C&P: Non-depolarizing Muscle Relaxants Flashcards
Aminosteroid muscle relaxants
Vecuronium, Rocuronium, Pancuronium
All increased duration of action in renal failure
Benzylisoquinolinium muscle relaxants
Atracurium, cis-atracurium, Mivacurium, Gallamine, Turbocare
Monoquaternary muscle relaxants
Vecuronium, rocuronium
both aminosteroids
Bisquaternary muscle relaxants
Pancuronium (aminosteroid)
Vecuronium: Structure
monoquaternary
Vecuronium: Dose (mg/kg)
0.1
Vecuronium: Onset/duration
medium onset medium duration
Vecuronium: Protein Bound (%)
10
Vecuronium: Metabolism/elimination in bile/elimination in urine
Metabolism: 20% (deacetylation)
Elimination in bile: 70%
Elimination in urine: 30%
Vecuronium: Effect in renal failure
Prolonged action (all the aminosteroids)
Rocuronium: Structure
Monoquaternary
Rocuronium: Dose (mg/kg)
0.6 (0.9 RSI)
Rocuronium: Onset/duration
rapid onset, medium duraiton
Rocuronium: Protein Bound (%)
10
Rocuronium: Metabolism/elimination in bile/elimination in urine
Metabolism: <5% (deacetylation)
Elimination in bile: 60%
Elimination in urine: 40%
Rocuronium: Effect in renal failure
Prolonged effect
Atracurium: Structure
Benzylisoquinolinium
10 stereoisomers
Atracurium: Dose (mg/kg)
0.5
Atracurium: Onset/duration
medium onset, medium duration
Atracurium: Protein Bound (%)
15
Atracurium: Metabolism/elimination in bile/elimination in urine
Metabolism: 90% (hoffman degradation and ester hydrolysis)
Elimination in bile: 0%
Elimination in urine: 10%
Atracurium: Effect in renal failure
No change
Cis-atracurium: Dose (mg/kg)
0.2
Cis-atracurium: Onset/duration
medium onset, medium duration
Cis-atracurium: Protein Bound (%)
15
Cis-atracurium: Metabolism/elimination in bile/elimination in urine
Metabolism: 95%
Elimination in bile: 0%
Elimination in urine: 5%
Cis-atracurium: Effect in renal failure
No change
Mivatracurium: Structure
Benzylisoquinolinium
3 stereoisomers
Mivatracurium: Dose (mg/kg)
0.2
Mivatracurium: Onset/duration
medium onset, short duration
Mivatracurium: Protein Bound (%)
10
Mivatracurium: Metabolism/elimination in bile/elimination in urine
Metabolism: 90% (by plasma cholinesterases)
Elimination in bile: 0%
Elimination in urine: 5%
Mivatracurium: Effect in renal failure
No change