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Pharm 512 Drugs > NMBA dosing, MOA, etc. > Flashcards

NMBA dosing, MOA, etc. Flashcards

1
Q

What type of drug is Succinylcholine?

A

D-NMBD:

Ultra short-acting

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2
Q

What is the MOA and metabolism of Succinylcholine?

A

ACh receptor agonist, continuous endplate depolarization;
↑ effects/duration: atypical pseudoChE, hypothermia, reduced ChE activity (liver dz, malnutrition, burns, PG, geriatrics)
CI: Pediatrics (< 8-14yo, unless E)
Metabolism: Pseudo/
Plasmacholinesterases

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3
Q

What is the induction and maintenance dose of Succinylcholine?

A

Induction dose: 1 mg/kg

Maintenance dose: 0.5-10mg/min

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4
Q

What is the half-life of Succinylcholine?

A

47 sec

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5
Q

What are the side effects/contraindications for Succinylcholine?

A

Hyperkalemia (↑0.5 mEq/L avoid in renal/burns, fasciculation/myalgia, muscular d/o, and atypical pseudocholinesterase pts, ↑ICP/IOP, tachycardia, and bradycardia w/ repeat doses, risk of MH

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6
Q

What type of drug is Atracurium?

A

ND-NMBD: Intermediate-acting

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7
Q

What is the MOA and metabolism of Atracurium?

A

Benzylisoquinoline nAChR antagonist.

Metabolism: Hoffman elimination. Non-specific esterase hydrolysis

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8
Q

What is the induction and maintenance dose of Atracurium?

A

Induction dose: 0.5 mg/kg
Maintenance dose: Intial: 0.25mg/kg
Repeat: 0.1mg/kg

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9
Q

What is the half-life of Atracurium?

A

20 min

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10
Q

What are the side effects/contraindications of Atracurium?

A

Skin flushing, moderate histamine release, hypotension, tachycardia

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11
Q

What type of drug is Cisatracurium?

A

ND-NMBA

Intermediate-acting

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12
Q

What is the MOA and metabolism of Cisatracurium?

A

Benzylisoquinoline relaxant, nAChR antagonist.

Metabolism: Hoffman elimination. Non-specific esterase hydrolysis.

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13
Q

What are the induction and maintenance doses of Cisatracurium?

A

Induction dose: 0.1 mg/kg

Maintenance dose: none

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14
Q

What NMBA is safe for kidney and liver patients and why?

A

Cis

Safe for kidney patients (and liver) d/t hoffman elimination

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15
Q

What is the half-life of Cisatracurium?

A

22 min

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16
Q

What are the side effects/contraindications of Cisatracurium?

A

Bronchospasm, bradycardia, hypotension (<1%)

17
Q

What type of drug is Vecuronium?

A

ND-NMBA Intermediate-acting

18
Q

What is the MOA and metabolism of Vecuronium?

A

Aminosteroid. nAChR antagonist.

Metabolism: Hepatic and renal

19
Q

What are the induction and maintenance doses of Vecuronium?

A

Induction dose:
0.1 mg/kg
Maintenance dose: Inital: 0.04mg/kg
Repeat: 0.01 mg/kg

20
Q

What is the half-life of Vecuronium?

A

30-80 min

21
Q

What type of drug is Rocuronium?

A

ND-NMBA Intermediate-acting

22
Q

What is the MOA and metabolism of Rocuronium?

A

Aminosteroid. nAChR antagonist. Metabolism: Hepatic and biliary

23
Q

What is the induction and maintenance dose of Rocuronium?

A

Induction dose: 0.6-1.2 mg/kg
RSI: 1.0-1.2mg/kg
Maintenance dose: 0.15 mg/kg

24
Q

What is the half-life of Rocuronium?

A
  1. 5-

2. 5 hr

25
Q

What are the side effects/contraindications of Rocuronium?

A

No histamine effects, does not cause CV effects

26
Q

What type of drug is Pancuronium?

A

ND-NMBA

Long-acting

27
Q

What is the MOA and metabolism of Pancuronium?

A

Aminosteroid nAChR antagonist.

Metabolism: Liver 10-20%

28
Q

What is the induction and maintenance dose of Pancuronium?

A

Induction dose: 0.08-1.8 mg/kg
0.1mg/kg
Maintenance dose: Initial: 0.04mg/kg
Repeat: 0.01mg/kg

29
Q

What is the half-life of Pancuronium?

A

2 hr

30
Q

What are the side effects/contraindications of Pancuronium?

A

Tachycardia, HTN; slightly vagolytic (blocks cardiac muscarinic effect)

31
Q

Would you reverse someone with no twitches?

A

No

32
Q

What dose of Neostigmine would you give if your patient had 1-3 twitches?

A

0.05 mg/kg

33
Q

What dose of Neostigmine would you give if your patient had 4 twitches with fade?

A

0.04 mg/kg

34
Q

What dose of Neostigmine would you give if your patient had 4 twitches with no fade?

A

0.015-0.025 mg/kg

Pharm 512 Drugs (16 decks)

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