NMB reversal agents & anticholinergics 2 Flashcards

1
Q

Compared to atropine, glycopyrrolate is MORE likely to cause:
a. tachycardia
b. xerostomia
c. sedation
d. mydriasis

A

b. xerostomia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

_____________ & ________________ easily cross lipid membranes, including the BBB, GI tract, & placenta.

A

atropine & scopolamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Does glycopyrrolate cross the BBB?

A

nope it’s ionized

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

_______________- increases the heart rate the most of all the muscarinic antagonists

A

atropine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

A very small dose of atropine can cause

A

paradoxical bradycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

_________________ is most effect at preventing motion sickness, providing sedation, and drying secretions.

A

Scopolamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Atropine & scopolamine are naturally occuring

A

tertiary amines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Why can atropine cause paradoxical bradycardia?

A

in small doses it is probably due to the inhibition of the presynaptic M1 receptor on vagal nerve endings- blockade turns off the negative feedback loop and allows for continued Ach release & bradycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Muscarinic antagonists do not affect the heart rate in patients with

A

a previous heart transplant (e.g. those with a denervated heart)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Should you still give heart transplant patients a muscarinic antagonist?

A

yes, because they can experience other cholinergic effects from AchE inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which muscarinic antagonist increases heart rate the least?

A

scopolamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which muscarinic antagonist does not prevent motion-induced nausea?

A

glycopyrrolate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which neuromuscular blocker is MOST effectively antagonized by sugammadex?
a. mivacurium
b. rocuronium
c. cisatracurium
d. succinylcholine

A

b. rocuronium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Sugammadex is a

A

gamma-cyclodextrin that encapsulates the aminosteroid neuromuscular blockers in the bloodstream

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Sugammadex has the greatest affinity for

A

rocuronium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Rocuronium can be used for ___________ without the drawbacks of succinylcholine

A

difficult intubation

17
Q

Sugammadex allows for a

A

dense block until the very end of the surgical procedure without the concerns of delayed extubation

18
Q

Side effects of Sugammadex include

A

anaphylaxis bradycardia, and a reduction in the effectiveness of hormonal contraceptives for up to 7 days

19
Q

If you need to reparalyze the patient after administering sugammadex, you can use

A

a neuromuscular blocker from outside the aminosteroid class; if you gave <4 mg/kg of sugammadex, you can redose rocuronium or vecuronium

20
Q

Sugammadex is excreted

A

unchanged by the kidneys

21
Q

What is the dose of post-intubation sugammadex?

A

16 mg/kg

22
Q

What is the dose of sugammadex for TOF 2/4 or better?

A

2 mg/kg

23
Q

What is the dose of sugammadex for TOF 0/4 + 2 PTC or better

A

4 mg/kg

24
Q

The patient’s ___________ should be used to dose sugammadex

A

actual body weight

25
Q

If the patient received sugammadex in the last 5 min. - 4 hours, you can give rocuronium at

A

1.2 mg/kg