Paralytics

Question 0

Action of Rocuronium

Answer 0

Skeletal muscle relaxation

Question 1

Classification of Rocuronium

Answer 1

Non-depolarizing neuromuscular blocker

Question 2

Onset of action for Rocuronium

Answer 2

60 sec

Question 3

Duration of action of Rocuronium

Answer 3

40-60 min

Question 4

Indications for Rocuronium

Answer 4

Maintenance of paralysis
Initial paralytic for patients with Succinylcholine contraindications (crush injury, malignant hypothermia, muscular dystrophy, hyperkalemia)

Question 5

Contraindications of Rocuronium

Answer 5

Hypersensitivity

Question 6

Caution for Rocuronium

Answer 6

Refrigerate or replace every 60 days

Patients w/ myasthenia gravis may have prolonged paralysis

Question 7

Dosage of Rocuronium

Answer 7

Adult: 1mg/kg IV IO push
Ped: 1mg/kg IV IO push

Question 8

Adverse reactions for Rocuronium

Answer 8

Tachycardia, temporary hypotension or hypertension

Question 10

Reference in protocol for Rocuronium

Answer 10

RSI
Traumatic emergency
Cardiac emergency

Question 11

Classification of Succinylcholine

Answer 11

Depolarizing neuromuscular blocker, short acting skeletal muscle relaxant

Question 12

Action of succinylcholine

Answer 12

Prolongs depolarization of muscle endplate
Skeletal muscle relaxant, causing flaccid paralysis
No effect on consciousness, pain or cerebration

Question 13

Succinylcholine 1. Onset

2. Duration

Answer 13

1. 30-60 sec

2. 4-10 min

Question 14

Succinylcholine Indication

Answer 14

Facilitate ETI in pts. with a gag reflex

Question 15

Succinylcholine Contraindication

Answer 15

Glaucoma, eye injuries
Hyper K
>24 hrs post burn
>7 days post crush injury syndrome

Question 16

Succinylcholine Use with Caution

Answer 16

Dysrhythmias due to vagal stimulation

Increased ICP

Question 17

Succinylcholine Dosage and Administration

Answer 17

Adult: 1.5mg/kg IV
Ped: 1.5mg/kg IV, pre-treat with Atropine to prevent vagal stimulation

Question 18

Succinylcholine Adverse Reactions

Answer 18

1. prolonged muscle relaxation, resp. depression or apnea, disrrhythmias, arrhythmias, HTN, HYPOTN, excessive salivation
2. Potential ICP in 2nd and 3rd doses

Question 19

Succinylcholine Reference in Protocol

Answer 19

RSI

Traumatic (crush injury)

Question 20

Vecuronium Classification

Answer 20

1. Skeletal Muscle Relaxant

2. Non-depolarizing neuromuscular blocker

Question 21

Vecuronium Action

Answer 21

Skeletal muscle relaxation to facilitate ETI

Question 22

Vecuronium 1. Onset 2. Duration

Answer 22

1. 1 min

2. 25-30 min

Question 23

Vecuronium Indication

Answer 23

1. Maintain paralysis post intubation
2. Initial means of paralysis with Crush Injury Syndrome
3. May prevent fasciculations prior to administering Succinylcholine

Question 24

Vecuronium Contraindication

Answer 24

Hypersensitivity

Question 25

Vecuronium Use with Caution

Answer 25

1. Elderly
2. CVD, obesity, hepatic disease, neuromuscular disease
3. Do not mix with alkaline solutions

Question 26

Vecuronium Dosage and Administration

Answer 26

Adult: 0.1mg/kg IV
Ped: 0.1mg/kg IV

Question 27

Vecuronium Adverse Reactions

Answer 27

Respiratory insufficiency or apnea, wheezing, aspiration, bradycardia, sinus arrest, HTN, HYPOTN, increased intraocular pressure

Question 28

Vecuronium Reference in Protocols

Answer 28

RSI

Traumatic (Crush Injury)