecuronium at 0.1 mg/kg
With Sugammadex, anaphylaxis occurs in --- percent of patients
Bradycardia and Cardiac arrest have been reported with Sugammadex. Which drugs may be useful in this context?
Sugammadex binds oral -----