Neuromuscular Blockade Flashcards
What is the brand name for doxacurium?
Nuromax
What is the ED95 for doxacurium (Nuromax)?
0.03 mg/kg
What is the intubating dose for doxacurium (Nuromax)?
0.05-0.08 mg/kg
What is the onset for doxacurium (Nuromax)?
4-5 minutes
What is the duration of doxacurium (Nuromax)?
60-90 minutes (dose dependent = dd)
What is an advantage of doxacurium (Nuromax)?
No CV effects
Metabolism of doxacurium (Nuromax)?
Renal > hepatic
What is the brand name for pipecuronium?
Arduan
What is the ED95 for pipecuronium (Arduan)?
0.05 mg/kg
What is the intubating dose of pipecuronium (Arduan)?
0.085 mg/kg
What is the onset of pipecuronium (Arduan)?
3-5 minutes
What is the duration of pipecuronium (Arduan)?
60-90 minutes (dd)
Pipecuronium (Arduan) metabolism?
Renal > hepatic
What are the advantages of pipecuronium (Arduan)?
NO CV effects, NO histamine
What is the brand name for pancuronium?
Pavulon
What is the ED95 for pancuronium (Pavulon)?
0.07 mg/kg
What is the intubating dose for pancuronium (Pavulon)?
0.1 mg/kg
What is the onset of pancuronium (Pavulon)?
3-5 minutes
What is the duration of pancuronium (Pavulon)?
60-90 minutes
Metabolism of pancuronium (Pavulon)?
Renal > hepatic
What to remember about pancuronium (Pavulon)?
Vagolytic side effects
What is the brand name for vecuronium?
Norcuron
What is the ED95 for vecuronium (Norcuron)?
0.05 mg/kg
What is the intubating dose for vecuronium (Norcuron)?
0.1 mg/kg
What is the onset for vecuronium (Norcuron)?
2.3 minutes
What is the duration for vecuronium (Norcuron)?
45-60 minutes (dd)
Metabolism of vecuronium (Norcuron)?
Hepatic > renal (both in first 24 hours)
What should you remember about vecuronium (Norcuron)?
NOT vagolytic, NO histamine release, but CAN inhibit catabolism of histamine; a powder that must be reconstituted
What is the brand name of mivacurium?
Mivacron
What is the ED95 of mivacurium (Mivacron)?
0.08 mg/kg
What is the intubating dose of mivacurium (Mivacron)?
0.15-0.2 mg/kg
What is the onset of mivacurium (Mivacron)?
1.5-3 minutes
What is the duration of mivacurium (Mivacron)?
10-20 minutes (dd)
Metabolism of mivacurium (Mivacron)?
Plasma cholinesterase
What should you remember about mivacurium (Mivacron)?
Prolonged action with atypical pseudocholinesterase or deficiency; anticholinesterases may prolong; causes HISTAMINE RELEASE
What is the brand name of cisatracurium?
Nimbex
What is the ED95 of cisatracurium (Nimbex)?
0.05 mg/kg
What is the intubating dose of cisatracurium (Nimbex)?
0.2 mg/kg
What is the onset of cisatracurium (Nimbex)?
2-3 minutes
What is the duration of cisatracurium (Nimbex)?
20-35 minutes
Cisatracurium (Nimbex) metabolism?
Hofmann elimination (organ independent)
What should you remember about cisatracurium (Nimbex)?
Less of metabolite laudanosine produced than in atracurium since there is only one metabolism pathway (1/5?), NO histamine release
What is the brand name for atracurium?
Tracrium
What is the ED95 for atracurium (Tracrium)?
0.2 mg/kg
What is the intubating dose for atracurium (Tracrium)?
0.5 mg/kg
What is the onset for atracurium (Tracrium)?
2-3 minutes
What is the duration of atracurium (Tracrium)?
20-35 min (dd)
Metabolism of atracurium (Tracrium)?
Hofmann elimination, nonspecific plasma esterase (organ independent)
What should you remember about atracurium (Tracrium)?
Causes HISTAMINE RELEASE; laudanosine is a metabolite which has to be eliminated by kidneys; drug must be refrigerated
What is the brand name of rocuronium?
Zemuron
What is the ED95 of rocuronium (Zemuron)?
0.3 mg/kg
What is the intubating dose of rocuronium (Zemuron)?
0.6 mg/kg (dd)
What is the onset of rocuronium (Zemuron)?
1-2 minutes
What is the duration of rocuronium (Zemuron)?
20-35 minutes
Metabolism of rocuronium (Zemuron)?
Hepatic > renal
What should you remember about rocuronium (Zemuron)?
Used for rapid sequence induction (RSI), priming dose does not improve onset
What is the brand name for succinylcholine?
Anectine
What is the ED95 for succinylcholine (Anectine)?
0.3 mg/kg
What is the intubating dose for succinylcholine (Anectine)?
1-1.5 mg/kg IV
OR
4-5 mg/kg IM
What is the onset of succinylcholine (Anectine)?
45-90 seconds
What is the duration of succinylchoine (Anectine)?
5-10 minutes
What is the infusion concentration for succinycholine?
1 gm/500 mL and titrate to effect
Metabolism of succinylcholine (Anectine)?
Plasma cholinesterase
What should you remember about succinylcholine (Anectine)?
Used for RSI, difficult airway; MH trigger; causes hyperkalemia; usually phase I block (can be pushed into phase II); atypical plasma cholinesterase prolongs duration (hetero 30 min - dibucaine 40-60; homo >3 hours - dibucaine 20); causes myalgia (can be prevented with defasciculating dose of nondepolarizing NMB)
