Muscle Relaxant Agents Flashcards
What is the standard IV dose of Succinylcholine for rapid sequence intubation in adults?
1.0–2 mg/kg
What is the typical onset of action for Succinylcholine after IV administration?
30 seconds
How long does the neuromuscular blockade from Succinylcholine usually last?
4–6 minutes
What is the mechanism of action of Succinylcholine?
Depolarizing neuromuscular blocker that mimics acetylcholine
Which of the following is a known dangerous side effect of Succinylcholine?
Malignant hyperthermia
In which of the following scenarios is Succinylcholine contraindicated?
Burn injury after 24 hours
Is Succinylcholine a non-depolarizing muscle relaxant?
No
Does Succinylcholine have a very short duration of action, typically under 10 minutes?
Yes
Is Hyperkalemia a possible side effect of Succinylcholine?
Yes
Should Succinylcholine be avoided in patients with a history of malignant hyperthermia?
Yes
Is Succinylcholine metabolized by plasma cholinesterase?
Yes
Does Succinylcholine cause muscle fasciculations prior to paralysis?
Yes
What is the typical IV dose of Rocuronium for rapid sequence intubation (RSI)?
0.6–1.2 mg/kg
What is the approximate onset of action of Rocuronium when used for RSI at high doses?
60-90 seconds
How long does the neuromuscular blockade typically last after a standard intubating dose of Rocuronium?
30–60 minutes
What is the mechanism of action of Rocuronium?
Non-depolarizing neuromuscular blocker (competitive antagonist)
Which of the following drugs can be used to reverse Rocuronium’s effects quickly?
Sugammadex
Which of the following is an appropriate use for Rocuronium?
Muscle relaxation for endotracheal intubation
Is Rocuronium a non-depolarizing neuromuscular blocker?
Yes
Does Rocuronium have a faster onset than Succinylcholine?
No
Does Rocuronium cause muscle fasciculations before paralysis?
No
Does Rocuronium provide any analgesic or sedative effects?
No
Is Rocuronium metabolized primarily by the liver?
Yes
What is the standard IV dose of Rocuronium for rapid sequence intubation?
0.6–1.2 mg/kg
What is the onset time of Rocuronium when given in RSI doses?
60-90 seconds
What is the average duration of action for Rocuronium?
30–60 minutes
Describe the mechanism of action of Rocuronium.
Rocuronium is a non-depolarizing neuromuscular blocker that competitively inhibits acetylcholine at nicotinic receptors in the neuromuscular junction.
List two clinical indications for using Rocuronium.
- Rapid sequence intubation
- Maintenance of muscle relaxation during surgery
What reversal agent is most specific and rapid for Rocuronium?
Sugammadex
Why might Rocuronium be preferred over Succinylcholine in some patients?
It avoids risks like hyperkalemia, malignant hyperthermia, and increased ICP
Does Rocuronium provide sedation or pain relief?
No
What is the typical dose of Cisatracurium in adults?
0.08-0.12 mg/kg
What is the typical onset of action for Cisatracurium at intubating doses?
2–3 minutes
What is the approximate duration of action of Cisatracurium?
20–40 minutes
What is the primary route of metabolism for Cisatracurium?
Hofmann elimination (organ-independent)
In which of the following scenarios is Cisatracurium particularly advantageous?
Both liver and renal failure
Is Cisatracurium a depolarizing neuromuscular blocker?
No
Can Cisatracurium be used safely in patients with renal or hepatic impairment?
Yes
Does the metabolism of Cisatracurium rely heavily on the liver?
No
Does Cisatracurium cause histamine release and is associated with hypotension and flushing?
No
Does Cisatracurium provide any analgesic or sedative properties?
No
What is the standard intubating dose of Cisatracurium?
0.08–0.12 mg/kg
What is the typical onset of action for Cisatracurium?
2–3 minutes
What is the average duration of action of Cisatracurium?
30–60 minutes
How is Cisatracurium metabolized?
Primarily via Hofmann elimination, which is temperature and pH-dependent and does not rely on liver or kidney function.
Name two clinical advantages of using Cisatracurium over other neuromuscular blockers.
- Minimal histamine release
- Safe use in liver or renal failure
Does Cisatracurium provide sedation or analgesia?
No
When might Cisatracurium be preferred over Rocuronium?
In patients with renal or hepatic dysfunction, or when longer-term neuromuscular blockade is needed in the ICU.
What is the typical intubating dose of Vecuronium in adults?
0.08-0.12 mg/kg
What is the average onset time of Vecuronium?
3-5 minutes
How long does the effect of a single dose of Vecuronium typically last?
30-60 minutes
What is the mechanism of action of Vecuronium?
Blocks acetylcholine at the neuromuscular junction
In which of the following situations is caution advised when using Vecuronium?
Hepatic impairment, Renal failure, Neuromuscular diseases
Is Vecuronium a depolarizing neuromuscular blocking agent?
No
Does Vecuronium have significant cardiovascular side effects such as bradycardia and hypotension?
It has minimal cardiovascular effects.
Is the elimination of Vecuronium dependent on both hepatic and renal function?
Yes
Does Vecuronium cause histamine release?
It has little to no histamine release.
Is Vecuronium suitable for use in rapid sequence induction?
No
What is the standard intubating dose of Vecuronium?
0.08–0.12 mg/kg IV
What is the typical onset time of action of Vecuronium?
3-5 minutes
What is the average clinical duration of Vecuronium?
30–60 minutes
What is the mechanism of action of Vecuronium?
It competitively inhibits acetylcholine at nicotinic receptors at the neuromuscular junction, preventing depolarization and muscle contraction.
Why must Vecuronium be used cautiously in patients with liver or kidney dysfunction?
Because it is partially metabolized by the liver and excreted by the kidneys, leading to prolonged effects.
List two advantages of Vecuronium.
- Minimal cardiovascular effects
- No histamine release
Can Vecuronium be used for maintenance of neuromuscular blockade in the ICU?
Yes
Does Vecuronium provide any analgesic or sedative properties?
No
What is the typical intubating dose of Pancuronium in adults?
0.08-0.12 mg/kg
What is the average onset time of Pancuronium?
2-3 minutes
How long does a single dose of Pancuronium typically last?
60–90 minutes
Which of the following is a notable side effect of Pancuronium?
Tachycardia
Pancuronium is best avoided in which patient population?
Patients with tachycardia or heart failure
Is Pancuronium a depolarizing neuromuscular blocking agent?
No
Does Pancuronium have vagolytic properties, which may lead to increased heart rate?
Yes
Is Pancuronium primarily eliminated via the liver?
No
Does Pancuronium have a short duration of action, making it ideal for short procedures?
No
Does Pancuronium release histamine?
No
What is the standard intubating dose of Pancuronium?
0.08–0.12 mg/kg IV
What is the typical onset time of Pancuronium?
2-3 minutes
What is the average duration of action of Pancuronium?
60–90 minutes
What is the mechanism of action of Pancuronium?
It competitively inhibits acetylcholine at nicotinic receptors at the neuromuscular junction, preventing muscle contraction.
Why might Pancuronium cause tachycardia?
Because of its vagolytic (antimuscarinic) effects, which inhibit parasympathetic (vagal) tone.
In what scenario might Pancuronium be especially useful?
In patients with bradycardia or when prolonged paralysis is required.
Name two clinical uses of Pancuronium.
- Facilitation of intubation
- Maintenance of muscle relaxation during long surgeries or mechanical ventilation
What is a contraindication or caution for using Pancuronium?
Patients with tachyarrhythmias, congestive heart failure, or renal insufficiency.
