Atomic Anesthesia

Neuromuscular blockers are packed with high-yield SEE/NCE material and knowing the drug names isn’t enough. In this episode, we break down the pharmacology you need to understand so you can apply it to board-style questions and clinical scenarios.
In this episode:
Depolarizing vs nondepolarizing neuromuscular blockade
Succinylcholine pharmacology, contraindications & major complications
Rocuronium, vecuronium & cisatracurium
Pseudocholinesterase deficiency & the dibucaine number
Factors that potentiate or cause resistance to neuromuscular blockade
Reversal, residual blockade & high-yield board pearls

This episode is part of our 12-week SEE/NCE podcast series, designed to follow the Atomic Anesthesia SEE/NCE Study Plan week by week.
Want to study along with the episode? Join the Atomic Anesthesia learning platform to get the accompanying worksheet, plus access to our members-only podcast episodes and additional SEE/NCE study resources.
FREE RESOURCE FOR THIS EPISODE:
SEE/NCE Study Plan — A structured, week-by-week plan to pass your boards. Head to atomicanesthesia.com/freebies/see-nce-study-plan to grab it free.
WANT THE FULL PLATFORM?
Atomic Anesthesia is the all-in-one study platform built specifically for SRNAs: 800 lessons, 10,000 quiz questions, flashcards, and interactive features. Join at atomicanesthesia.com.
Mentioned in this episode:
💜 PARTNERS: The Incomologists®
https://theincomologists.com/
You work hard caring for others—let us take care of you. Whether you’re a W-2 employee or transitioning to a 1099 role, we understand the unique challenges healthcare professionals face, from insurance coverage to financial planning. That’s where we step in.
Like you, we are a team of healthcare providers who understand your needs and help you find tailored insurance plans and financial strategies without the hassle or pressure. And we’re a partner you can rely on, today and in the future.
We evaluate all available options and resources in the market to protect our clients, so contact us, and we’ll get started! - Jake Bevilacqua, CRNA (jake@theincomologists.com)

Carotid endarterectomy is a critical procedure requiring careful management to protect cerebral perfusion, especially during cross-clamping. This episode delves into essential intraoperative considerations, particularly mean arterial pressure (MAP) targets, and strategies to maintain cerebral blood flow through monitoring and potential shunting.
Preoperative assessment and baseline establishment
Intraoperative monitoring techniques and A-line importance
MAP target calculation and cerebral autoregulation adjustments
Induction and maintenance anesthesia specifics
Strategies for smooth emergence and minimizing complications

FREE RESOURCE FOR THIS EPISODE:
SEE/NCE Study Plan — A structured, week-by-week plan to pass your boards. Head to atomicanesthesia.com/freebies/see-nce-study-plan to grab it free.
MORE FREE STUDY RESOURCES:
Non-Opioid Pharmacology Cheat Sheet — Every non-opioid analgesic you need to know, on one page
GPCR Cheat Sheet — G-protein coupled receptors decoded for anesthesia
Malignant Hyperthermia Reference Guide — Recognize MH fast. Treat it faster — one-page reference
WANT THE FULL PLATFORM?
Atomic Anesthesia is the all-in-one study platform built specifically for SRNAs — lessons, quizzes, flashcards, and more. Join at atomicanesthesia.com.

Welcome to the Atomic Anesthesia podcast hosted by CRNA professor Dr. Rhea Temmermand and Co-Founder Sachi Lord. On this show, you'll hear clear, clinically grounded discussions designed for nurse anesthesia residents and CRNAs who want to feel more confident in complex pharmacology, physiology, and real-world anesthesia decision-making.
Want more content like this? Become a member of our learning platform: http://atomicanesthesia.com
In this episode:
Train-of-four basics, including what the twitches actually represent and how to interpret your TOF count
TOF count vs TOF ratio, understanding fade, and why four twitches does not necessarily mean full recovery
Post-tetanic count, depth of neuromuscular blockade, and when to use different stimulation patterns
Ulnar vs facial nerve monitoring, Phase I vs Phase II succinylcholine blockade, and qualitative vs quantitative monitoring
Using TOF to guide neostigmine and sugammadex reversal, plus high-yield SEE/NCE concepts and practice board questions

💜 FREE DOWNLOADS: Grab your copy of customized study plans & worksheets.
GPCR Cheat Sheet — The G-protein coupled receptor mechanisms behind the alpha antagonists, beta blockers, and signaling pathways that show up in every OR vasodilator conversation.
SEE/NCE Study Plan — A structured plan to help you prepare for the SEE and NCE without burning out — hypertension treatment is a high-yield topic.
Non-Opioid Pharmacology Cheat Sheet — Propofol, ketamine, dexmedetomidine, and the rest of the non-opioid sedation toolkit on one page.

