THESE DRUGS are indicated as adjuncts to anesthesia for the induction of neuromuscular blockade for endotracheal intubation, mechanical ventilation, or surgery. They must always be administered with concurrent sedation and an I.V. analgesic because they do not impair consciousness or reduce pain. Patients receiving these drugs must have airway support and require mechanical ventilation after administration. Test your knowledge of these drugs by matching each brand name in Section I with its generic name in Section II.

Section I

______1. Tracrium (GlaxoSmithKline)

______2. Anectine (Sandoz)

______3. Pavulon (Organon)

Section II

a. succinylcholine chloride injection. Classified as an ultra-short-acting depolarizing-type skeletal muscle relaxant, this drug is typically administered via I.V. bolus injection but can also be given I.M. if I.V. access cannot be obtained. Its onset of action is less than 1 minute. When given I.V., its duration of action is 5 to 10 minutes. The labeling includes a boxed warning about the risk of cardiac arrest from hyperkalemic rhabdomyolysis.

b. atracurium besylate injection. This drug is an intermediate-duration, nondepolarizing, skeletal muscle relaxant. Because atracurium besylate is a complex molecule, it has a broad spectrum of potencies and adverse reactions. It can be administered as an I.V. bolus injection or I.V. infusion. Its onset of action is 3 to 4 minutes and its duration of action is 20 to 35 minutes.

c. pancuronium bromide injection. This medication belongs to a class of drugs known as aminosteroid, nondepolarizing neuromuscular blockade agents. It is administered via rapid I.V. bolus or as an I.V. infusion. Its onset of action is 2 to 3 minutes and its duration of action ranges from 45 to 60 minutes. It is contraindicated for use in neonates, including premature infants, because the formulation contains benzyl alcohol, which is potentially toxic.

Answers: 1b, 2a, 3c