Release Date: October 2008
Expiration Date: October 31, 2009

NEEDS STATEMENT
The purpose of this activity is to provide information to anesthesiologists and other interested practitioners on challenges associated with neuromuscular block that can be encountered during procedures, including selection of an appropriate neuromuscular blocking agent (NMBA), rapid sequence induction, monitoring, and reversal of neuromuscular block. The need for this activity was determined through input from Core’s past participants as well as literature and research review that indicated the information should be available to a wider audience and through additional CME delivery methods.

TARGET AUDIENCE
This activity is intended for anesthesiologists and pharmacists involved in the selection and use of neuromuscular blocking drugs.

LEARNING OBJECTIVES
Upon completion of this educational activity, participants should be able to:

1. Discuss factors that influence selection of the optimal NMBA, including the characteristics and pharmacological properties that differentiate NMBAs and translate these into clinical applications for specific patient groups and settings.
2. Evaluate current practices and drugs used in rapid sequence induction.
3. Review the aspects of appropriate monitoring of neuromuscular block, including the rationale, and pros and cons of new and established techniques.
4. Explain the rationale for reversal of neuromuscular block and compare the evidence on clinical outcomes with new and established agents.

ACCREDITATION STATEMENT
Physicians: This CME activity was planned and produced in accordance with the Accreditation Council for Continuing Medical Education (ACCME) Essentials and Standards. Core Medical Publishing is accredited by the ACCME to sponsor CME for physicians. Core Medical Publishing designates this activity for a maximum of 1 hour of AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with their participation in the activity.

Pharmacists: AKH Inc. is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This program has been assigned the Universal Program Number 077-999-08-042-H01-P and is acceptable for 1 contact hour (0.10 CEU).

METHOD OF PARTICIPATION
This activity should take approximately 60 minutes to complete. There are no fees for participating in and receiving credit for this activity. The participant should, in order, read the objectives and monograph, answer the multiple-choice online post-test and complete the evaluation form. The evaluation form provides each participant with the opportunity to comment on the quality of the instructional process, the perception of enhanced professional effectiveness, the perception of commercial bias, and his/her views on future educational needs. A score of at least 80% is required to successfully complete this activity. Retests are NOT available. Credit is available through October 31, 2009.

FACULTY
Jørgen Viby-Mogensen, DMSc
Professor at the Academic Department of Anaesthesia and Intensive Care
Copenhagen University Hospital
Copenhagen, Denmark

Rajinder K. Mirakhur, MBBS, MD, PhD
Professor of Anaesthetics
Queen's University
Belfast, Northern Ireland, UK

James E. Caldwell, MBChB
Professor of Clinical Anesthesia and Director of Clinical Anesthesia Services
University of California at San Francisco
San Francisco, California

Lars I. Eriksson, MD, PhD
Professor and Academic Chairman
Department of Anaesthesiology and Intensive Care Medicine
Karolinska Institute
Stockholm, Sweden

MEDICAL WRITER
Medical writing support was provided by Neil Venn, PhD, and Paul Chrisp, PhD, on behalf of Core Medical Publishing, during the preparation of this paper.

DISCLOSURE STATEMENTS
Professor Viby-Mogensen received consulting fees and honoraria from and has been a paid advisor to Avera Pharmaceuticals, GlaxoSmithKline, and Organon, a part of Schering-Plough Corporation.

Professor Mirakhur has been a paid advisor to and has received research and unrestricted educational grants from GlaxoSmithKline and Organon, a part of Schering-Plough Corporation.

Dr. Caldwell has received research funding from Organon, a part of Schering-Plough Corporation and GlaxoWellcome (now GlaxoSmithKline).

Professor Eriksson has received research funding and honoraria from Abbott Scandinavia, Avera Pharmaceuticals, GlaxoSmithKline, and Organon, a part of Schering-Plough Corporation.

Drs. Venn and Chrisp report no conflict of interest.

Any real or apparent conflict of interest has been addressed through Core Medical Publishing's and AKH Inc.'s conflict resolution procedures. Responsibility for opinions, conclusions, and interpretation of data lies with the authors.

This activity includes discussion of non-FDA–approved uses of gantacurium for neuromuscular block and sugammadex for neuromuscular block reversal. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

SOFTWARE REQUIREMENTS
PC
Microsoft Windows 2000 SE or above.
Internet Explorer (v5.5 or greater), or Firefox
Adobe Acrobat Reader*

MAC
MAC OS 10.2.8
Safari
Adobe Acrobat Reader*
Internet Explorer is not supported on the Macintosh.

* Required to view printable (PDF) version of the lesson.

AMA and ACPE credit and content provided by: Core Medical Publishing and AKH Inc.

Copyright © Applied Clinical Education, Core Medical Publishing and AKH Inc. 2008.

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