Pancuronium bromide is a nondepolarizing neuromuscular blocking agent possessing all of the characteristic pharmacological actions of this class of drugs (curariform). It acts by competing for cholinergic receptors at the motor end-plate. The antagonism to acetylcholine is inhibited and neuromuscular block is reversed by anticholinesterase agents such as pyridostigmine, neostigmine, and edrophonium. Pancuronium bromide is approximately ⅓ less potent than vecuronium and approximately 5 times as potent as d-tubocurarine; the duration of neuromuscular blockade produced by Pancuronium bromide is longer than that of vecuronium at initially equipotent doses.
The ED95 (dose required to produce 95% suppression of muscle twitch response) is approximately 0.05 mg/kg under balanced anesthesia and 0.03 mg/kg under halothane anesthesia. These doses produce effective skeletal muscle relaxation (as judged by time from maximum effect to 25% recovery of control twitch height) for approximately 22 minutes; the duration from injection to 90% recovery of control twitch height is approximately 65 minutes. The intubating dose of 0.1 mg/kg (balanced anesthesia) will effectively abolish twitch response within approximately 4 minutes; time from injection to 25% recovery from this dose is approximately 100 minutes.
The elimination half-life of Pancuronium has been reported to range between 89–161 minutes. The volume of distribution ranges from 241–280 mL/kg and plasma clearance is approximately 1.1–1.9 mL/minute/kg. Approximately 40% of the total dose of Pancuronium has been recovered in urine as unchanged Pancuronium and its metabolites while approximately 11% has been recovered in bile. As much as 25% of an injected dose may be recovered as 3-hydroxy metabolite, which is half as potent a blocking agent as Pancuronium. Less than 5% of the injected dose is recovered as 17-hydroxy metabolite and 3,17-dihydroxy metabolite, which have been judged to be approximately 50 times less potent than Pancuronium. Pancuronium exhibits strong binding to gamma globulin and moderate binding to albumin. Approximately 13% is unbound to plasma protein. In patients with cirrhosis the volume of distribution is increased by approximately 50%, the plasma clearance is decreased by approximately 22% and the elimination half-life is doubled. Similar results were noted in patients with biliary obstruction, except that plasma clearance was less than half the normal rate. The initial total dose to achieve adequate relaxation may thus be high in patients with hepatic and/or biliary tract dysfunction, while the duration of action is greater than usual.
The elimination half-life is doubled and the plasma clearance is reduced by approximately 60% in patients with renal failure. The volume of distribution is variable, and in some cases elevated. The rate of recovery of neuromuscular blockade, as determined by peripheral nerve stimulation is variable and sometimes very much slower than normal.
• Production of skeletal muscle relaxation during surgery after general anesthesia.
• Facilitation of endotracheal intubation.
• Treatment to increase pulmonary compliance during assisted or controlled respiration.
Known hypersensitivity to pancuronium bromide or any ingredient in the formulation.
Respiratory Effects:
Potential for severely compromised respiratory function and respiratory paralysis.
Should be used only by individuals experienced in the use of neuromuscular blocking agents and in the maintenance of an adequate airway and respiratory support. Facilities and personnel necessary for intubation, administration of oxygen, and assisted or controlled respiration should be immediately available.
IV cholinesterase inhibitor (e.g., neostigmine, pyridostigmine, edrophonium) should be readily available. (See Reversal of Neuromuscular Blockade under Dosage and Administration.)
Use with caution in patients with pulmonary impairment or respiratory depression.
Neuromuscular Disease:
Possible profound neuromuscular blockade in patients with neuromuscular disease (e.g., myasthenia gravis, Eaton-Lambert syndrome).
Reduce initial dosage; monitor response carefully with a peripheral nerve stimulator.
Hypersensitivity Reactions:
Hypersensitivity reactions (bronchospasm, flushing, redness, hypotension, tachycardia) reported rarely.
