Reversal of Nondepolarizing Muscle Relaxants

Updated: October 17, 2022

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Background

Epidemiology

Anatomy

Pathophysiology

Etiology

Genetics

Prognostic Factors

Clinical History

Physical Examination

Age group

Associated comorbidity

Associated activity

Acuity of presentation

Differential Diagnoses

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

Staging

Treatment Paradigm

by Stage

by Modality

Chemotherapy

Radiation Therapy

Surgical Interventions

Hormone Therapy

Immunotherapy

Hyperthermia

Photodynamic Therapy

Stem Cell Transplant

Targeted Therapy

Palliative Care

Medication

 

pyridostigmine

0.1 - 0.25

mg/kg

Orally 

once a day


for full recovery 10-20 mg is very effective
To prevent side effects a dose of 0.6-1.2 mg IV atropine sulfate given immediately before pyridostigmine



pyridostigmine

0.1 - 0.25

mg/kg

Orally 

once a day


for full recovery 10-20 mg is very effective
To prevent side effects a dose of 0.6-1.2 mg IV atropine sulfate given immediately before pyridostigmine



neostigmine and glycopyrrolate 

The recommended IV dosage of neostigmine/glycopyrrolate is (0.03 mg/kg/ 0.006 mg/kg)
To counteract the effects of neuromuscular blocking agents with half-lives usually briefer or in cases where the initial twitch response exceeds 10% of baseline or if a second twitch is observed
The recommended IV dosage of neostigmine/glycopyrrolate is (0.07 mg/kg/0.014 mg/kg)
To counteract the effects of NMBAs with extended half-lives, or in situations where the initial twitch response approaches approximately 10% of the baseline or when there is a requirement for swift recovery
The total maximum dose of neostigmine is either 0.07 mg/kg or a maximum of 5 mg of neostigmine, depending on whatever amount is small



metocurine 

Administer dose of 0.1 to 0.2 mg/kg intravenously



 

pyridostigmine

0.1 - o.2

mg/kg

Intravenous (IV)

once a day


for full recovery 0.1-0.25 mg/kg/dose is very effective



pyridostigmine

0.1 - o.2

mg/kg

Intravenous (IV)

once a day


for full recovery 0.1-0.25 mg/kg/dose is very effective



neostigmine and glycopyrrolate 

The recommended IV dosage of neostigmine/glycopyrrolate is (0.03 mg/kg/ 0.006 mg/kg)
To counteract the effects of neuromuscular blocking agents with half-lives usually briefer or in cases where the initial twitch response exceeds 10% of baseline or if a second twitch is observed
The recommended IV dosage of neostigmine/glycopyrrolate is (0.07 mg/kg/0.014 mg/kg)
To counteract the effects of NMBAs with extended half-lives, or in situations where the initial twitch response approaches approximately 10% of the baseline or when there is a requirement for swift recovery
The total maximum dose of neostigmine is either 0.07 mg/kg or a maximum of 5 mg of neostigmine, depending on whatever amount is small



 

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Reversal of Nondepolarizing Muscle Relaxants

Updated : October 17, 2022

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