NAGELHOUT PHARMACOLOGY 1 EXAM 1
EXAMPREP STUDY GUIDE QUESTIONS AND
CORRECT ANSWERS COMPLETE REVIEW
MATERIAL
●● Depolarizing NMB
Answer: Succinylcholine
●● Intermediate Acting Nondepolarizing NMBs (4)
(Length of duration)
Answer: Atracurium
Cisatracurium
Vecuronium
Rocuromium
(30-60 minutes)
●● Long Acting Nondepolarizing NMB
(Length of duration)
Answer: Pancuronium
60-90 minutes
,●● Short Acting Nondepolarizing NMBs
(Length of duration)
Answer: None
(20-30 minutes)
●● NMB Reversal Agents (3)
Answer: Neostigmine
Edrophonium
Sugammadex (not approved by FDA)
●● NMBs work at ____ receptors
Answer: Nicotinic Cholinergic (sub-m)
●● Neurotransmitter of the NM junction
Answer: acetylcholine
●● Breaks down acetylcholine at the NM synapse/junction
Answer: acetylcholinesterase
●● Non-depolarizing agents are: agonists or antagonists
Answer: Antagonist
,●● Depolarizing agents act as: agonist or antagonist??
Answer: Agonist then antagonist
●● Onset time definition
Answer: time from drug administration to maximum effect
●● Clinical duration definition
Answer: time from drug administration to 25% recovery of twitch
response
●● Total duration of action definition
Answer: time from drug administration to 90% recovery of twitch
response (point at which pt is recovered)
●● Recovery index definition
Answer: time from 25% to 75% recovery of twitch response (how fast?)
●● Train of Four Index
Answer: 4th twitch of TOF/1st twitch of TOF
●● Muscle stimulated by ulnar nerve in TOF
Answer: Adductor pollicis
, ●● Best nerve/muscle to measure onset of NMB
Answer: Facial Nerve
Orbicularis Oculi (Corrugator supercilii = best)
(reflects diaphragm blockade)
●● Best nerve/muscle to measure emersion from NMB
Answer: Ulnar Nerve
Adductor Pollicis
●● Single Twitch Test
Answer: 1.0 Hz
Single stimulus
Compares pre (baseline) and post NMB hand twitch
●● Train of Four Test
Answer: 4 - 2 Hz twitches
Compares 4th twitch to 1st twitch (fade)
Reflects 70-100% blockade
●● Double Burst Simulation (DBS) Test
Answer: 2 - 50 Hz twitches
0.75 seconds apart
EXAMPREP STUDY GUIDE QUESTIONS AND
CORRECT ANSWERS COMPLETE REVIEW
MATERIAL
●● Depolarizing NMB
Answer: Succinylcholine
●● Intermediate Acting Nondepolarizing NMBs (4)
(Length of duration)
Answer: Atracurium
Cisatracurium
Vecuronium
Rocuromium
(30-60 minutes)
●● Long Acting Nondepolarizing NMB
(Length of duration)
Answer: Pancuronium
60-90 minutes
,●● Short Acting Nondepolarizing NMBs
(Length of duration)
Answer: None
(20-30 minutes)
●● NMB Reversal Agents (3)
Answer: Neostigmine
Edrophonium
Sugammadex (not approved by FDA)
●● NMBs work at ____ receptors
Answer: Nicotinic Cholinergic (sub-m)
●● Neurotransmitter of the NM junction
Answer: acetylcholine
●● Breaks down acetylcholine at the NM synapse/junction
Answer: acetylcholinesterase
●● Non-depolarizing agents are: agonists or antagonists
Answer: Antagonist
,●● Depolarizing agents act as: agonist or antagonist??
Answer: Agonist then antagonist
●● Onset time definition
Answer: time from drug administration to maximum effect
●● Clinical duration definition
Answer: time from drug administration to 25% recovery of twitch
response
●● Total duration of action definition
Answer: time from drug administration to 90% recovery of twitch
response (point at which pt is recovered)
●● Recovery index definition
Answer: time from 25% to 75% recovery of twitch response (how fast?)
●● Train of Four Index
Answer: 4th twitch of TOF/1st twitch of TOF
●● Muscle stimulated by ulnar nerve in TOF
Answer: Adductor pollicis
, ●● Best nerve/muscle to measure onset of NMB
Answer: Facial Nerve
Orbicularis Oculi (Corrugator supercilii = best)
(reflects diaphragm blockade)
●● Best nerve/muscle to measure emersion from NMB
Answer: Ulnar Nerve
Adductor Pollicis
●● Single Twitch Test
Answer: 1.0 Hz
Single stimulus
Compares pre (baseline) and post NMB hand twitch
●● Train of Four Test
Answer: 4 - 2 Hz twitches
Compares 4th twitch to 1st twitch (fade)
Reflects 70-100% blockade
●● Double Burst Simulation (DBS) Test
Answer: 2 - 50 Hz twitches
0.75 seconds apart