Anesthetics, general (enflurane, halothane, isoflurane)
Increased potency of neuromuscular blockade
Select pancuronium dosage at lower end of recommended initial range
Antidepressants, tricyclic
Possible ventricular arrhythmias in patients receiving tricyclic antiderpessants concomitantly with pancuronium and halothane
Use with caution
Anti-infective agents (aminoglycosides, bacitracin, polymyxins, tetracyclines)
Possible prolonged duration of neuromuscular blockade
Magnesium salts
Possible increased neuromuscular blockade
Reduce pancuronium dosage if necessary
Neuromuscular blocking agents, nondepolarizing (e.g., atracurium, vecuronium)
Increased potency of neuromuscular blockade
Concomitant use not recommended
Quinidine
Possible recurrence of paralysis
Succinylcholine
Prior administration of succinylcholine may increase potency and prolong duration of neuromuscular blockade
Allow effects of succinylcholine to subside before administering pancuronium
Skeletal muscle weakness, slight elevation in pulse rate and excessive salivation.
• Store between 2-8 C°
• Injection 4mg/2ml: Box of 10 Ampoules
CUROPAN®
Injection 4mg/2ml
Neuromuscular Blocking Agents
Antimyasthenic, Muscle Relaxant
category C
Pancuronium bromide is a nondepolarizing neuromuscular blocking agent possessing all of the characteristic pharmacological actions of this class of drugs (curariform). It acts by competing for cholinergic receptors at the motor end-plate. The antagonism to acetylcholine is inhibited and neuromuscular block is reversed by anticholinesterase agents such as pyridostigmine, neostigmine, and edrophonium. Pancuronium bromide is approximately ⅓ less potent than vecuronium and approximately 5 times as potent as d-tubocurarine; the duration of neuromuscular blockade produced by Pancuronium bromide is longer than that of vecuronium at initially equipotent doses.
The ED95 (dose required to produce 95% suppression of muscle twitch response) is approximately 0.05 mg/kg under balanced anesthesia and 0.03 mg/kg under halothane anesthesia. These doses produce effective skeletal muscle relaxation (as judged by time from maximum effect to 25% recovery of control twitch height) for approximately 22 minutes; the duration from injection to 90% recovery of control twitch height is approximately 65 minutes. The intubating dose of 0.1 mg/kg (balanced anesthesia) will effectively abolish twitch response within approximately 4 minutes; time from injection to 25% recovery from this dose is approximately 100 minutes.
The elimination half-life of Pancuronium has been reported to range between 89–161 minutes. The volume of distribution ranges from 241–280 mL/kg and plasma clearance is approximately 1.1–1.9 mL/minute/kg. Approximately 40% of the total dose of Pancuronium has been recovered in urine as unchanged Pancuronium and its metabolites while approximately 11% has been recovered in bile. As much as 25% of an injected dose may be recovered as 3-hydroxy metabolite, which is half as potent a blocking agent as Pancuronium. Less than 5% of the injected dose is recovered as 17-hydroxy metabolite and 3,17-dihydroxy metabolite, which have been judged to be approximately 50 times less potent than Pancuronium. Pancuronium exhibits strong binding to gamma globulin and moderate binding to albumin. Approximately 13% is unbound to plasma protein. In patients with cirrhosis the volume of distribution is increased by approximately 50%, the plasma clearance is decreased by approximately 22% and the elimination half-life is doubled. Similar results were noted in patients with biliary obstruction, except that plasma clearance was less than half the normal rate. The initial total dose to achieve adequate relaxation may thus be high in patients with hepatic and/or biliary tract dysfunction, while the duration of action is greater than usual.
The elimination half-life is doubled and the plasma clearance is reduced by approximately 60% in patients with renal failure. The volume of distribution is variable, and in some cases elevated. The rate of recovery of neuromuscular blockade, as determined by peripheral nerve stimulation is variable and sometimes very much slower than normal.
• Production of skeletal muscle relaxation during surgery after general anesthesia.
• Facilitation of endotracheal intubation.
