Docmoates: Add medication infobox (Drugbox) to monographs

2026-06-17T16:09:35Z

Add medication infobox (Drugbox) to monographs

← Older revision		Revision as of 16:09, 17 June 2026
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			{{Drugbox
			\| name = Neuromuscular blockers and reversal agents
			\| therapeutic = Skeletal muscle paralytic
			\| pharmacologic = Depolarizing (succinylcholine) and nondepolarizing (rocuronium, vecuronium, cisatracurium) neuromuscular blockers
			\| onset = Succinylcholine very fast and brief; rocuronium fast with intermediate duration; cisatracurium organ-independent elimination.
			\| halflife = Short to intermediate; no routine level.
			\| routes = IV
			\| highalert = <span style="color:#b00020;">'''Yes'''</span>
			\| blackbox = <span style="color:#b00020;">'''Yes'''</span> (see Safety)
			\| antidote = Neostigmine (with an anticholinergic) reverses nondepolarizing blockers; sugammadex reverses rocuronium and vecuronium; dantrolene for malignant hyperthermia. Succinylcholine has no direct reversal.
			\| pregnancy = Used in anesthesia care as needed.
			}}

	<div style="border-left:4px solid #3f6f5b;background:#f3f6f4;padding:8px 12px;margin-bottom:12px;font-size:0.95em;">		<div style="border-left:4px solid #3f6f5b;background:#f3f6f4;padding:8px 12px;margin-bottom:12px;font-size:0.95em;">
	''Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and '''must be verified against current manufacturer labeling before clinical use'''. This is educational content, not prescribing guidance.''		''Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and '''must be verified against current manufacturer labeling before clinical use'''. This is educational content, not prescribing guidance.''

Docmoates: NCLEX nursing pharmacology monographs — batch import

2026-06-17T14:06:17Z

NCLEX nursing pharmacology monographs — batch import

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<div style="border-left:4px solid #3f6f5b;background:#f3f6f4;padding:8px 12px;margin-bottom:12px;font-size:0.95em;">
''Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and '''must be verified against current manufacturer labeling before clinical use'''. This is educational content, not prescribing guidance.''
</div>

'''Neuromuscular blockers and reversal agents''' — Skeletal muscle paralytic; Depolarizing (succinylcholine) and nondepolarizing (rocuronium, vecuronium, cisatracurium) neuromuscular blockers.

== Identification ==
* '''Therapeutic class:''' Skeletal muscle paralytic.
* '''Pharmacologic class:''' Depolarizing (succinylcholine) and nondepolarizing (rocuronium, vecuronium, cisatracurium) neuromuscular blockers.

== Pharmacology ==
* '''Mechanism of action:''' Block acetylcholine at the neuromuscular junction to paralyze skeletal muscle (succinylcholine depolarizes first, causing fasciculations); they have no sedative or analgesic effect.
* '''Onset / peak / duration:''' Succinylcholine very fast and brief; rocuronium fast with intermediate duration; cisatracurium organ-independent elimination.
* '''Half-life / therapeutic level:''' Short to intermediate; no routine level.

== Clinical use ==
* '''Indications:''' Rapid sequence intubation, surgical paralysis, mechanical ventilation facilitation.
* '''Usual dose, route, frequency:''' IV in intubated, ventilated patients only.
* '''Maximum dose / adjustments:''' Always used with sedation and analgesia; succinylcholine avoided in burns, crush injury, and chronic paralysis (hyperkalemia).

== Safety ==
* '''Contraindications:''' Succinylcholine with personal or family history of malignant hyperthermia, major burns or crush injury, or hyperkalemia.
* '''Black box warning:''' Succinylcholine carries a boxed warning that, rarely, it can cause acute rhabdomyolysis with hyperkalemia and cardiac arrest in children with undiagnosed skeletal muscle disease; use in children is restricted to emergency intubation.
* '''Interactions:''' Aminoglycosides and other agents enhance blockade, certain anesthetics.
* '''Pregnancy / lactation:''' Used in anesthesia care as needed.
* '''High-alert:''' Yes.

== Adverse effects ==
* '''Common side effects:''' Muscle fasciculations and postoperative muscle pain (succinylcholine).
* '''Serious effects to report:''' Malignant hyperthermia (succinylcholine), hyperkalemia, prolonged paralysis, inability to ventilate.
* '''Antidote / reversal:''' Neostigmine (with an anticholinergic) reverses nondepolarizing blockers; sugammadex reverses rocuronium and vecuronium; dantrolene for malignant hyperthermia. Succinylcholine has no direct reversal.

== Nursing process ==
* '''Assessment before administration:''' Airway and ventilation readiness, malignant hyperthermia and hyperkalemia risk, sedation plan.
* '''Interventions during therapy:''' Never give without securing the airway and providing sedation and analgesia; the patient cannot breathe or move independently; continuous monitoring; train-of-four monitoring.
* '''Monitor:''' Ventilation, oxygenation, train-of-four, sedation adequacy.
* '''Evaluation / expected outcome:''' Adequate paralysis for the procedure with full support.

== Patient teaching ==
* '''Patient teaching:''' Procedural; reassure that breathing is supported by the ventilator.
* '''Notify provider if:''' Not applicable (monitored, ventilated setting).
* '''Administration tips:''' Paralytics require concurrent sedation and analgesia; high-alert, double-check.

[[Category:Anesthesia Agents]]

Neuromuscular blockers and reversal agents - Revision history

Docmoates: Add medication infobox (Drugbox) to monographs

Docmoates: NCLEX nursing pharmacology monographs — batch import