Muscle Relaxants

Topics in this chapter

• Neuromuscular Blocker Pharmacology
• Succinylcholine and Depolarizing Block
• Nondepolarizing Relaxants
• Pharmacokinetics and Elimination
• Adverse Effects and Complications
• Monitoring and Reversal

Practice questions

1. Question 1Q-12A1EA

   A 35-year-old male is scheduled for an emergency exploratory laparotomy. Rapid sequence intubation (RSI) is planned. Which of the following neuromuscular blocking agents has the fastest onset of action at standard intubating doses?

   1. A.Atracurium
   2. B.Succinylcholine
   3. C.Rocuronium
   4. D.Vecuronium
   See the answer and solution
2. Question 2Q-5AAF50

   Which of the following non-depolarizing muscle relaxants undergoes Hofmann elimination, making it the agent of choice in patients with severe hepatic and renal failure?

   1. A.Pancuronium
   2. B.Vecuronium
   3. C.Cisatracurium
   4. D.Rocuronium
   See the answer and solution
3. Question 3Q-773F94

   A 50-year-old man with end-stage renal disease receives vecuronium for general anesthesia. Postoperatively, he experiences prolonged neuromuscular blockade. Which pharmacokinetic property of vecuronium explains this observation?

   1. A.Hepatic degradation by plasma esterases
   2. B.Renal excretion of active metabolites
   3. C.Pulmonary elimination
   4. D.Hofmann elimination
   See the answer and solution
4. Question 4Q-3D7551

   Sugammadex is a modified gamma-cyclodextrin designed specifically to reverse the neuromuscular blockade induced by which of the following drugs?

   1. A.Succinylcholine
   2. B.Rocuronium
   3. C.Atracurium
   4. D.Mivacurium
   See the answer and solution
5. Question 5Q-62E965

   Which of the following adverse effects is classically associated with the administration of succinylcholine in patients with severe burns, massive trauma, or upper motor neuron lesions?

   1. A.Severe hypokalemia
   2. B.Hyperkalemic cardiac arrest
   3. C.Metabolic alkalosis
   4. D.Prolonged apnea due to plasma cholinesterase deficiency
   See the answer and solution