Hello, and welcome back to ACRAC. I'm Jed Wolfaw, and I'm thrilled to have back with me today after a little hiatus, Dr. Jillian Isaac for another key word episode.

This is going to be a great one, and we're going to talk about two really key issues. First, non-depolarizing neuromuscular blockers, and second, myathenic syndromes, both highly tested things on the board exams.

So let's jump right in, Jillian. Welcome back to the show.

Thank you.

Dr. Wolfaw said our first topic is non-depolarizing muscle relaxants, and I think this is probably one of the highest yield keyword episodes that I've done.

Because so many questions on the basic and the advanced and the ITE revolve around these medications, because we use them every day, and there's a lot of questions that can come from them.

You need to know about them in terms of indications, contraindications, side effects, drug interactions. So it's an important topic.

And I know that it seems like we've done this before, but we haven't. I look through all my old keyword podcasts, and know we've done sex and a coin.

But what I like is I feel like we're starting to come full circle, and you start to see the overlap in these outlines. Like I think when you look at the outline that's published by the ABA, it's really overwhelming, because there's just like lists and lists of words.

But what you see is they start to come back. So for example, when we did renal failure, we asked some questions about neuromuscular blockade, because it's affected by renal failure and the same thing with liver failure.

So you may see some questions come back and kind of see overlap, but I think that's actually a really good thing, because as you start studying and you go through certain things, you'll see the overlap again and again.

And that also helps you realize where the high yield topics are.

So if you look on the ABA content outline, this is under the basic, but keep in mind that 30% of the advanced exam is basic and about half of the ITE is basic.

But it's under pharmacology and it's muscle relaxes, non-depolarizing, and they want you to know about the mechanism of action, pharmacokinetics, and pharmacodynamics, prolongation of action, synergism, metabolism, excretion, side effects, and toxicity, indications, and contraindications, antagonism of blockade and drug interactions, specifically antibiotics, antipyletics, lithium, magnesium, inhalational anesthetics.

And this is a very similar to any drug, basically any drug that they give you they want you to know these things. Now what's being tested, it's a little bit all over the place.

So I actually put it in chronological order this time, rather than an order of importance.

So back in 08, they were asking about neuromuscular blockades in chronic renal failure. They asked about pharmacology, a feculeum in 09, then they asked about myesthenia and eaten lambart and the effects of muscle relaxants in these syndromes, which we'll get to later.

And that was tested in 08 and 2010. And then factors that prolonged neuromuscular blockade was tested in 2008 and 2011.

They asked about transmission ions and ED95s in 2011, they talked about fennetowin and neuromuscular blockade in 2012, as well as interactions with volatile anesthetics.

Interestingly enough, they asked about non-depolarizing neuromuscular blocking drugs and hyperparathyroidism in 2014, 2017 and 2020.

So this is a more current topic and they've been asking about that you don't see it in like the older test questions that have been released.

I'm asking about the side of action. I know that's been on the basic in the past several years. Blockade recovery and reversal. Again, that's a very high yield topic. So that was tested in 08, 2010, 2018, 2019, brainstem reflexes and these drugs in 2019 and then monitoring 2019.

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