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Current Anesthesiology Reports

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01-06-2018 | Neuromuscular Blockade (GS Murphy, Section Editor)

Sugammadex: Clinical Pharmacokinetics and Pharmacodynamics

Authors: Jennifer Nguyen-Lee, Natalie Moreland, Alireza Sadoughi, Reza Borna, Ali Salehi, Jonathan S. Jahr

Published in: Current Anesthesiology Reports | Issue 2/2018

Abstract

Purpose of Review

The purpose of this chapter is to provide an evidence based understanding of the pharmacokinetics and pharmacodynamics of sugammadex.

Recent Findings

Sugammadex is a c-cyclodextrin that rapidly reverses the effect of aminosteroid nondepolarizing neuromuscular blocking agents (NMBAs) rocuronium and vecuronium by forming an inactive 1:1 complex. It is only available in an intravenous form with a bioavailabilty of 100%. It does not bind to plasma proteins and is eliminated unchanged by the kidneys. The type of NMBA used and the degree of the residual neuromuscular blockade at the time of administration determine the dose of sugammadex needed and the speed of reversal. Plasma levels of exogenous compounds with similar steroidal structure, such as some hormones, hormonal contraceptives, and pheromones may also be reduced following administration of sugammadex. While the package insert does not indicate dosage adjustments in elderly patients, or those with hepatic, cardiac, pulmonary comorbidities (not approved in pediatric patients less than 18 years or patients with a creatinine clearance less than 30 ml/min), sugammadex dosing possibly should be adjusted based upon the patient’s age and comorbidities, including liver or kidney failure and morbid obesity.

Summary

Sugammadex has been shown to be an effective agent in reversing the effects of NMBAs with an acceptable safety and efficacy profile.

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Title: Sugammadex: Clinical Pharmacokinetics and Pharmacodynamics
Authors: Jennifer Nguyen-Lee
Natalie Moreland
Alireza Sadoughi
Reza Borna
Ali Salehi
Jonathan S. Jahr
Publication date: 01-06-2018
Publisher: Springer US
Published in: Current Anesthesiology Reports / Issue 2/2018
Electronic ISSN: 2167-6275
DOI: https://doi.org/10.1007/s40140-018-0266-5

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Sugammadex: Clinical Pharmacokinetics and Pharmacodynamics

Abstract

Purpose of Review

Recent Findings

Summary

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose of Review

Recent Findings

Summary

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