ND-NMB acts as competitive antagonist →
competes with ACh for nAChR binding → blocks cholinergic transmission → muscle
relaxation (> 70% post-synaptic nAChR occupancy required to result in block)
ND-NMB also inhibits pre-synaptic ACh receptors →prevents enhancement of ACh
release → fade with repeated stimulation

ND-NMB acts as competitive antagonist →
competes with ACh for nAChR binding → blocks cholinergic transmission → muscle
relaxation (> 70% post-synaptic nAChR occupancy required to result in block)
ND-NMB also inhibits pre-synaptic ACh receptors →prevents enhancement of ACh
release → fade with repeated stimulation

Doesn’t cross BBB

PB 10%

PB 15%

VD 0.2L/kg

VD 0.15L/kg

<5% Metabolism Hep

77% Hofmann degradation →
laudanosine and quat.
monoacrylates
Minimal ester hydrolysis
Inactive metabolites

Renal: 30-40%
Liver: 60%

Ren: 10-30% (laud.)
Liver: (laudanosine)

Pl cl: 3ml/kg/min

Pl cl 4-5ml/kg/min

El t1/2: 90mins

El t1/2: 25mins

HISTAMINE RELEASE
- None
EFFECT ON ANS
- Can be vagolytic (↑HR)
OTHER
- Anaphylaxis
- Pain on injection

HISTAMINE RELEASE
- None
VAGOLYSIS
- None
OTHER
- Anaphylaxis

Monoquaternary

Bisquaternary. 1 of 10 stereoisomers. In atrac (15% wt, 50% pot)

Non-Depolarizing
Aminosteroid

Non-Depolarizing
Isoquinolone

1. to facilitate tracheal intubation during routine and modified rapid
sequence induction
2. for controlled ventilation.

to facilitate intubation and controlled ventilation

Aminosteroid

Benzylisoquinolinium ester

Level 1

Level 1

Int @ 100 – 120s
RSI @ 60s
Duration 35mins

Intubate @ 3 – 5min

Duration 45mins

Clear, colourless solution, 10mg/mL rocuronium bromide

Clear, 10mg in 5mL as cisatracurium besylate, stored at 4°C.

ED95 0.3 mg/kg
Int 0.6 mg/kg
RSI 0.9 ~ 1.2 mg/kg
Inf 9 – 12 mcg/kg/min

ED95 0.05 mg/kg
Int 0.15 mg/kg

Inf 1 – 2 mcg/kg/min

Duration prolonged by:
- ↓K ↓Ca ↑Mg
- ↑pH ↑PaCO2
- ↓temp ↓protein Dehydration

Reversible with sugammadex

Duration prolonged by:
- ↓K ↓Ca ↑Mg
- ↑pH ↑PaCO2
- ↓temp ↓protein Dehydration