Continuous Paralytics Flashcards

1
Q

Which muscarinic receptor is associated with CNS, salivary, parietal?

a. M1
b. M2
x. M3

A

a. M1

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2
Q

Which muscarinic receptor is associated with the heart?

A

M2

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3
Q

Which muscarinic receptor is associated with smooth muscle, exocrine?

A

M3

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4
Q

__ paralytic has vagolytic actions?

a. pancuronium
b. atracurium

A

a. pancuronium

tachycardia

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5
Q

Which paralytic is mostly associated with histamine release?

A

atracurium

some pancuronium

hypotension and flushing

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6
Q

Which paralytic has significant M2 blockade?

A

pancuronium

tachycardia

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7
Q

Which paralytic is metabolized by pseudocholinesterase hydrolysis?

A

succinylcholine

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8
Q

Which paralytic is metabolized by ester hydrolysis and eliminated via Hoffman elimination?

A

cisatracurium

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9
Q

What is drug of choice for continuous paralytic in ARDS?

A

cisatracurium

no trials with other NMBAs

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10
Q

The routine administration of NMBAs to mechanically ventilated pts with status asthmatics is recommended

a. true
b. false

A

b. false

SCCM guidelines recommend against this

can use a trial of an NMBA in life threatening situations

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11
Q

Pancuronium is not recommended for continuous paralytic

a. true
b. false

A

a. true

long half life

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12
Q

Continuous paralytics:

Why does cisatracurium pose less risk for AEs such as seizures compared to atracurium?

A

cisatracurium produces less laudanosine

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13
Q

cisatracurium bolus dosing?

A

0.1-0.2mg/kg

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14
Q

cisatracurium continuous infusion dosing?

A

3mcg/kg/min initially, then 1-2mcg/kg/min maintenance

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15
Q

What is the “train of four” (TOF)?

A

used to assess continuous sedation

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16
Q

The goal of the train of four is __ to __ out of 4 twitches

A

1, 2

twitches fade with non-depolarizing NMBAs

17
Q

Can rely on train of four alone to monitor sedation

a. true
b. false

A

b. false

do not rely on TOF alone, should also monitor ventilator synchrony, and oxygen consumption to guide therapy

18
Q

Pts that are paralyzed must be mechanically ventilated

a. true
b. false

A

a. true

19
Q

Need to limit RASS score to what range in paralyzed pts?

A

-4 to -5