Pancuronium
Pavulon
Class:
Neuromuscular blocker (non-depolarizing).
Neuromuscular blocker (non-depolarizing).
Mechanism of Action:
Pancuronium produces complete muscular relaxation by binding to the receptor for acetylcholine at the neuromuscular junction, without initiating depolarization of the muscle membrane. As the concentration of acetylcholine rises in the neuromuscular junction, Pancuronium is displaced and muscle tone is regained.
Pancuronium produces complete muscular relaxation by binding to the receptor for acetylcholine at the neuromuscular junction, without initiating depolarization of the muscle membrane. As the concentration of acetylcholine rises in the neuromuscular junction, Pancuronium is displaced and muscle tone is regained.
Indications:
- In emergency care to optimize condtions for endotracheal intubation and assisted ventilations.
- Induction or maintenance of paralysis after intubation to assist ventilation.
Contraindications:
- Known hypersenitivity to the drug.
- Inability to control airway and/or support ventilations with oxygen and positive pressure.
- Neuromuscular disease (e.g., myasthenia gravis).
Adverse reactions:
Transient hypotension Tachycardia, Dysrhythmias, Hypertension, Excessive salvation, Pain, burning at IV injection site.
Transient hypotension Tachycardia, Dysrhythmias, Hypertension, Excessive salvation, Pain, burning at IV injection site.
Drug Interactions:
Positive chronotropic drugs may potentiate tachycardia.
Positive chronotropic drugs may potentiate tachycardia.
Adult Dosage and Administration
0.04-0.1 mg/kg slow IV; repeat q 30-60 min prn.
0.04-0.1 mg/kg slow IV; repeat q 30-60 min prn.
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Pediatric Dosage and Administration:0.04-0.1 mg/kg slow IV.
Newborn: 0.02 m/kg dose.
Duration of Action:
- Onset: Paralysis in 3-5 min.
- Duration: 45-60 minutes.
Special Considerations:
- Pregnancy safety: Category C.
- Patients must be sedated completely and have an artificial airway during paralysis. Carefully monitor the patient and be prepared to resuscitate.
- Pancuronium has no effect on consciousness or pain.
- Pancuronium will not stop neuronal seizure activity or decrease central nervous system damage caused by seizures.
- Heart rate and cardiac output will be increased.
- Pancuronium is excreted in the urine; doses should be decreased for patients with renal disease.
- Neuromuscular blocking agents result in respiratory paralysis. Therefore, intubation and ventilatory support must be readily available.