• Treatment to increase pulmonary compliance during assisted or controlled respiration.
Known hypersensitivity to pancuronium bromide or any ingredient in the formulation.
Respiratory Effects:
Potential for severely compromised respiratory function and respiratory paralysis.
Should be used only by individuals experienced in the use of neuromuscular blocking agents and in the maintenance of an adequate airway and respiratory support. Facilities and personnel necessary for intubation, administration of oxygen, and assisted or controlled respiration should be immediately available.
IV cholinesterase inhibitor (e.g., neostigmine, pyridostigmine, edrophonium) should be readily available. (See Reversal of Neuromuscular Blockade under Dosage and Administration.)
Use with caution in patients with pulmonary impairment or respiratory depression.
Neuromuscular Disease:
Possible profound neuromuscular blockade in patients with neuromuscular disease (e.g., myasthenia gravis, Eaton-Lambert syndrome).
Reduce initial dosage; monitor response carefully with a peripheral nerve stimulator.
Hypersensitivity Reactions:
Hypersensitivity reactions (bronchospasm, flushing, redness, hypotension, tachycardia) reported rarely.
Anesthetics, general (enflurane, halothane, isoflurane)
Increased potency of neuromuscular blockade
Select pancuronium dosage at lower end of recommended initial range
Antidepressants, tricyclic
Possible ventricular arrhythmias in patients receiving tricyclic antiderpessants concomitantly with pancuronium and halothane
Use with caution
Anti-infective agents (aminoglycosides, bacitracin, polymyxins, tetracyclines)
Possible prolonged duration of neuromuscular blockade
Magnesium salts
Possible increased neuromuscular blockade
Reduce pancuronium dosage if necessary
Neuromuscular blocking agents, nondepolarizing (e.g., atracurium, vecuronium)
Increased potency of neuromuscular blockade
Concomitant use not recommended
Quinidine
Possible recurrence of paralysis
Succinylcholine
Prior administration of succinylcholine may increase potency and prolong duration of neuromuscular blockade
Allow effects of succinylcholine to subside before administering pancuronium
Skeletal muscle weakness, slight elevation in pulse rate and excessive salivation.
• Store between 2-8 C°
• Injection 4mg/2ml: Box of 10 Ampoules
CUROPAN®
[view] =>CUROPAN®
) ) [field_contraindications] => Array ( [0] => Array ( [value] => Known hypersensitivity to pancuronium bromide or any ingredient in the formulation. [format] => 1 [safe] =>Known hypersensitivity to pancuronium bromide or any ingredient in the formulation.
[view] =>Known hypersensitivity to pancuronium bromide or any ingredient in the formulation.
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[view] =>Injection 4mg/2ml
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Anesthetics, general (enflurane, halothane, isoflurane) |
Increased potency of neuromuscular blockade |
Select pancuronium dosage at lower end of recommended initial range |
Antidepressants, tricyclic |
Possible ventricular arrhythmias in patients receiving tricyclic antiderpessants concomitantly with pancuronium and halothane |
Use with caution |
Anti-infective agents (aminoglycosides, bacitracin, polymyxins, tetracyclines) |
Possible prolonged duration of neuromuscular blockade |
|
Magnesium salts |
Possible increased neuromuscular blockade |
Reduce pancuronium dosage if necessary |
Neuromuscular blocking agents, nondepolarizing (e.g., atracurium, vecuronium) |
Increased potency of neuromuscular blockade |
Concomitant use not recommended |
Quinidine |
Possible recurrence of paralysis |
|
Succinylcholine |
Prior administration of succinylcholine may increase potency and prolong duration of neuromuscular blockade |
Allow effects of succinylcholine to subside before administering pancuronium |
[format] => 1 [safe] =>
Anesthetics, general (enflurane, halothane, isoflurane)
Increased potency of neuromuscular blockade
Select pancuronium dosage at lower end of recommended initial range
Antidepressants, tricyclic
Possible ventricular arrhythmias in patients receiving tricyclic antiderpessants concomitantly with pancuronium and halothane
Use with caution
Anti-infective agents (aminoglycosides, bacitracin, polymyxins, tetracyclines)
Possible prolonged duration of neuromuscular blockade
Magnesium salts
Possible increased neuromuscular blockade
Reduce pancuronium dosage if necessary
