NAGELHOUT EXAM SCRIPT STUDY GUIDE 2026 FULL SOLUTION A+

NAGELHOUT EXAM SCRIPT STUDY GUIDE 2026
FULL SOLUTION A+

◉ 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