MB40

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MB39 | MB41 | MCQ-Muscle Relaxants & Antagonists | Primary Pharmacology Black Bank

Question

MB40 [Jul2012]
ED95 in regards to neuromuscular blockers means.
 A. Dose required to cause twitch height depression TO 95% of control value
 B. Dose required to cause twitch height depression OF 95% of control value
 C. 95% of patients will be paralysed at this dose

Answer:B almost CORRECT

ED95: MEDIAN dose required for 95% twitch depression, in other words 95% depression of twitch height in 50% of patients, that's why we use 2 X ED95 for intubation

MB40 - 15A-15B-16B

Sugammadex causes effective reversal of:
A. Rocuronium

B. Vecuronium

C. Rocuronium and Vecuronium
D. Rocuronium, vecuronium and pancuronium

E. None of the above

Comments

ANSWER C

From Open Anesthesia:
According to Miller, potency of a NMBD is best described as the effective dose –
“The dose of a neuromuscular blocking drug required to produce an effect (e.g., 50%,
90%, or 95% depression of twitch height, commonly expressed as ED50, ED90, and ED95,
respectively“. 
Thus, the ED95 is the amount of NMBD required to reduce twitch height by 95%.

ED95 (mg/kg) of Commonly used NMBDs (Adapted from Table 29-4 in Miller)

   Rocuronium: 0.31 (0.6-1 mg/kg induction, 1.9 to 3.2x the ED95)
   Vecuronium: 0.04 (0.1 mg/kg induction, 2.5x the ED95)
   Pancuronium: 0.07 (0.1 mg/kg induction, 1.4x the ED95)
   Cisatracurium: 0.04 (0.2 mg/kg induction, 5x the ED95, onset in 2.8 mins (Ref. 1)

Note that the reason that rocuronium onset is so rapid is that it is not very potent,
thus high concentrations (10-fold higher than for vecuronium and pancuronium) are required.


References

  • Stoelting, 5th ed, p338
Dr mitta 11:12, 18 November 2015 (CST)
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