Nagelhout Pharm 2 Exam 1
Ultra short acting depolarizer - Answer-Succinylcholine
Short-Acting non-depolarizer - Answer-NONE
Intermediate acting non-depolarizer - Answer--Atracurium
-Cisatracurium
-Vecuronium
-Rocuronium
Long acting non-depolarizer - Answer--Pancuronium
Agents used to treat alzheimers - Answer--Donepezil (Aricept)
-Rivastigmine (Exelon)
-Galantamine (Razadyne)
-Tacrine (Cognex)
How do alzheimer's drugs work? - Answer-They are cholinesterase inhibitors. More acetylcholine
availability, patient more alert/aware.
What is important to know about alzheimer's drugs and anesthetic? - Answer-Succinylcholine effects
may last longer. Inability to appropriately breakdown excess acetylcholine.
Single twitch monitoring test - Answer--A single electrical stimulus ranging from 0.1-1.0 Hz.
,*Requires baseline before drug administration; generally used as qualitative rather than quantitative
assessment.*
Train-of-four test? Useful during? Not used with? - Answer-A series of four twitches at 2Hz. Every half
second for two seconds.
*Reflects blockade from 70-100%;
useful during onset, maintenance and emergence.
Administration of Succs
Double-burst test - Answer-Two short bursts of 50Hz tetanus seperated by 0.75 seconds.
*Similar to TOF; useful during onset, maintenance, and emergence; may be easier to detect fade than
with TOF; tactile evaluation.*
Tetanus test - Answer-Generally, consists of rapid delivery of a 30, 50, or 100 Hz stimulus for 5 seconds.
*Should be used sparingly for deep block assessment, painful.*
Posttetanic count? Parameters? - Answer-50-Hz. Tetanus for 5 seconds, a 3 second pause, then single
twitches of 1Hz.
*Used only when TOF or double burst stimulation response is absent; count less than eight indicates a
deep block, and prolonged recovery is likely.*
, Onset time - Answer-Time from drug administration to maximal effect.
Clinical duration - Answer-Time from drug administration to 25% recovery of twitch response
Total duration of action - Answer-Time from drug administration to 90% recovery of twitch response
Recovery Index - Answer-time from 25% to 75% recovery of twitch response
Where to measure onset of relaxant - Answer-Facial nerve. Orbicularis oculi and corrugator supercilii
(*best site*).
Where to measure recovery from relaxant - Answer-Ulnar nerve innervation of adductor pollicis.
Sequence of onset of muscle relaxant? Recovery? - Answer-1. Eye lids
2. Extremities
3. Chest - intercostals (from strap muscles in the neck downward).
4. Abdominal muscles
5. Diaphragm
Vice Versa
4 Characteristics of NM blockade? - Answer-Oribicularis oculi response to facial nerve stimulation
reflects the extent of neuromuscular blockade of the diaphragm better than does the adductor pollicis.
upper airway muscles are more sensitive than peripheral muscles
Ultra short acting depolarizer - Answer-Succinylcholine
Short-Acting non-depolarizer - Answer-NONE
Intermediate acting non-depolarizer - Answer--Atracurium
-Cisatracurium
-Vecuronium
-Rocuronium
Long acting non-depolarizer - Answer--Pancuronium
Agents used to treat alzheimers - Answer--Donepezil (Aricept)
-Rivastigmine (Exelon)
-Galantamine (Razadyne)
-Tacrine (Cognex)
How do alzheimer's drugs work? - Answer-They are cholinesterase inhibitors. More acetylcholine
availability, patient more alert/aware.
What is important to know about alzheimer's drugs and anesthetic? - Answer-Succinylcholine effects
may last longer. Inability to appropriately breakdown excess acetylcholine.
Single twitch monitoring test - Answer--A single electrical stimulus ranging from 0.1-1.0 Hz.
,*Requires baseline before drug administration; generally used as qualitative rather than quantitative
assessment.*
Train-of-four test? Useful during? Not used with? - Answer-A series of four twitches at 2Hz. Every half
second for two seconds.
*Reflects blockade from 70-100%;
useful during onset, maintenance and emergence.
Administration of Succs
Double-burst test - Answer-Two short bursts of 50Hz tetanus seperated by 0.75 seconds.
*Similar to TOF; useful during onset, maintenance, and emergence; may be easier to detect fade than
with TOF; tactile evaluation.*
Tetanus test - Answer-Generally, consists of rapid delivery of a 30, 50, or 100 Hz stimulus for 5 seconds.
*Should be used sparingly for deep block assessment, painful.*
Posttetanic count? Parameters? - Answer-50-Hz. Tetanus for 5 seconds, a 3 second pause, then single
twitches of 1Hz.
*Used only when TOF or double burst stimulation response is absent; count less than eight indicates a
deep block, and prolonged recovery is likely.*
, Onset time - Answer-Time from drug administration to maximal effect.
Clinical duration - Answer-Time from drug administration to 25% recovery of twitch response
Total duration of action - Answer-Time from drug administration to 90% recovery of twitch response
Recovery Index - Answer-time from 25% to 75% recovery of twitch response
Where to measure onset of relaxant - Answer-Facial nerve. Orbicularis oculi and corrugator supercilii
(*best site*).
Where to measure recovery from relaxant - Answer-Ulnar nerve innervation of adductor pollicis.
Sequence of onset of muscle relaxant? Recovery? - Answer-1. Eye lids
2. Extremities
3. Chest - intercostals (from strap muscles in the neck downward).
4. Abdominal muscles
5. Diaphragm
Vice Versa
4 Characteristics of NM blockade? - Answer-Oribicularis oculi response to facial nerve stimulation
reflects the extent of neuromuscular blockade of the diaphragm better than does the adductor pollicis.
upper airway muscles are more sensitive than peripheral muscles
