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Marie Altagrace Medastin

on 18 May 2016

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Transcript of suga

By Marie Altagrace Medastin, CRNA, MSN


The first selective relaxant binding agent (SRBA)
Sugammadex (tradename Bridion)
rocuronium, vecuronium, and pancuronium in that order
Does not have affect atracurium or cisatracurium
operates with aminosteriod agents not benzylisoquinoline agent
indicated for the reversal of neuromuscular blockade by rocuronium or vecuronium
a modified gama-cyclodextrin
lipophilic core and a hydrophilic periphery
has negatively charged carboxyl thio extensions that electrostatically bind to the positively charged ammonium group of the NMBD
NMBD molecule (a modified steroid) bound within sugammadex's lipophilic core, is rendered unavailable to bind to the acetylcholine receptor at the neuromuscular junction, bound in a ratio of one sugammadex molecule to one molecule of the NMBA
causes a concentration gradient and any remaining rocuronium or vecuronium molecules are attracted back into the plasma and become bound to free sugammadex molecules
Benefits of Sugammadex
Reversal of NMBD without effecting acetylcholinesterase
Cardiovascular and autonomic stability
Short duration and fast onset
Avoid succinocholine
Renally excreted with no metabolites
Elimination 1/2 life is 1.8 hours
>90% of dose excreted within 24 hours
2mg/kg for children >2 to <17
Adults >18: 4mg/kg for deep blockade or 2mg/kg for moderate blockade
For immediate reversal max dose of 16mg/kg
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