Sugammadex is effective for reversal of neuromuscular blockade produced by which class of relaxants?

Sugammadex is effective for reversal of neuromuscular blockade produced by which class of relaxants?

• A. Benzylisoquinoline relaxants
• B. Aminosteroid relaxants
• C. Both benzylisoquinoline and aminosteroid relaxants
• D. None of the above

Answer: (B)

Sugammadex reverses neuromuscular blockade by selectively binding to certain steroidal muscle relaxants. It is a gamma-cyclodextrin that forms a tight 1:1 complex with aminosteroid neuromuscular blocking agents, such as rocuronium and vecuronium (and also pancuronium in many cases). By trapping the drug in the plasma, it lowers the free concentration of the NMBA at the nicotinic receptors, allowing acetylcholine to resume normal transmission at the neuromuscular junction and the blockade to rapidly wear off. This mechanism is structure-specific: benzylisoquinoline relaxants (like atracurium, cisatracurium, and mivacurium) do not form stable complexes with sugammadex, so reversal is not effective for those agents. Therefore, the class for which sugammadex is effective is aminosteroid relaxants, making rocuronium and vecuronium reversal with sugammadex rapid and reliable.

Sugammadex reverses neuromuscular blockade by selectively binding to certain steroidal muscle relaxants. It is a gamma-cyclodextrin that forms a tight 1:1 complex with aminosteroid neuromuscular blocking agents, such as rocuronium and vecuronium (and also pancuronium in many cases). By trapping the drug in the plasma, it lowers the free concentration of the NMBA at the nicotinic receptors, allowing acetylcholine to resume normal transmission at the neuromuscular junction and the blockade to rapidly wear off. This mechanism is structure-specific: benzylisoquinoline relaxants (like atracurium, cisatracurium, and mivacurium) do not form stable complexes with sugammadex, so reversal is not effective for those agents. Therefore, the class for which sugammadex is effective is aminosteroid relaxants, making rocuronium and vecuronium reversal with sugammadex rapid and reliable.