Neuromuscular blocking agents, nondepolarizing (e.g., atracurium, vecuronium)
Increased potency of neuromuscular blockade
Concomitant use not recommended
Quinidine
Possible recurrence of paralysis
Succinylcholine
Prior administration of succinylcholine may increase potency and prolong duration of neuromuscular blockade
Allow effects of succinylcholine to subside before administering pancuronium
[view] =>
Anesthetics, general (enflurane, halothane, isoflurane)
Increased potency of neuromuscular blockade
Select pancuronium dosage at lower end of recommended initial range
Antidepressants, tricyclic
Possible ventricular arrhythmias in patients receiving tricyclic antiderpessants concomitantly with pancuronium and halothane
Use with caution
Anti-infective agents (aminoglycosides, bacitracin, polymyxins, tetracyclines)
Possible prolonged duration of neuromuscular blockade
Magnesium salts
Possible increased neuromuscular blockade
Reduce pancuronium dosage if necessary
Neuromuscular blocking agents, nondepolarizing (e.g., atracurium, vecuronium)
Increased potency of neuromuscular blockade
Concomitant use not recommended
Quinidine
Possible recurrence of paralysis
Succinylcholine
Prior administration of succinylcholine may increase potency and prolong duration of neuromuscular blockade
Allow effects of succinylcholine to subside before administering pancuronium
) ) [field_indications] => Array ( [0] => Array ( [value] => • Production of skeletal muscle relaxation during surgery after general anesthesia. • Facilitation of endotracheal intubation. • Treatment to increase pulmonary compliance during assisted or controlled respiration. [format] => 1 [safe] =>
• Production of skeletal muscle relaxation during surgery after general anesthesia.
• Facilitation of endotracheal intubation.
• Treatment to increase pulmonary compliance during assisted or controlled respiration.
• Production of skeletal muscle relaxation during surgery after general anesthesia.
• Facilitation of endotracheal intubation.
• Treatment to increase pulmonary compliance during assisted or controlled respiration.
• Injection 4mg/2ml: Box of 10 Ampoules
[view] =>• Injection 4mg/2ml: Box of 10 Ampoules
) ) [field_pdf] => Array ( [0] => Array ( [fid] => 177 [uid] => 1 [filename] => pancuronium.pdf [filepath] => sites/default/files/pdf/pancuronium.pdf [filemime] => application/pdf [filesize] => 147888 [status] => 1 [timestamp] => 1329487493 [list] => 1 [data] => [i18nsync] => 1 [nid] => 276 [view] => ) ) [field_pharmacokinetics] => Array ( [0] => Array ( [value] => The elimination half-life of Pancuronium has been reported to range between 89–161 minutes. The volume of distribution ranges from 241–280 mL/kg and plasma clearance is approximately 1.1–1.9 mL/minute/kg. Approximately 40% of the total dose of Pancuronium has been recovered in urine as unchanged Pancuronium and its metabolites while approximately 11% has been recovered in bile. As much as 25% of an injected dose may be recovered as 3-hydroxy metabolite, which is half as potent a blocking agent as Pancuronium. Less than 5% of the injected dose is recovered as 17-hydroxy metabolite and 3,17-dihydroxy metabolite, which have been judged to be approximately 50 times less potent than Pancuronium. Pancuronium exhibits strong binding to gamma globulin and moderate binding to albumin. Approximately 13% is unbound to plasma protein. In patients with cirrhosis the volume of distribution is increased by approximately 50%, the plasma clearance is decreased by approximately 22% and the elimination half-life is doubled. Similar results were noted in patients with biliary obstruction, except that plasma clearance was less than half the normal rate. The initial total dose to achieve adequate relaxation may thus be high in patients with hepatic and/or biliary tract dysfunction, while the duration of action is greater than usual. The elimination half-life is doubled and the plasma clearance is reduced by approximately 60% in patients with renal failure. The volume of distribution is variable, and in some cases elevated. The rate of recovery of neuromuscular blockade, as determined by peripheral nerve stimulation is variable and sometimes very much slower than normal. [format] => 1 [safe] =>The elimination half-life of Pancuronium has been reported to range between 89–161 minutes. The volume of distribution ranges from 241–280 mL/kg and plasma clearance is approximately 1.1–1.9 mL/minute/kg. Approximately 40% of