1. Rapacuronium: 1. Is a depolarising muscle relaxant. 2. Is typically given in a dose of 1.5 mgs/kg. 3. Produces intubating conditions within 1 circulation time. 4. Has a duration of effect of 15 - 20 minutes if given in a dose of 1.5 mgs/kg.

2. FTFT

3. The most likely severe adverse effect of rapacuronium given at a dose of 1.5 mg / kg is: A. Bradycardia. B. Myocardial depression. C. Transient hyperkalaemia. D. Bronchospasm. E. Raised intra-ocular pressure.

4. ANSWER : D The drug is a low-potency, non-depolarising relaxant and is the 16-N-allyl-17-propionate analogue of vecuronium. It does not increase either serum potassium or intra-ocular pressure

5. When used within the therapeutic range, which of the following drugs is most likely to potentiate neuromuscular blockade induced by vecuronium? A. Magnesium. B. Cyclophosphamide. C. Lithium. D. Phenytoin. E. Bambuterol

6. ANSWER : A

7. Which of the following relaxants are likely to be potentiated in a patient on cyclophosphamide? 1. Suxamethonium. 2. Cisatracurium. 3. Mivacurium. 4. Rapacuronium

8. TFTF

9. The constant infusion of Vecuronium for a period of more than 48 hours has been implicated in: 1. The persistence of residual weakness which may last 3-6 months. 2. An acute myopathy which becomes apparent as the neuromuscular junction (NMJ) returns to normal. 3. A cardiomyopathy in asthmatics who have received high dose steroids. 4. Prolonged NMJ failure in patients with renal failure

10. ALL CORRECT

11. Suxamethonium: 1. Is unlikely to cause muscle pains in a young, ambulant woman. 2. Causes a rise in serum potassium typically of the order of 0.5-1.0 mmol/L. 3. Causes an atypically large rise in serum potassium in patients with renal failure. 4. Causes a rise in serum potassium which is not prevented by pretreatment with a non-depolarizing muscle relaxant

12. FTFT

13. Mivacurium: 1. Is metabolised by plasma cholinesterase. 2. Has an elimination half-life of about 20 minutes. 3. Will lower systemic vascular resistance by about 1/3 when given at a dose of 0.2 mg/kg. 4. Does not cause significant histamine release.

14. TFTF

15. Cisatracurium: 1. Releases histamine when given at a dose of 0.1 mg/kg. 2. Is metabolised primarily by Hofmann degradation. 3. Is an aminosteroid compound. 4. Is metabolised to largely inactive compounds

16. FTFT

17. Pancuronium: 1. Is excreted largely unchanged in the urine. 2. Has an active metabolite that retains 50% of the activity of pancuronium. 3. Can cause a myopathy if used for prolonged periods. 4. Is a benzylquinolinium compound.

18. TTTF

19. Which of the following statements are true regarding atracurium: 1. It theoretically has 16 stereo-isomers. 2. More than 50% of its neuromuscular blocking activity is due to cisatracurium in the preparation. 3. It does not need to be given in modified dosage to a patient in renal failure. 4. It is a benzylisoquinolinium

20. ALL CORRECT

21. Histamine release is a feature of administration of which of the following relaxants? 1. Rocuronium. 2. Mivacurium. 3. Vecuronium. 4. Atracurium.

22. FTFT

23. Concomitant use of an anticonvulsant drug such as phenytoin will( SINGLE ANSWER) A. Potentiate the action of both rocuronium and suxamethonium. B. Diminish the action of both rocuronium and suxamethonium. C. Potentiate the action of rocuronium but diminish that of suxamethonium. D. Potentiate the action of suxamethonium but diminish that of rocuronium. E. None of the above.

24. D

25. Factors which may potentiate the neuromuscular blocking activity of rocuronium include: 1. Hypermagnesaemia 2. Hypokalaemia 3. Respiratory acidosis 4. Hypothermia

26. ALL CORRECT

27. With regard to Cisatracurium and atracurium: 1. Cisatracurium is the major constituent by weight of atracurium. 2. Cisatracurium is three times more potent than atracurium. 3. Cisatracurium has the same onset time as atracurium when given in equipotent dosage. 4. Cisatracurium has a similar duration of effect to atracurium.

28. FTFT

29. Which of the following is NOT metabolised by plasma cholinesterase? A. Procaine B. Cocaine C. Dibucaine D. Suxamethonium E. Esmolol F. Mivacurium

30. In reversing neuromuscular blockade, which of the following combinations is best matched with respect to time of onset? A. Atropine & neostigmine B. Atropine & glycopyrrolate C. Atropine & edrophonium D. Atropine & physostigmine E. Glycopyrrolate and edrophonium

31. Rocuronium: A. Monoquaternary at physiological pH B. More lipid soluble than pancuronium C. 30% metabolised (?deacetylated) in the liver D. Rapid onset is due to its high potency E. Fastest onset is with 2 times ED95 dose F. Is bisquaternary