Sugammadex: Difference between revisions
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===Serious=== | ===Serious=== | ||
*[[Anaphylaxis]] (0.3%), hypersensitivity reaction | *[[Anaphylaxis]] (0.3%), hypersensitivity reaction | ||
*Bradycardia (1-5%) | *Bradycardia/Asystole (1-5%) <ref>Bhavani, S. S. (2018). Severe bradycardia and asystole after sugammadex. British Journal of Anaesthesia, 121(1), 95–96.</ref> | ||
*[[Prolonged QT]] | *[[Prolonged QT]] | ||
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*Coughing | *Coughing | ||
*Extremity pain | *Extremity pain | ||
*Parosmia, hypoesthesia | *Parosmia, hypoesthesia | ||
==Pharmacology== | ==Pharmacology== | ||
Revision as of 18:39, 12 August 2018
Administration
- Type/Class: γ-cyclodextrin, antidote
- Dosage Forms:
- 200mg/2mL (100mg/mL)
- 500mg/5mL (100mg/mL)
- Routes of Administration: IV
- Common Trade Names: Bridion
Adult Dosing
IV bolus injection infused over 10 seconds via central or peripheral line with 16 mg/kg will reverse a single 1.2 mg/kg dose of rocuronium in approximately 3 minutes.[1]
- 4 mg/kg if patient has no twitch responses to train-of-four and emergent reverse is not needed
- 2mg/kg if patient has a second twitch after train of four and no emergent reversal is needed
Pediatric Dosing
- No approved dosing or usage
Special Populations
- Pregnancy Rating: There are no data on use in pregnant women
- Lactation risk: Unknown
Renal Dosing
- Adult: Unknown
- Pediatric: Unknown
Hepatic Dosing
- Adult: Unknown
- Pediatric: Unknown
Indications
- Rocuronium or vecuronium reversal
Contraindications
- Allergy to class/drug and or prior documentation of hypersensitivity
Adverse Reactions
Adverse effects are described in the anesthesia literature and the most serious side effect is in patients with a known hypersensitivity to Sugammadex[2]
Serious
- Anaphylaxis (0.3%), hypersensitivity reaction
- Bradycardia/Asystole (1-5%) [3]
- Prolonged QT
Common
- Nausea/vomiting
- Headache
- Coughing
- Extremity pain
- Parosmia, hypoesthesia
Pharmacology
- Onset of action: reverses paralysis in ~3 minutes
- Half-life: 2h
- Metabolism:
- Excretion: Renal
Mechanism of Action
- Encapsulates rocuronium or vecuronium in plasma, reducing the amount of neuromuscular blocking agent available to bind to nicotinic receptors in the neuromuscular junction and thereby reversing neuromuscular blockade
Comments
- Sugammadex is only FDA approved for reversal for patients undergoing surgery. The drug has been used in Europe since 2008[4]
See Also
References
- ↑ Abrishami A et al. "Sugammadex, a selective reversal medication for preventing postoperative residual neuromuscular blockade". Cochrane Database of Systematic Reviews. 2009(4). CD007362. doi:10.1002/14651858.CD007362.pub2. PMID 19821409
- ↑ Park J. Benefits and risks of sugammadex. Korean J Anesthesiol. 2015 Feb; 68(1): 1–2.
- ↑ Bhavani, S. S. (2018). Severe bradycardia and asystole after sugammadex. British Journal of Anaesthesia, 121(1), 95–96.
- ↑ Assessment Report for Bridion. European Medicines Agency