Nagelhout Pharm 2 Final 2026 Exam
Questions and Verified Answers |
Already Graded A+
Ultra short acting Depolarizing neuromuscular blocker
(Length of duration) - 🧠 ANSWER ✔✔Succinylcholine
(5 - 15 minutes)
Short Acting Nondepolarizing NMBs
(Length of duration) - 🧠 ANSWER ✔✔Mivacurium
(20-30 minutes)
Intermediate Acting Nondepolarizing NMBs (4)
,(Length of duration) - 🧠 ANSWER ✔✔Atracurium
Cisatracurium
Vecuronium
Rocuromium
(30-60 minutes)
Long Acting Nondepolarizing NMB
(Length of duration) - 🧠 ANSWER ✔✔Pancuronium
(60-90 minutes)
NMB Reversal Agents (3) - 🧠 ANSWER ✔✔Neostigmine
Edrophonium
Sugammadex
NMBs work at ____ receptors - 🧠 ANSWER ✔✔Nicotinic Cholinergic (sub-
m)
Nicotinic Cholinergic (sub-m) use positive or negative feedback? - 🧠
ANSWER ✔✔Positive feedback. This explains fade with NDMBs.
Neurotransmitter of the NM junction - 🧠 ANSWER ✔✔acetylcholine
,Breaks down acetylcholine at the NM synapse/junction - 🧠 ANSWER
✔✔acetylcholinesterase
Phase 2, Non-depolarizing agents are: agonists or antagonists - 🧠
ANSWER ✔✔Antagonist
Phase 1, Depolarizing agents act as: agonist or antagonist?? - 🧠 ANSWER
✔✔Agonist then antagonist
Train of Four Ratio - 🧠 ANSWER ✔✔Strength of 4th twitch:Strength of 1st
twitch (when it is 90% patient considered recovered)
Best nerve/muscle to measure onset of NMB - 🧠 ANSWER ✔✔Facial Nerve
Orbicularis Oculi (Corrugator supercilii = best)
(reflects diaphragm blockade)
(negative-black electrode over nerve)
Best nerve/muscle to measure emergence from NMB - 🧠 ANSWER
✔✔Ulnar Nerve
Adductor Pollicis
Measures thumb adduction (Red proximal)
COPYRIGHT©NINJANERD 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE. PRIVACY
STATEMENT. ALL RIGHTS RESERVED
3
, Single Twitch Test - 🧠 ANSWER ✔✔1.0 Hz
Single stimulus
Compares pre (baseline) and post NMB hand twitch
Train of Four Test - 🧠 ANSWER ✔✔4 - 2 Hz twitches
Compares 4th twitch to 1st twitch (fade)
Reflects 70-100% blockade
*Succ has no fade, all 4 twitches equal*
Double Burst Simulation (DBS) Test - 🧠 ANSWER ✔✔2 - 50 Hz twitches
0.75 seconds apart
Compares 2 twitches to monitor for fade
Tetanus Test - 🧠 ANSWER ✔✔100 Hz twitch for 5 seconds
Painful
Posttetanic Count Test - 🧠 ANSWER ✔✔50 Hz stimulus for 5 sec → 3 sec
pause → 1 Hz single twitch every second
Only used when patient is 100% paralyzed
0 = call for ventilator (>9 minutes til TOF)
Questions and Verified Answers |
Already Graded A+
Ultra short acting Depolarizing neuromuscular blocker
(Length of duration) - 🧠 ANSWER ✔✔Succinylcholine
(5 - 15 minutes)
Short Acting Nondepolarizing NMBs
(Length of duration) - 🧠 ANSWER ✔✔Mivacurium
(20-30 minutes)
Intermediate Acting Nondepolarizing NMBs (4)
,(Length of duration) - 🧠 ANSWER ✔✔Atracurium
Cisatracurium
Vecuronium
Rocuromium
(30-60 minutes)
Long Acting Nondepolarizing NMB
(Length of duration) - 🧠 ANSWER ✔✔Pancuronium
(60-90 minutes)
NMB Reversal Agents (3) - 🧠 ANSWER ✔✔Neostigmine
Edrophonium
Sugammadex
NMBs work at ____ receptors - 🧠 ANSWER ✔✔Nicotinic Cholinergic (sub-
m)
Nicotinic Cholinergic (sub-m) use positive or negative feedback? - 🧠
ANSWER ✔✔Positive feedback. This explains fade with NDMBs.
Neurotransmitter of the NM junction - 🧠 ANSWER ✔✔acetylcholine
,Breaks down acetylcholine at the NM synapse/junction - 🧠 ANSWER
✔✔acetylcholinesterase
Phase 2, Non-depolarizing agents are: agonists or antagonists - 🧠
ANSWER ✔✔Antagonist
Phase 1, Depolarizing agents act as: agonist or antagonist?? - 🧠 ANSWER
✔✔Agonist then antagonist
Train of Four Ratio - 🧠 ANSWER ✔✔Strength of 4th twitch:Strength of 1st
twitch (when it is 90% patient considered recovered)
Best nerve/muscle to measure onset of NMB - 🧠 ANSWER ✔✔Facial Nerve
Orbicularis Oculi (Corrugator supercilii = best)
(reflects diaphragm blockade)
(negative-black electrode over nerve)
Best nerve/muscle to measure emergence from NMB - 🧠 ANSWER
✔✔Ulnar Nerve
Adductor Pollicis
Measures thumb adduction (Red proximal)
COPYRIGHT©NINJANERD 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE. PRIVACY
STATEMENT. ALL RIGHTS RESERVED
3
, Single Twitch Test - 🧠 ANSWER ✔✔1.0 Hz
Single stimulus
Compares pre (baseline) and post NMB hand twitch
Train of Four Test - 🧠 ANSWER ✔✔4 - 2 Hz twitches
Compares 4th twitch to 1st twitch (fade)
Reflects 70-100% blockade
*Succ has no fade, all 4 twitches equal*
Double Burst Simulation (DBS) Test - 🧠 ANSWER ✔✔2 - 50 Hz twitches
0.75 seconds apart
Compares 2 twitches to monitor for fade
Tetanus Test - 🧠 ANSWER ✔✔100 Hz twitch for 5 seconds
Painful
Posttetanic Count Test - 🧠 ANSWER ✔✔50 Hz stimulus for 5 sec → 3 sec
pause → 1 Hz single twitch every second
Only used when patient is 100% paralyzed
0 = call for ventilator (>9 minutes til TOF)
