27. Neuromuscular blocking drugs

Question 1

Rocuronium and scoline interaction

Answer 1

Rocuronium antagonist of Scoline. Increase the dose in case of use of Scoline after use of rocuronium

Question 2

Increase the duration of NMBA

Answer 2

Mg, lithium, hypothermia dalotrene tamoxifen
In these cases decrease the dose

Question 3

IBW or TBW with scoline and NDMR for induction

Answer 3

Scoline TBW
NDMR IBW

Question 4

Receptors after burns

Answer 4

Upregulation starts after 24h
Recover to normal levels after 1-2 years
No use scoline
Increares resistance to NDMR and sensitivity to DMR

Question 5

Mature vs immature receptor characteristics (NMBA)

Answer 5

Mature increase conductance decrease time open
Mature Epsilon, Immature gamma

Question 6

Scoline and neostigmine interaction

Answer 6

Neostigmine decrease butyrylch.
Together increase action of scoline

Question 7

NMBA longest peak effect

Answer 7

D tubo / panacurium
Of the intermediate cisatracium

Question 8

C.O. and NMBA

Answer 8

Increase of cardiac output shortness onset

Question 9

Precurarization. Charac and S.E.

Answer 9

Give NDMR before scoline
No affects BP, produces bradycardia

Question 10

Tamoxifen effect in NMBA

Answer 10

Increase ED50, decrease need (decrease dose)

Question 11

TOF scale

Answer 11

TOF 0 PTC 0 intense
TOF 0 deep
1-3 moderate
TOF 4 0.1-0.4 light
0.4-0.9 minimal

Question 12

Upregulation Acetylcholine receptors

Answer 12

Spinal cord injury, immobilization, stroke, burns, MS, GB

Question 13

Downregulation Acetylcholine receptors

Answer 13

MG, poisoning (Organophosphates, Antich)

Question 14

Dobucaine number

Answer 14

Genetic makeup for butyrylch.
20 Homozygotic mutation. Scoline effect 4-8 hours
60. Heterz. 50-100%
80. Normal

Question 15

Neostigmine

Answer 15

Takes 15 min to work if TOF 4
Takes 20-30 if TOF 1-3
Can produce mild hypothermia (34.5)

Question 16

Sugammadex and coagulation

Answer 16

Increase PT PTT with no increased risk of bleeding