Pulmonary Disorders I

Reversal of nondepolarizing NMBAs with a failed airway

An acetylcholinesterase inhibitor (neostigmine or pyridostigmine) in combination with an

anticholinergic (atropine or glycopyrrolate)

Sugammadex binds the aminosteroid class of nondepolarizing NMBAs (vecuronium and

rocuronium).

Agent

Dose

Onset

Duration

Cautions

Succinylcholine

IV: 1–2 mg/kg

IM: 3–4 mg/

kg (max 150

mg)

IV: 1 min

IM: 2–3 min

IV: 3–5 min

IM: 10–30

min

deficiency

hyperkalemia (prolonged immobilization,

crush injuries, myopathies, burns, muscular

dystrophy, stroke, and spinal cord injuries)

Rocuronium

IV: 0.6–1.2

mg/kg

1–2 min

30–60 min

dysfunction, minimal increase in duration

with renal dysfunction

Vecuronium

IV: 0.08–0.1

mg/kg

2–3 min

20–60 min

dysfunction

Provide continued sedation/analgesia as needed if an intermediate-acting NMBA was used and assists

in adequate oxygenation and ventilation

Maintain head-of-bed elevation at 30–45 degrees

Mouth and eye care

Bowel regimen

Stress ulcer and deep vein thrombosis prophylaxis