Vecuronium

Question 1

What will shorten the duration of block by vecuronium?

Answer 1

Phenytoin

Carbamazepine

(they induce liver enzymes)

Question 2

What will potentiate the effects of NMBs?

Answer 2

• acidosis
• high dose gent
• magnesium

Question 3

What will prolong the duration of block by vecuronium?

Answer 3

Hepatic/renal dysfunction, because vec is metabolised in the liver and excreted in bile/urine

Question 4

What is the absorption/distribution of vecuronium?

Answer 4

• 10% protein bound
• volume of distribution - 0.23 L/kg

Question 5

What is the MOA of vecuronium?

Answer 5

• competitive inhibition of ACh at nicotinic receptors at NMJ
  
  • binds to alpha subunit of receptor but does not open ion channel

Question 6

What is the dose of vecuronium?

Answer 6

• 0.1 mg/kg allows intubation 90-120s
• duration 45mins
• white powder (10mg/vial) for reconstitution with water

Question 7

How is vecuronium metabolised?

Answer 7

• hepatic metabolism by deacetylation
  
  • 3 and 17-hydroxyvecuronium
  • 3, 17-hydroxyvecuronium
• clinically insignificant metabolites
• excreted in bile 70%
• excreted in urine 30%

Question 8

What is vecuronium?

Answer 8

Monoquaternary analogue of pancuronium - differs by one methyl group