Neuromuscular Reversal Agents

5.10
Neuromuscular Reversal Agents

Sugammadex

  • Mechanism of Action
    • Binds and antagonizes rocuronium and vecuronium
  • Clinical Indications
    • Reversal of neuromuscular blockade
      • Depends on the degree of blockade
      • 2–4 mg/kg IV
    • Rapid reversal of neuromuscular blockade
      • 16 mg/kg IV
  • Cerebral
    • Minimal
  • Cardiovascular
    • Case reports of bradycardia and PEA after administration
  • Pulmonary
    • Possible acute bronchospasm from anaphylactoid reaction
  • Renal
    • Eliminated unchanged by the kidneys
  • Hepatic
    • Minimal
  • Contraindications
    • Renal disease [27]
  • Board Facts
    • Fastest neuromuscular blockade reversal agent [71]
    • Antimuscarinic coadministration is not necessary
    • ↓ Birth control efficacy [72]
    • After sugammadex administration, larger dose of rocuronium/vecuronium, cisatracurium or succinylcholine will be required for re‐paralysis
    • ↓ Incidence of PONV compared to neostigmine [73]

Neostigmine

  • Neostigmine
  • Pyridostigmine
  • Edrophonium
  • Physostigmine
  • Mechanism of Action
    • Inhibits acetylcholinesterase
  • Clinical Indications
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  6. Gastrointestinal Disease

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Oct 16, 2024 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Neuromuscular Reversal Agents

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