Core pharmacology

Class Group

Neuromuscular - Miscellaneous

Legacy Cicm Level

Level 3

Introduction

Cyclodextrin Selective Relaxant Binding Agent

Indications Uses

1. Reversal of NMB by aminosteroid NMBA (Rocuronium>vecuronium>>pancuronium)

Presentation

Clear colourless or pale yellow solution for injection
Contains 100mg/ml of y-Cyclodextrin Sugammadex

Mechanism of action

Encapsulates steroid portion of aminosteroid molecules. The binding leads to a decrease of free drug in the central compartment, leading to a diffusion gradient away from the NMJ.
Median time to recovery 90 seconds

Adverse Effects Toxicity

1. Anaphylaxis
2. Fluclox can displace aminosteroids from Sugammadex

Protein binding

Not protein bound

Metabolism

None

Excretion

95% unaltered in urine

Half-life

T1/2 is 1.8 hours

Route And Dose

4mg/kg for deep block
2mg/kg for shallow block
16mg/kg for rescue reversal in RSI CICO scenario