Neuromuscular Blockers

Question 1

NMB Indications

Answer 1

Facilitate endotracheal intubation, mechanical ventilation, ctrl inc ICP, spasm assoc. w/ tetanus; sedation and analgesia optimized prior

Question 2

Succinylcholine Dose

Answer 2

Indication: endotracheal intubation; Dose: 1-1.5 mg/kg up to 150 mg total dose

Question 3

Succinylcholine Contraindications

Answer 3

personal/family h/o malignant hyperthermia, severe burns, myopathies w/ elevated creatine phosphokinase, penetrating eye injuries, pre-existing hyperkalemia

Question 4

Cisatracurium

Answer 4

Indication: continuous blockade, 0.15-0.2 mg/kg bolus followed by 3 mcg/kg/min, range: 0.5-5 mcg/kg/min

Question 5

Clinical Factors that Increase NMB Effect

Answer 5

HypoK, HypoCa, HypoNa, HyperMg, acidosis, hypothermia, renal/hepatic failure, neuromuscular diseases

Question 6

Medications that Increase NMB Effect

Answer 6

Anesthetics (fluranes), AGs, Clinda, Polymixin, Vanco, Class 1 AAD, B blockers, CCBS, Lim dantrolene

Question 7

Clinical Factors that Decrease NMB Effect

Answer 7

Alkalosis, HyperCa, demyelinating lesions

Question 8

Medications that Increase NMB Effect

Answer 8

Anticholinesterases, Ca, Carbamazepine, phenytoin, theophyline, caffeine