Neuromuscular Blocking Agents

Question 1

Succinylcholine - Dose

Answer 1

1-2 mg/kg

Question 2

Succinylcholine - Timing

Answer 2

• Onset: l min
• Duration: 10 min
• Spontaneous recovery 20 min

Question 3

Succinylcholine - Reversal/Excretion

Answer 3

• No reversal agent

* Rapidly metabolized by plasma cholinesterase

Question 4

Succinylcholine - Indications/Adverse Effects

Answer 4

Depolarizing agent

• Used for intubation
• Not recommended in pediatrics
• Not recommended in burn patients due to risk of hyperkalemia leading to cardiac arrest
• Prolonged paralysis in pseudocholinesterase deficiency
• MH trigger
• Can produce muscle pain and fasciculations
• S/E: Brady/tachycardia, increased potassium
• Must be refrigerated

Question 5

Mivacurium - Dose

Answer 5

0.25 mg/kg

Question 6

Mivacurium - Timing

Answer 6

• Onset: 5 min
• Duration: 15-20 min
• Spontaneous recovery 25-30 min

Question 7

Mivacurium - Reversal/Excretion

Answer 7

• Reversed with anticholinesterase and anticholinergic agents
• Metabolized by plasma cholinesterase

Question 8

Mivacurium - Indications/Adverse Effects

Answer 8

Non-depolarizing agent (short-acting)

• Used for intubation due to duration and recovery times
• Prolonged paralysis in pseudocholinesterase deficiency
• Hypotension, tachycardia
• Typically used in pediatric patients

Question 9

Rocuronium - Dose

Answer 9

• 0.5 mg/kg (intubation)

* 0.075-0.15 mg/kg (maintenance)

Question 10

Rocuronium - Timing

Answer 10

• Onset: 1 min
• Duration: 22-67 min
• Spontaneous recovery 30-50 min

Question 11

Rocuronium - Reversal/Excretion

Answer 11

• Reversed with anticholinesterase and anticholinergic agents

Question 12

Rocuronium- Indication/Adverse Effects

Answer 12

Non-depolarizing agent (short-acting)

• Used for intubation, mechanical ventilation, skeletal muscle relaxation during surgery
• Minimal hemodynamic effects
• May cause bronchospasm, wheezing and hiccups