Muscle Relaxants

Question 1

MOA: Succinylcholine

Answer 1

ACh receptor agonist, continuous endplate depolarization;

↑ effects/duration: atypical pseudoChE, hypothermia, reduced ChE activity (liver dz, malnutrition, burns, PG, geriatrics)

CI: Pediatrics (< 8-14yo, unless E)

Metabolism: Pseudo/Plasmacholinesterases

Elimination:

Question 2

Intubation Dose: Succinylcholine

Answer 2

1 mg/kg

Question 3

Maintenance Dose: Succinylcholine

Answer 3

0.5-10 mg/min

Question 4

Half Life: Succinylcholine

Answer 4

47 seconds

Question 5

MOA: Atracurium

Answer 5

Benzylisoquinoline nAChR antagonist.

Metabolism: Hoffman elimination. Non-specific esterase hydrolysis.

Question 6

Intubation Dose: Atracurium

Answer 6

0.5 mg/kg

Question 7

Maintenance Dose: Atracurium

Answer 7

0.25 mg/kg then 0.1 mg/kg

Question 8

Half Life: Atracurium

Answer 8

20 minutes

Question 9

MOA: Cisatracurium

Answer 9

Benzylisoquinoline nAChR antagonist.

Metabolism: Hoffman elimination. Non-specific esterase hydrolysis.

Question 10

Intubation Dose: Cisatracurium

Answer 10

0.1 mg/kg

(no maintenance dose)

Question 11

MOA: Vecuronium

Answer 11

Aminosteroid. nAChR antagonist.

Question 12

Intubation Dose: Vecuronium

Answer 12

0.1 mg/kg

Question 13

Maintenance Dose: Vecuronium

Answer 13

0.04 mg/kg then 0.01 mg/kg

Question 14

Half Life: Cisatracurium

Answer 14

22 minutes

Question 15

Half Life: Vecuronium

Answer 15

30-80 minutes

Question 16

MOA: Rocuronium

Answer 16

Aminosteroid. nAChR antagonist.

Question 17

Intubation Dose: Rocuronium

Answer 17

0.6-1.2 mg/kg

RSI: 1-1.2 mg/kg

Question 18

Maintenance Dose: Rocuronium

Answer 18

0.15 mg/kg

Question 19

Half Life: Rocuronium

Answer 19

1.5-2.5 hours

Question 20

MOA: Pancuronium

Answer 20

Aminosteroid. nAChR antagonist.

Metabolism: 10-20% liver

Long-Acting

Question 21

Intubation Dose: Pancuronium

Answer 21

0.1 Mg/kg (0.08-1.8 mg/kg)

Question 22

Maintenance Dose: Pancuronium

Answer 22

0.04 mg/kg then 0.01 mg/kg

Question 23

Half Life: Pancuronium

Answer 23

2 Hours