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Differences in rocuronium over other non-depolarizing muscle relaxants (NDMR) include which of the following?
A. More rapid onset of action
B. Metabolism by pseudocholinesterase
C. Shorter duration of action
D. Lack of potentiation with aminoglycoside antibiotics
E. Active metabolism by liver enzymes
Answer
The answer is A. Of the nondepolarizing muscle relaxants in current use, rocuronium has the most rapid onset of action at clinically indicated dosages. Rocuronium is a nondepolarizing neuromuscular relaxant with an intermediate duration of action in adults, although this duration of action may be prolonged in infants and may be classified as a long-acting NMBD. Its duration of action in adults is similar to vecuronium, atracurium, and cisatracurium. Rocuronium may have a prolonged duration of action in patients with renal or hepatic dysfunction, especially at higher dosing (2-3 x ED95). At an ED95 dose (0.3 mg/kg), the onset time is 1.5 to 3 minutes, whereas with the other intermediate nondepolarizing muscle relaxants, the onset time is much longer (3 to 7 minutes). Increasing the dosage of rocuronium to 2-4 x the ED95 can decrease onset time to 60-90 seconds. This makes rocuronium a viable alternative for rapid sequence induction of patients in which you may want to avoid succinylcholine (pediatric population). [1].
Notes
- ↑ Barash: Clinical Anesthesia, ed 5, pp 427, 435-436
Keywords
Wikipedia:Neuromuscular-blocking_drug
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