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Neuromuscular Blockers
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What are the clinical uses for neuromuscular blockers?
Facilitate tracheal intubation
Improve surgical working conditions
Mechanical ventilation of lungs
Treat laryngospasm
What do neuromuscular blockers do?
Interrupt transmission of nerve impulses at NMJ (postsynaptic receptor)
What are the two types of NMBs?
Depolarizing or nondepolarizing
Depolarizing
: bind to/activates receptor (succinylcholine for example)
Non depolarizing
: bind to and block the receptor so that acetylcholine can not bind
What is the brand name for Succinylcholine?
Anectine
What class of drug is Sux?
Depolarizing NMBD
What is Sux?
2 acetylcholine molecules stacked end-to-end
How is Sux used?
Intubation
Paralysis
Laryngospasm
What is the supplied concentration of Sux?
20mg/mL
What is the intubation dose for Sux?
1-2mg/kg IV
What is the laryngospasm concentration of Sux?
0.1mg/kg IV
What is the onset of Sux?
30 secs
What is the duration of action of Sux?
3-5 mins
What are fasciculations?
involuntary muscle twitches/contractions that are visible under the skin
a clue that the Sux has become effective
What will prevent the fasciculations seen in Sux?
A small dose of rocuronium (5-10mg)
How is Sux metabolized?
By plasma cholinesterase- not dependent on liver or kidneys
What are Sux adverse effects?
Hyperkalemia (increased blood postassium)
Myalgia (muscle pain/soreness)
What is the brand name for Rocuronium?
Zemuron
What class of drug is rocuronium?
aminosteroid, nondepolarizing
What is Roc used for?
to induce paralysis
For RSI
What is the onset for Roc?
1-2 minutes (can be faster if higher dose is given)
How long dose Roc last?
20-35 minutes
What is the metabolism of Roc?
Liver and kidneys
What is the intubation dose for Roc?
The maintenance dose?
The infusion dose?
Intubation:0.6-1.2mg/kg
Maintenance
: 0.1mg/kg
Infusion
: 5-12mcg/kg/min
What is the brand name for Vecuronium?
Norcuron
What class of drug is Vec?
aminosteroid, non-depolarizing
What is Vec used for?
Paralysis
How is Vec supplied?
10mg powder vial reconstitued to 1mg/mL
What is the onset of Vec?
3-5 mins
What is the duration of Vec?
20-35mins
How is Vec metabolized?
Liver and Kidneys
What are the doses of Vec?
Intubation:
Infusion:
Maitenance:
Intubation: 0.08-0.12mg/kg
Infusion
: 1-2mcg/kg/min
Maintenance
: 0.01mg/kg
What is the brand name for Cisatracurium?
Nimbex
What class of drug is cisatracurium?
Benzyl isoquinolinium, non-depolarizing
What is cisatracurium used for?
paralysis
What is the supplied concentration of cisatracurium?
20mg vial (2mg/mL)
What is the dose of cisatracurium?
Intubation:
Infusion:
Intubation
: 0.1-0.15mg/kg
Infusion
: 1-2mcg/kg/min
What is the onset of cisatracurium?
3-5mins
What is the duration of cisatracurium?
20-35mins
Why would one want Cisatracurium over Rocuronium?
Cisatrascurium is good for patients with renal and hepatic dysfunction
Intubation dose:
Pancuronium
Vecuronium
Rocuronium
Cisatracurium
Pancuronium
: 0.1mg/kg
Vecuronium
: 0.08-0.1 mg/kg
Rocuronium
: 0.6-1.2mg/kg
Cisatracurium
: 0.1mg/kg
Author
eoden
ID
171597
Card Set
Neuromuscular Blockers
Description
neuromuscular blockers in anesthesia
Updated
2012-09-18T03:13:41Z
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