the total dose of Pancuronium has been recovered in urine as unchanged Pancuronium and its metabolites while approximately 11% has been recovered in bile. As much as 25% of an injected dose may be recovered as 3-hydroxy metabolite, which is half as potent a blocking agent as Pancuronium. Less than 5% of the injected dose is recovered as 17-hydroxy metabolite and 3,17-dihydroxy metabolite, which have been judged to be approximately 50 times less potent than Pancuronium. Pancuronium exhibits strong binding to gamma globulin and moderate binding to albumin. Approximately 13% is unbound to plasma protein. In patients with cirrhosis the volume of distribution is increased by approximately 50%, the plasma clearance is decreased by approximately 22% and the elimination half-life is doubled. Similar results were noted in patients with biliary obstruction, except that plasma clearance was less than half the normal rate. The initial total dose to achieve adequate relaxation may thus be high in patients with hepatic and/or biliary tract dysfunction, while the duration of action is greater than usual.
The elimination half-life is doubled and the plasma clearance is reduced by approximately 60% in patients with renal failure. The volume of distribution is variable, and in some cases elevated. The rate of recovery of neuromuscular blockade, as determined by peripheral nerve stimulation is variable and sometimes very much slower than normal.
[view] =>The elimination half-life of Pancuronium has been reported to range between 89–161 minutes. The volume of distribution ranges from 241–280 mL/kg and plasma clearance is approximately 1.1–1.9 mL/minute/kg. Approximately 40% of the total dose of Pancuronium has been recovered in urine as unchanged Pancuronium and its metabolites while approximately 11% has been recovered in bile. As much as 25% of an injected dose may be recovered as 3-hydroxy metabolite, which is half as potent a blocking agent as Pancuronium. Less than 5% of the injected dose is recovered as 17-hydroxy metabolite and 3,17-dihydroxy metabolite, which have been judged to be approximately 50 times less potent than Pancuronium. Pancuronium exhibits strong binding to gamma globulin and moderate binding to albumin. Approximately 13% is unbound to plasma protein. In patients with cirrhosis the volume of distribution is increased by approximately 50%, the plasma clearance is decreased by approximately 22% and the elimination half-life is doubled. Similar results were noted in patients with biliary obstruction, except that plasma clearance was less than half the normal rate. The initial total dose to achieve adequate relaxation may thus be high in patients with hepatic and/or biliary tract dysfunction, while the duration of action is greater than usual.
The elimination half-life is doubled and the plasma clearance is reduced by approximately 60% in patients with renal failure. The volume of distribution is variable, and in some cases elevated. The rate of recovery of neuromuscular blockade, as determined by peripheral nerve stimulation is variable and sometimes very much slower than normal.
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[view] =>Neuromuscular Blocking Agents
) ) [field_precautions] => Array ( [0] => Array ( [value] => Respiratory Effects: Potential for severely compromised respiratory function and respiratory paralysis. Should be used only by individuals experienced in the use of neuromuscular blocking agents and in the maintenance of an adequate airway and respiratory support. Facilities and personnel necessary for intubation, administration of oxygen, and assisted or controlled respiration should be immediately available. IV cholinesterase inhibitor (e.g., neostigmine, pyridostigmine, edrophonium) should be readily available. (See Reversal of Neuromuscular Blockade under Dosage and Administration.) Use with caution in patients with pulmonary impairment or respiratory depression. Neuromuscular Disease: Possible profound neuromuscular blockade in patients with neuromuscular disease (e.g., myasthenia gravis, Eaton-Lambert syndrome). Reduce initial dosage; monitor response carefully with a peripheral nerve stimulator. Hypersensitivity Reactions: Hypersensitivity reactions (bronchospasm, flushing, redness, hypotension, tachycardia) reported rarely. [format] => 1 [safe] =>Respiratory Effects:
Potential for severely compromised respiratory function and respiratory paralysis.
