Continuous Paralytics Flashcards
Which muscarinic receptor is associated with CNS, salivary, parietal?
a. M1
b. M2
x. M3
a. M1
Which muscarinic receptor is associated with the heart?
M2
Which muscarinic receptor is associated with smooth muscle, exocrine?
M3
__ paralytic has vagolytic actions?
a. pancuronium
b. atracurium
a. pancuronium
tachycardia
Which paralytic is mostly associated with histamine release?
atracurium
some pancuronium
hypotension and flushing
Which paralytic has significant M2 blockade?
pancuronium
tachycardia
Which paralytic is metabolized by pseudocholinesterase hydrolysis?
succinylcholine
Which paralytic is metabolized by ester hydrolysis and eliminated via Hoffman elimination?
cisatracurium
What is drug of choice for continuous paralytic in ARDS?
cisatracurium
no trials with other NMBAs
The routine administration of NMBAs to mechanically ventilated pts with status asthmatics is recommended
a. true
b. false
b. false
SCCM guidelines recommend against this
can use a trial of an NMBA in life threatening situations
Pancuronium is not recommended for continuous paralytic
a. true
b. false
a. true
long half life
Continuous paralytics:
Why does cisatracurium pose less risk for AEs such as seizures compared to atracurium?
cisatracurium produces less laudanosine
cisatracurium bolus dosing?
0.1-0.2mg/kg
cisatracurium continuous infusion dosing?
3mcg/kg/min initially, then 1-2mcg/kg/min maintenance
What is the “train of four” (TOF)?
used to assess continuous sedation
The goal of the train of four is __ to __ out of 4 twitches
1, 2
twitches fade with non-depolarizing NMBAs
Can rely on train of four alone to monitor sedation
a. true
b. false
b. false
do not rely on TOF alone, should also monitor ventilator synchrony, and oxygen consumption to guide therapy
Pts that are paralyzed must be mechanically ventilated
a. true
b. false
a. true
Need to limit RASS score to what range in paralyzed pts?
-4 to -5
