PNS And NMB

Question 1

4 monitoring phases

Answer 1

Baseline (no NMB)
Intubation- intub dose NMB
Maintenance- redosing
Emergence- reversal

Question 2

Order of muscles most resistant to most sensitive 8

Answer 2

VC, diaphragm, orbicularis oculi, abd rectus, adductor pollicis, masseter, pharyngeal, extraocular

Question 3

% NMB left with: 4 responses, 3 responses, 2 responses, 1 response

Answer 3

<70%, 75%, 80%, 90%

Question 4

TOF ratio

Use, how to

Answer 4

Non depolarizing blocks. Last divided by first

Question 5

NMB dosing types

Answer 5

Intubating dose, relaxant dose (after sch for ett), or defasciculating (before sch)

Question 6

Succ

__ acting. Dose. Larger dose needed when what

Answer 6

Short. 0.5-2 mg/kg. If precurarization w NDMR.

Question 7

Succ

Onset, DOA, gtt rate

Answer 7

30-60 sec. 3-5 min. 1g/500 ml, 2-4 mg/min or 50-100 mcg/kg/min

Question 8

Mivacurium

__ acting. Dose. When to use.

Answer 8

Short. 0.2 mg/kg. To avoid myalgia w succ

Question 9

Mivacurium

Onset, DOA, useful when

Answer 9

2-3 min, 12-20 min. O/P surgery for intubation

Question 10

Intermediate acting
DOA
Onset- which most rapid
Minimal __ effects

Answer 10

20-30 min. Roc. Circulatory.

Question 11

How much of dose as priming dose

Answer 11

1/10 of surgical relaxation dose

Question 12

Doses
Roc
Vec

Answer 12

0.6-1.2 mg/kg

.1-.2 mg/kg

Question 13

Doses
Atracurium
Cis-atracurium

Answer 13

.2-.5 mg/kg

.15-.2 mg/kg

Question 14

Long acting muscle relaxants
Onset
Maintenance for which procedure length
Duration

Answer 14

3-5 min, >2 hr procedure, 60-90 min

Question 15

Long acting muscle relaxants

Drug, dose

Answer 15

Pancuronium

.07-.15 mg/kg

Question 16

Gtt rate
Atracurium
Vec
Roc

Answer 16

4-12 mcg/kg/min
1 mcg/kg/min
3-12 mcg/kg/min

Question 17

Gtt rate
Cisatracurium
Mivacurium

Answer 17

0.4-4 mcg/kg/min

3-15 mcg/kg/min

Question 18

Intubating dose (mg/kg)
Panc
Doxacurium

Answer 18

.1

.05-.08

Question 19

Intubating dose (mg/kg)
Pipecuronium
Atracurium

Answer 19

.14

.4-.5

Question 20

Intubating dose (mg/kg)
Vec
Roc

Answer 20

.08-.1

.6-1.2

Question 21

Intubating dose (mg/kg)
Cisatracurium
Mivacurium

Answer 21

.1

.25

Question 22

Adequate surgical relaxation for abdominal surgery

Answer 22

> 80% twitch depression, 1 or 2 twitches on TOF

Question 23

Succ

Intermittent doses, max, timing

Answer 23

0.6 mg/kg over 10-30 sec, 150 mg total

Question 24

Succ maintenance dose, timing

Answer 24

.04-.07 mg/kg q 5-10 min

Question 25

Succ gtt dose

Answer 25

2.5 mg/min (0.5-10) | Dilute 1-2 mg/ml

Question 26

Mivacurium Intubation dose Extended block dose Recovery when

Answer 26

.15mg/kg bolus 6-7 mcg/kg/min 15-30 min

Question 27

Roc Intubation: rsi Maintenance

Answer 27

.6-1.2 mg/kg, 0.6 initial. | .1-.2 mg/kg

Question 28

Roc | Maintenance dose gtt

Answer 28

.01-.012 mg/kg/min

Question 29

Roc Skeletal muscle relaxation Initial, maint

Answer 29

0.6 mg/kg. 0.1-0.2 mg/kg repeated as needed or just do gtt

Question 30

Vec Intermittent dose Higher dose for rapid onset Maintenance

Answer 30

.08-.1 mg/kg IBW. (0.3) | .01-.015 mg/kg q 25-45 min

Question 31

Vec Bolus then gtt Reduce dose in who

Answer 31

.08-.3 mg/kg bolus, then in 30 min.1 mcg/kg/min (0.8-1.2). | Renal failure q

Question 32

Atracurium May be given as what Initial bolus then which dose after

Answer 32

Undiluted | 0.4-.5 mg/kg then .08-.01 mg/kg q 20-45 min

Question 33

Atracurium | Gtt

Answer 33

After bolus (.4 mg), 5-9 mcg/kg/min gtt. (2-15 range)

Question 34

Atracurium Dont use in what, why Vial concentration

Answer 34

Renal failure- toxic metabolite iadanosine | 50 mg/5 ml or 100 mg/10 ml

Question 35

Cisatracurium (nimbex) | Initial dose, following doses

Answer 35

.15-.2 MG/KG | .03 mg/kg q 50 min

Question 36

Nimbex Gtt Dose reductions

Answer 36

Bolus dose then 1-3 mcg/kg/min. Renal or hepatic failure- dont need to reduce dose

Question 37

Nimbex is DOC in which cases

Answer 37

HR high or MAP >110 on panc, steroid use >72hrs, renal dysfunc (cr cl <30 ml/min), hx asthma/bronchospasm

Question 38

Pancuronium Intermittent dose Bolus/gtt

Answer 38

.1-.2 mg/kg q 1-3 hrs | Load: .04-.1 mg/kg, then 1-1.7 mcg/kg/min

Question 39

Doxacurium Anesthesia adjunct Initial then what, duration

Answer 39

.05-.08 mg/kg, 100-160 min

Question 40

Doxacurium | Maintenance, duration

Answer 40

.005-.01 mg/kg, 30-45 min

Question 41

Doxacurium ETT intubation dose Concentration

Answer 41

.05 mg/kg. If w succ .025. | 1 mg/ml

Question 42

__, __, and __ are antag by __ within __ min when single twitch is 10% of control. Or __ min when all 4 twitches are present

Answer 42

Atra, vec, panc. 30. 10.

Question 43

``` Test - TOF equivalent 5 sec head/leg lift Normal grip Masseter All uncomfortable at TOF ```

Answer 43

0. 6 0. 7 0. 86

Question 44

Neostigmine | Dose, onset, duration

Answer 44

25-75 mcg/kg 5-15 min 45-90 min

Question 45

Pyridostigmine Dose On DOA

Answer 45

100-300 mcg/kg 10-20 60-120

Question 46

Edrophonium Dose On DOA

Answer 46

500-1000 mcg/kg 5-10 30-60

Question 47

Atropine Dose Onset Duration

Answer 47

15 mcg/kg 1-2 min 1-2 hr

Question 48

Glyco Dose Onset DOA

Answer 48

10-20 mcg/kg 2 min 2-4 hr

Question 49

Which drug most reliable in deep block

Answer 49

Neostigmine

Question 50

Onset and peak glyco vs neostigmine. Atropine peak.

Answer 50

Neo: on 3 min, peak 7-10 min. Glyco peaks 3-5 min. Atropine 1-2 min