Sugammadex is used for rapid reversal of rocuronium-induced neuromuscular blockade. Its mechanism of action is:

• A Acetylcholinesterase inhibition
• B Activation of butyrylcholinesterase
• C Direct competition at the nicotinic receptor
• D Encapsulation of the neuromuscular blocking agent ✓

Explanation

Sugammadex is a modified gamma-cyclodextrin that encapsulates rocuronium (and vecuronium) in a 1:1 ratio, rendering it unavailable to bind to the nicotinic receptor. It provides rapid and complete reversal even from deep blockade. Neostigmine works via acetylcholinesterase inhibition. Direct competition is not the mechanism. Butyrylcholinesterase metabolizes succinylcholine.

Reference: Katzung and Trevor's Basic and Clinical Pharmacology, 15th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.