💜 CONNECT: 📥 Email questions, comments or topic suggestions to Rhea & Sachi at hello@atomicanesthesia.com, follow us on social media, and sign up for our newsletter.
Mentioned in this episode:
💜 PARTNERS: The Incomologists®
https://theincomologists.com/
You work hard caring for others—let us take care of you. Whether you’re a W-2 employee or transitioning to a 1099 role, we understand the unique challenges healthcare professionals face, from insurance coverage to financial planning. That’s where we step in.
Like you, we are a team of healthcare providers who understand your needs and help you find tailored insurance plans and financial strategies without the hassle or pressure. And we’re a partner you can rely on, today and in the future.
We evaluate all available options and resources in the market to protect our clients, so contact us, and we’ll get started! - Jake Bevilacqua, CRNA (jake@theincomologists.com)

Welcome to the Atomic Anesthesia podcast hosted by CRNA professor Dr. Rhea Temmermand and Co-Founder Sachi Lord. On this show, you'll hear clear, clinically grounded discussions designed for nurse anesthesia residents and CRNAs who want to feel more confident in complex pharmacology, physiology, and real-world anesthesia decision-making.
Want more content like this? Become a member of our learning platform: http://atomicanesthesia.com
In this episode:
The three mechanism buckets every OR vasodilator falls into — nitric oxide donors, calcium channel blockers, alpha antagonists — and why the bucket tells you the side effect profile before you ever look up the drug
The full NO → cGMP → PKG → smooth muscle relaxation cascade behind nitroglycerin and nitroprusside, and why one drops preload while the other balanced-dilates
Cyanide toxicity and coronary steal with nitroprusside — when to use it, when to cap it, and when to pick something else
Clevidipine vs nicardipine vs hydralazine — which drug fits which case, and why hydralazine is falling out of favor for tight OR control
Controlled hypotension for neuro cases, afterload management in cardiac surgery, and hypertensive emergencies including aortic dissection and pheochromocytoma

💜 FREE DOWNLOADS: Grab your copy of customized study plans & worksheets.
GPCR Cheat Sheet — The G-protein coupled receptor mechanisms behind the alpha antagonists, beta blockers, and signaling pathways that show up in every OR vasodilator conversation.
SEE/NCE Study Plan — A structured plan to help you prepare for the SEE and NCE without burning out — hypertension treatment is a high-yield topic.
Non-Opioid Pharmacology Cheat Sheet — Propofol, ketamine, dexmedetomidine, and the rest of the non-opioid sedation toolkit on one page.

💜 CONNECT: 📥 Email questions, comments or topic suggestions to Dr. Temmermand at hello@atomicanesthesia.com, follow us on social media, and sign up for our newsletter.
💜 PARTNERS: The Incomologists®
https://theincomologists.com/
You work hard caring for others—let us take care of you. Whether you're a W-2 employee or transitioning to a 1099 role, we understand the unique challenges healthcare professionals face, from insurance coverage to financial planning. That's where we step in.
Like you, we are a team of healthcare providers who understand your needs and help you find tailored insurance plans and financial strategies without the hassle or pressure. And we're a partner you can rely on, today and in the future.
We evaluate all available options and resources in the market to protect our clients, so contact us, and we'll get started! — Jake Bevilacqua, CRNA (jake@theincomologists.com)

Welcome to the Atomic Anesthesia podcast hosted by CRNA professor Dr. Rhea Temmermand and Co-Founder Sachi Lord. On this show, you'll hear clear, clinically grounded discussions designed for nurse anesthesia residents and CRNAs who want to feel more confident in complex pharmacology, physiology, and real-world anesthesia decision-making.
Want more content like this? Become a member of our learning platform: http://atomicanesthesia.com
In this episode:
Exactly how PONV happens in the brain, no vague "vomiting center" hand waving
All 5 real mechanisms behind how dexamethasone actually stops nausea and vomiting
The practical dosing, timing, and combination strategy that gets the best PONV prevention

References:
Chu CC, Hsing CH, Shieh JP, Chien CC, Ho CM, Wang JJ. The cellular mechanisms of the antiemetic action of dexamethasone and related glucocorticoids against vomiting. Eur J Pharmacol. 2014;722:48-54.
Horn CC, Wallisch WJ, Homanics GE, Williams JP. Pathophysiological and neurochemical mechanisms of postoperative nausea and vomiting. Eur J Pharmacol. 2014;722:55-66.
Ho CM, Wu HL, Ho ST, Wang JJ. Dexamethasone prevents postoperative nausea and vomiting: benefit versus risk. Acta Anaesthesiol Taiwan. 2011;49(3):100-104.

💜 FREE DOWNLOADS: Grab your copy of customized study plans & worksheets.
SEE/NCE Study Plan — a structured, week-by-week plan to pass your boards
Non-Opioid Pharmacology Cheat Sheet — every non-opioid analgesic you need to know, one page
GPCR Cheat Sheet — G-protein coupled receptors decoded for anesthesia

💜 CONNECT: 📥 Email questions, comments or topic suggestions to Rhea or Sachi at hello@atomicanesthesia.com, follow us on social media, and sign up for our newsletter.
Mentioned in this episode:
💜 PARTNERS: The Incomologists®
https://theincomologists.com/
You work hard caring for others—let us take care of you. Whether you’re a W-2 employee or transitioning to a 1099 role, we understand the unique challenges healthcare professionals face, from insurance coverage to financial planning. That’s where we step in.
Like you, we are a team of healthcare providers who understand your needs and help you find tailored insurance plans and financial strategies without the hassle or pressure. And we’re a partner you can rely on, today and in the future.
We evaluate all available options and resources in the market to protect our clients, so contact us, and we’ll get started! - Jake Bevilacqua, CRNA (jake@theincomologists.com)