Sugammadex Flashcards Preview

Apex 5 - 3 Neuromuscular Blockers Reversal Agents (5) > Sugammadex > Flashcards

Flashcards in Sugammadex Deck (32)
Loading flashcards...
1

Which neuromuscular blocker is MOST effectively antagonized by sugammadex?

Study on!!!

2

Sugammadex selectively binds to the ----- nondepolarizing neuromuscular blockers 

A. Aminosteroids

B. Benzylisoquinolines

Aminosteroids

3

Rank Sugammadex affinity to the aminosteroid nondepolarizing neuromuscular blockers. Start with the strongest

 

Rocuronium > Vecuronium > Pancuronium

4

Sugammadex has ----- on Succinylcholine or the benzylisoquinolines (atracurium, cisatracurium, and mivacurium)

"no effect"

5

Sugammadex is a gamma-cyclodextrin made of ----- sugars assembled in a ring

eight sugars

6

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.

"encapsulates"

7

Encapsulating rocuronium ----- the free concentration of the drug in the plasma

"decreases"

8

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

Concentration gradient

9

The affinity for rocuronium is strong, but not -----.

"irreversible"

10

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

"dissociation"

11

Sugammadex ----- interact with neuromuscular receptors and neurotransmitters

"does not"

12

Because it does not interact with neuromuscular receptors and neurotransmitters, it has ----- major systemic side effects

"No"

13

How Does Sugammadex Improve Safety? Rocuronium can be used for difficult ----- without the drawbacks of  succinylcholine

Difficult intubation

14

Sugammadex can reverse a dense neuromuscular block quickly, thus greatly reducing the risk of -----.

Residual paralysis

15

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!

Delayed extubation

16

There is a need for a 1:1 molar ratio between sugammadex and muscle relaxant, so the dose is calculated on the degree of -----

Block present

17

If the agent to reverse is Rocuronium or Vecuronium, and you have a TOF 2/4 or better, administer --- mg/kg of Sugammadex

2mg/kg

18

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

4 mg/kg

19

You may reverse with Sugammadex --- minutes after administration of 1.2 mg/kg or less of Rocuronium.

3 minutes

20

You may reverse with Sugammadex 3 minutes after administration of 1.2 mg/kg or less of Rocuronium. Give --- mg/kg of Sugammadex

16 mg/kg

21

Rocuronium is primarily excreted by the ----- system

Biliary system (Liver)

22

Unlike rocuronium, which is primarily excreted by the biliary system, Sugammadex and the Sugammadex-Rocuronium complex are excreted unchanged by the -----.

Kidneys

23

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.

Aminosteroid class

24

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

"only option"

25

Alternatively, if an amount equal to or less than --- mg/kg of sugammadex was administered, you can re-dose rocuronium or vecuronium

4 mg/kg

26

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

27

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

28

With Sugammadex, anaphylaxis occurs in --- percent of patients

0.3 percent

29

Bradycardia and Cardiac arrest have been reported with Sugammadex. Which drugs may be useful in this context?

Anticholinergics

30

Sugammadex binds oral -----

Contraceptives