Sugammadex Reversal — MFDS Part 1 MCQ

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HardPharmacologySugammadex ReversalMFDS Part 1

In an adult undergoing general anaesthesia, an anaesthetist plans to use sugammadex to reverse drug-induced neuromuscular blockade. Under the current UK Summary of Product Characteristics, which pair of neuromuscular blocking drugs can both have their blockade reversed with sugammadex?

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Reveal the answer and explanation

Correct answer: C — Rocuronium and vecuronium

Explanation lettering: D = shown as A · A = shown as C · E = shown as D · C = shown as E

A is correct. Sugammadex is a modified gamma-cyclodextrin selective relaxant-binding agent. It forms plasma complexes with the aminosteroidal non-depolarising neuromuscular blockers rocuronium and vecuronium, reducing the free drug available to bind nicotinic receptors and thereby reversing blockade. Although pancuronium is also aminosteroidal, the UK SmPC advises against using sugammadex for its reversal because efficacy and safety data are insufficient; this excludes B and C. Atracurium and cisatracurium are benzylisoquinolinium non-depolarising blockers and are not reversed by sugammadex, excluding D. Suxamethonium is a depolarising blocker, while atracurium is nonsteroidal, so E is also incorrect.

Reference: electronic Medicines Compendium. Bridion 100 mg/ml solution for injection, Summary of Product Characteristics, sections 4.4 and 5.1. Revised 8 May 2025. https://www.medicines.org.uk/emc/product/6409/smpc