CPAN REVIEW UPDATED TIPS QUESTIONS AND
ANSWERS SURE A+
✔✔morphine - ✔✔opioid:
-alt in pain perception and emotional response
-onset less than 1 min, peak 20 min
-duration 1-4 hrs
-myocardial function preserved
-causes histamine release, watch for hypersensitivity
-slight hypotension
✔✔fentanyl citrate (Sublimaze) - ✔✔opioid:
-short duration of action
-onset 1-3 min, duration 30-60 min
-stored in fat and muscle tissue
-watch for apnea and chest wall rigidity
-when released from tissue, may have delayed resp depression
-best for renal patients
✔✔naloxone (Narcan) - ✔✔opioid antagonist
-rapid reversal
-onset 1-2 min
-duration dependent on dose/route
, -dilute 0.4mg with 9ml NS
✔✔depolarizing agent - ✔✔neuromuscular blocking agent (muscle relaxant) that
occupies receptor sites on motor end plate causing initial depolarization of all skeletal
muscles
no reversal agents available
✔✔nondepolarizing agent - ✔✔neuromuscular blocking agent (muscle relaxant) that
occupies receptor sites on motor end plate without activation muscle contraction (block
activation)
can be revered after some spontaneous recovery
✔✔anticholinesterase, anticholinergic - ✔✔can reverse nondepolarizing muscle relaxant
agents
✔✔succinylcholine (Anectine) - ✔✔muscle relaxant: depolarizing agent
-metabolized by psudocholinesterase (if someone has deficiency block will be
prolonged)
-ultra short acting (onset 1 min, duration 5 min)
-no reversal agents
-postop myalgias
-bradycardia, alt potassium levels (poss cardiac standstill)
-major MH trigger
✔✔rocuronium (Zemuron)
vecuronium (Norcuron)
cisatracurium (Nimbex)
pancuronium (Pavulon)
atracuriu (Tracrium) - ✔✔nondepolarizing agents (5)
✔✔sugammadex - ✔✔med that reverses neuro blockade induced by rocuronium or
vecuronium in adults
-can reverse mod or deep block
-side effects: vomiting, dry mouth, tachy, dizziness, hypotension, occasionally neg
pressure pulm edema
✔✔urine - ✔✔sugammadex encapsulates roc/vec molecules and holds them until
excreted in _____
✔✔expensive
interacts with birth control
interacts with warfarin, Pradaxa, Xarelto - ✔✔downsides to sugammadex (3)
✔✔regional anesthesia - ✔✔injecting local anesthetic into a specific region of the body
in order to create a numbing effect; localized to area of surgery
ANSWERS SURE A+
✔✔morphine - ✔✔opioid:
-alt in pain perception and emotional response
-onset less than 1 min, peak 20 min
-duration 1-4 hrs
-myocardial function preserved
-causes histamine release, watch for hypersensitivity
-slight hypotension
✔✔fentanyl citrate (Sublimaze) - ✔✔opioid:
-short duration of action
-onset 1-3 min, duration 30-60 min
-stored in fat and muscle tissue
-watch for apnea and chest wall rigidity
-when released from tissue, may have delayed resp depression
-best for renal patients
✔✔naloxone (Narcan) - ✔✔opioid antagonist
-rapid reversal
-onset 1-2 min
-duration dependent on dose/route
, -dilute 0.4mg with 9ml NS
✔✔depolarizing agent - ✔✔neuromuscular blocking agent (muscle relaxant) that
occupies receptor sites on motor end plate causing initial depolarization of all skeletal
muscles
no reversal agents available
✔✔nondepolarizing agent - ✔✔neuromuscular blocking agent (muscle relaxant) that
occupies receptor sites on motor end plate without activation muscle contraction (block
activation)
can be revered after some spontaneous recovery
✔✔anticholinesterase, anticholinergic - ✔✔can reverse nondepolarizing muscle relaxant
agents
✔✔succinylcholine (Anectine) - ✔✔muscle relaxant: depolarizing agent
-metabolized by psudocholinesterase (if someone has deficiency block will be
prolonged)
-ultra short acting (onset 1 min, duration 5 min)
-no reversal agents
-postop myalgias
-bradycardia, alt potassium levels (poss cardiac standstill)
-major MH trigger
✔✔rocuronium (Zemuron)
vecuronium (Norcuron)
cisatracurium (Nimbex)
pancuronium (Pavulon)
atracuriu (Tracrium) - ✔✔nondepolarizing agents (5)
✔✔sugammadex - ✔✔med that reverses neuro blockade induced by rocuronium or
vecuronium in adults
-can reverse mod or deep block
-side effects: vomiting, dry mouth, tachy, dizziness, hypotension, occasionally neg
pressure pulm edema
✔✔urine - ✔✔sugammadex encapsulates roc/vec molecules and holds them until
excreted in _____
✔✔expensive
interacts with birth control
interacts with warfarin, Pradaxa, Xarelto - ✔✔downsides to sugammadex (3)
✔✔regional anesthesia - ✔✔injecting local anesthetic into a specific region of the body
in order to create a numbing effect; localized to area of surgery
