Sugammadex Not for Atracurium — FRCA Primary MCQ

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EasyPharmacology - NeuromuscularSugammadex Not for AtracuriumFRCA Primary

Regarding sugammadex it should NOT be used with which non-depolarising agent?

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Correct answer: B — Atracurium

Sugammadex does NOT reverse benzylisoquinolinium agents (atracurium / cisatracurium / mivacurium) because it only encapsulates aminosteroidal molecules. It reverses rocuronium (highest affinity) > vecuronium > pancuronium (lowest affinity). For benzylisoquinolinium agents use neostigmine (if TOF ≥2) or allow spontaneous recovery (atracurium/cisatracurium via Hofmann elimination).

Reference: Peck Hill Williams 2014 Pharmacology for Anaesthesia and Intensive Care