Reversal Agents - Sugammadex Flashcards
Sugammadex
(Used at ARMC if you have 0/4 twitches and case is done or when infiltration of IV is seen after reversing)
What is the recommended dose of Sugammadex if the patient is experiencing a deep neuromuscular block after recent neuromuscular blocking drug (NMBD) administration?
A) 2 mg/kg
B) 4 mg/kg
C) 8 mg/kg
D) 16 mg/kg
D) 16 mg/kg
What adverse effect can occur if Sugammadex is pushed too quickly via IV?
A) Hypertension
B) Bradycardia
C) Hypotension (HoTN)
D) Tachycardia
C) Hypotension (HoTN)
When would you administer Sugammadex at a dose of 2 mg/kg?
A) When there are 2 twitches in the train-of-four (TOF) count
B) When there is 1 post-tetanic twitch
C) When the patient is under deep neuromuscular block
D) When the patient has 0/4 twitches in TOF count
A) When there are 2 twitches in the train-of-four (TOF) count
What is the primary mechanism of action of Sugammadex?
A) Competitive inhibition at nicotinic acetylcholine receptors
B) Enzymatic breakdown of neuromuscular blocking drugs (NMBDs)
C) Encapsulation and inactivation of aminosteroid NMBDs, forming a water-soluble complex
D) Reversal of benzylisoquinolinium-induced neuromuscular block
C) Encapsulation and inactivation of aminosteroid NMBDs, forming a water-soluble complex
MOA: Encapsulates and inactivates aminosteroid NMBDs (Roc>Vec); results in formation of water-soluble complex; reverses profound aminosteroid-induced block
You encounter a patient with 1 post-tetanic twitch after a neuromuscular block. What is the appropriate dose of Sugammadex for reversal?
A) 2 mg/kg
B) 4 mg/kg
C) 8 mg/kg
D) 16 mg/kg
B) 4 mg/kg
What is the onset time of Sugammadex when administered intravenously?
A) 1 minute
B) 3 minutes
C) 5 minutes
D) 10 minutes
B) 3 minutes
Which concentration of Sugammadex is available for use?
A) 50 mg/mL
B) 100 mg/mL
C) 150 mg/mL
D) 200 mg/mL
B) 100 mg/mL
What is the half-life of Sugammadex in patients with normal renal function?
A) 30 minutes
B) 2 hours
C) 6 hours
D) 19 hours
B) 2 hours
½ Life: 2 hours (depends on renal function; up to 19 hours in severe impairment)
How is Sugammadex primarily eliminated from the body?
A) Metabolized by the liver
B) Excreted in bile
C) Mostly excreted unchanged in urine
D) Metabolized by the kidneys
C) Mostly excreted unchanged in urine
Elimination: No metabolites; mostly excreted unchanged in urine; 90% out by 24 hours; 70% out in 6 hours
What percentage of Sugammadex is eliminated within 6 hours after administration?
A) 50%
B) 70%
C) 90%
D) 100%
B) 70%
What type of molecule is Sugammadex classified as?
A) Gamma-Cyclodextrin
B) Beta-Blocker
C) Cholinesterase inhibitor
D) Neuromuscular blocking agent
A) Gamma-Cyclodextrin
How long does it take for 90% of Sugammadex to be excreted from the body in patients with normal renal function?
A) 6 hours
B) 12 hours
C) 24 hours
D) 48 hours
C) 24 hours
Sugammadex is contraindicated in which of the following scenarios? (Multiple Answer)
A) Hypersensitivity to Sugammadex
B) Hypersensitivity to cyclodextrins
C) Renal impairment
D) Hepatic failure
A) Hypersensitivity to Sugammadex
B) Hypersensitivity to cyclodextrins
C/I: In hypersensitivity to Sugammadex (0.3%) in past or cyclodextrins.
Which of the following is a true statement regarding Sugammadex’s effects? (Multiple Answer)
A) Sugammadex has no cholinergic effects such as bradycardia.
B) Sugammadex can reduce the free plasma concentrations of hormonal contraceptives.
C) Sugammadex is effective against benzylisoquinoline neuromuscular blocking drugs (NMBDs).
D) Sugammadex requires caution in patients with renal impairment.
Correct Answers: A, B, D
