Muscle Relaxants / Reversals Flashcards
Succinylcholine Dose + Concentration + Trade Name
Anectine
Conc: 20 mg/ml
Dose: 1 - 1.5 mg/kg
Cisatricurium Dose + Concentration + Trade Name
Nimbex
Conc: 2 mg/ml
Dose 0.1 mg/kg
Vecuronium Dose + Concentration + Trade Name
Norcuron
Conc: 1 mg/ml
Dose 0.1 mg/kg –> IDEAL BW
Rocuronium Dose + Concentration + Trade Name
Zemuron
Conc: 10 mg/ml
Dosed on IDEAL BW
Dose 0.6 mg/kg
RSI 1.2 mg/kg
Pancuronium Dose + Concentration + Trade Name
Pavulon
Conc: 2 mg/ml
Dose 0.1 mg/kg –> IDEAL BW
Neostigmine Dose
0.04 - 0.07 mg/kg
Max 5 mg
Sugammadex Dose + Trade Name
2 - 16 mg/kg
Bridion
Glycopyrrolate Dose + Trade Name
Robinul
0.2 mg per mg of Neostigmine
Max 1 mg
Succinylcholine MOA
Depolarizing neuromuscular blocking agent
Increases Na conductance via nACh
Can cause an increase in K by 0.5 mEq/dL
Cause Fasciculations
Non-Depolarizing NMB MOA
Binds at 2 nACH to prevent depolarization
Neostigmine MOA
Anticholinesterase inhibitors
Increases ACh for nACh receptors
Competetive w NDMB
Sugammadex MOA
Encapsulates steroidal NMBD
Only works for Roc, Vec, Panc
Binds to free drug in plasma
Glycopyrrolate MOA
Blocks ACh at muscarinic receptor
Blocks SLUDGE-MB (miosis,
bradycardia)
Succinylcholine Onset
30 - 60 sec
Succinylcholine Duration
5 - 10 min
Cisatricurium Onset
2 - 3 min
Cisatricurium Duration
40 - 75 min
Vecuronium Onset
2 - 3 min
Vecuronium Duration
45 - 90 minutes
Rocuronium Onset
2 - 3 mins for normal dose
1.5 min for RSI dose
Rocuronium Duration
35 - 75 min per TexWes Guide
Pancuronium Onset
2 - 3 min
Pancuronium Duration
60 - 120 mins
Succinylcholine Pharmacodynamics
Metabolism: plasma esterases
Cisatricurium Pharmacodynamics
Benzylisoquinolinium
Metabolism: Hoffman Elimination
BETTER FOR LIVER & KIDNEY PATIENTS
Vecuronium Pharmacodynamics
Aminosteroid
Metabolism: 20% Renal & 80% Liver/Biliary
Rocuronium Pharmacodynamics
Aminosteroid
Metabolism: Unchanged in Bile 70% & Renal 30%
Pancuronium Pharmacodynamics
Aminosteroid
Metabolism: 80% unchanged in urine
20% hepatic
Increased HR, MAP and CO r/t vagal blockade on SA node
Suggamadex Onset
1 - 4 min
Suggamadex Duration
1.5 - 3 hr
Neostigmine Onset
5 - 10 min
Neostigmine Duration
60 min
Roc E 1/2 time
1 hr
Vec E 1/2 time
1 hr
Panc E 1/2 time:
2 hr
Succinylcholine E 1/2 time
< 1 min
