Suggamadex passes FDA

offlabel · Dec 19, 2015

Is suggamadex a better reversal agent or a way to fix sloppy anesthetics?

allnurses Guide · Dec 19, 2015

Is suggamadex a better reversal agent or a way to fix sloppy anesthetics?

Suggamadex is a true reversal agent that binds to the muscle relaxant and theoretically should prevent residual muscle relaxant problems that occur to some extent in all patients.

offlabel · Dec 20, 2015

I guess we'll see. I don't see it for the routine use that's being implied, given the reception it's being given.

allnurses Guide · Dec 20, 2015

I guess we'll see. I don't see it for the routine use that's being implied, given the reception it's being given.

It has been in routine use in Europe for several years now. It avoids the side effects that come with giving are other "reversal" agents.

jwk · Dec 20, 2015

The main question in the US will be the cost. If it's cost-prohibitive, which it's rumored to be, it won't get much use.

offlabel · Dec 20, 2015

It's available, I know. What does "routine" mean? Are more than 50% of NMB being reversed there?

allnurses Guide · Dec 20, 2015

The main question in the US will be the cost. If it's cost-prohibitive, which it's rumored to be, it won't get much use.

I agree to some extent, but look at the case of Zofran and Desflurane. The pharmaceutical companies weren't happy with the initial sales so they starting attacking their competitors with theoretical concerns.

Droperidol was black boxed by the FDA even though Zofran has shown to have at least the same risk factor for prolonged QT interval as low dose droperidol.

Desflurane has a similar story with compound A "toxicity", which has shown to have no clinical relevance at all no matter the flow rate or the renal function of the patient.

I foresee something similar with Suggamadex or another engineered drug shortage this time with neostigmine.

Also, I know for a fact the military is already putting in their orders for Suggamadex. The military is one of the largest healthcare providers in the U.S.

allnurses Guide · Dec 20, 2015

It's available, I know. What does "routine" mean? Are more than 50% of NMB being reversed there?

That is a good question. When I did a literature search all I could find was cost analysis from a few years ago with no indication of how often it is being used now in Europe.

offlabel · Dec 21, 2015

I agree to some extent, but look at the case of Zofran and Desflurane. The pharmaceutical companies weren't happy with the initial sales so they starting attacking their competitors with theoretical concerns.
Droperidol was black boxed by the FDA even though Zofran has shown to have at least the same risk factor for prolonged QT interval as low dose droperidol.
Desflurane has a similar story with compound A "toxicity", which has shown to have no clinical relevance at all no matter the flow rate or the renal function of the patient.
I foresee something similar with Suggamadex or another engineered drug shortage this time with neostigmine.
Also, I know for a fact the military is already putting in their orders for Suggamadex. The military is one of the largest healthcare providers in the U.S.

It was sevoflurane, but I get the point.

allnurses Guide · Dec 21, 2015

It was sevoflurane, but I get the point.

Lol... Just for clarification: It was the Desflurane reps and their parent pharmaceutical company that came up with the lie about compound A and low flow Sevoflurane that a lot of anesthesia providers still believe to this day even if they are using amsorb instead of soda lime.