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Flashcards in NMBD Deck (14)
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1

Succinylcholine dosage:

1 mg/kg - 60 sec onset
9-13 minutes to recover to 90% strength

2

Why rapid recovery?

SCH is rapidly metabolized in plasma by pseudocholinesterase. SCH rapidly diffuses away from NMJ - no pseudocholinesterase present in NMJ

3

What else does pseudocholinesterase metabolize?

SCH, mivacurium, procaine, chloroprocaine, tetracaine, cocaine, heroin

4

Dibucaine test numbers:

>70 - normal
40-60 heterozygous 1.5-2x longer
<30 homozygous 4-8 hrs

5

SCH cardiovascular effects:

Bradycardia, junctional rhythm, sinus arrest

6

SCH kalemia effects:

Increase 0.5 mEq/dL in healthy individuals

7

Susceptible to hyperkalemia:

burn, severe abdominal infections, metabolic acidosis, closed head injury, hemi or paraplegia, muscular dystrophies, guillain-barre

8

Intermediate acting steroid agents

Vecuronium, Rocuronium

9

Intermediate acting benzlisoquinolinium

Atracurium, Cisatracurium

10

Steroid NMBA potency

Pan>Van>Roc

11

Vecuronium metabolism:

Liver is principle organ, 30-40% cleared in bile unchanged. Renal 30%

12

Rocuronium metabolism:

Primarily eliminated by the liver and excreted in bile

13

Factors that increase non-depolarizing potency

-Inhalational anesthetics (Des>Sevo>Iso) - decrease the dosage required, prolong the duration of action and time to recovery
-Aminoglycosides, clindamycin
-Hypothermia, magnesium sulfate

14

NMBA that release histamine?

Benzylisoquinolinium agents - atracurium, mivacurium, tubocurarine