NMBDs
2008a(7) Describe the terms train of four stimulation & double burst stimulation with respect to peripheral nerve stimulators. Describe their advantages & disadvantages when used to evaluate non-depolarising neuromuscular blockade
2007a(1) Describe the potential adverse effects of administering neostigmine post-operatively
2006b(4) Describe the advantages and disadvantages of rocuronium for a rapid sequence induction
2000b(16) Compare and contrast the pharmacology of atracurium and cis-atracurium
1999a(12) Explain fade and post-tetanic fasciculation associated with the NMBDs
Primary Examination SAQs 
Hi Amanda! Many, many thanks for your example answers. Regarding 1999a(11), atropine, scopolamine and glycopyrrolate, I noticed that your pharmacokinetics are for hyoscine butylbromide (i.e. buscopan) rather than scopolamine (hyoscine). I know it’s unlikely they’ll ask us about scopolamine as it’s not available in Australia, but “hyoscine” is still in the syllabus and I’m never sure if they mean scopolamine or hyoscine butylbromide! If the middle column is indeed hyoscine/scopolamine, then this may be more correct:
Absorption: Well absorbed via transdermal patch, as well as IV/IM. Dose: 0.3-0.6mg IV; 1.5mg in 72hr patch (10-20mg is hyoscine hydrobromide, not scopolamine). SoO: 10 mins IV, transdermal variable, up to 6 hours. Duration Action: 2-4 hours following IV bolus. Distribution: (2L/kg probably correct). Metabolism: conjugation in the liver (not ester hydrolysis which is how hyoscine hydrobromide is metabolised). Cheers!
Riaz
January 19, 2013 at 7:30 pm
Hi Riaz
I think it’s safer for you to answer a question based on drugs that are commonly available in Australia or New Zealand. If you are getting bogged down on a drug based on which salt it is conjugated with, it may be that you are over-thinking the question. Also bear in mind that this question hasn’t been asked in nearly 14 years, and with the new syllabus, is unlikely to be asked in this format – they seem to be working hard to make the exam more relevant. AD.
primarysaqs
January 19, 2013 at 8:21 pm
Hi Amanda,
Great website. Thanks very much for providing as a resource. For the question on train-of four vs DBS, according to Peck, Hill and William, disappearance of T4 corresponds to receptor occupancy of 90%. Further, at 75% receptor occupancy, T4:T1 is 0.75.
A study published by McGrath and Hunter in BJA (2003) also states that T4 disappears at 75% depression of T1.
The answer given states disappearance of fourth twitch represents 75% block which I think is incorrect.
Thanks
Luke Tobin
Luke
February 24, 2013 at 11:45 am
Many thanks for the feedback – sorry for the late reply! The answer has been corrected.
primarysaqs
March 4, 2014 at 3:35 pm