Should be used only by individuals experienced in the use of neuromuscular blocking agents and in the maintenance of an adequate airway and respiratory support. Facilities and personnel necessary for intubation, administration of oxygen, and assisted or controlled respiration should be immediately available.
IV cholinesterase inhibitor (e.g., neostigmine, pyridostigmine, edrophonium) should be readily available. (See Reversal of Neuromuscular Blockade under Dosage and Administration.)
Use with caution in patients with pulmonary impairment or respiratory depression.
Neuromuscular Disease:
Possible profound neuromuscular blockade in patients with neuromuscular disease (e.g., myasthenia gravis, Eaton-Lambert syndrome).
Reduce initial dosage; monitor response carefully with a peripheral nerve stimulator.
Hypersensitivity Reactions:
Hypersensitivity reactions (bronchospasm, flushing, redness, hypotension, tachycardia) reported rarely.
Respiratory Effects:
Potential for severely compromised respiratory function and respiratory paralysis.
Should be used only by individuals experienced in the use of neuromuscular blocking agents and in the maintenance of an adequate airway and respiratory support. Facilities and personnel necessary for intubation, administration of oxygen, and assisted or controlled respiration should be immediately available.
IV cholinesterase inhibitor (e.g., neostigmine, pyridostigmine, edrophonium) should be readily available. (See Reversal of Neuromuscular Blockade under Dosage and Administration.)
Use with caution in patients with pulmonary impairment or respiratory depression.
Neuromuscular Disease:
Possible profound neuromuscular blockade in patients with neuromuscular disease (e.g., myasthenia gravis, Eaton-Lambert syndrome).
Reduce initial dosage; monitor response carefully with a peripheral nerve stimulator.
Hypersensitivity Reactions:
Hypersensitivity reactions (bronchospasm, flushing, redness, hypotension, tachycardia) reported rarely.
category C
[view] =>category C
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[view] =>Skeletal muscle weakness, slight elevation in pulse rate and excessive salivation.
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[view] =>• Store between 2-8 C°
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Injection 4mg/2ml
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Neuromuscular Blocking Agents
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Antimyasthenic, Muscle Relaxant
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category C
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[#printed] => 1 ) [#title] => [#description] => [#children] =>category C
Pancuronium bromide is a nondepolarizing neuromuscular blocking agent possessing all of the characteristic pharmacological actions of this class of drugs (curariform). It acts by competing for cholinergic receptors at the motor end-plate. The antagonism to acetylcholine is inhibited and neuromuscular block is reversed by anticholinesterase agents such as pyridostigmine, neostigmine, and edrophonium. Pancuronium bromide is approximately ⅓ less potent than vecuronium and approximately 5 times as potent as d-tubocurarine; the duration of neuromuscular blockade produced by Pancuronium bromide is longer than that of vecuronium at initially equipotent doses.
The ED95 (dose required to produce 95% suppression of muscle twitch response) is approximately 0.05 mg/kg under balanced anesthesia and 0.03 mg/kg under halothane anesthesia. These doses produce effective skeletal muscle relaxation (as judged by time from maximum effect to 25% recovery of control twitch height) for approximately 22 minutes; the duration from injection to 90% recovery of control twitch height is approximately 65 minutes. The intubating dose of 0.1 mg/kg (balanced anesthesia) will effectively abolish twitch response within approximately 4 minutes; time from injection to 25% recovery from this dose is approximately 100 minutes.
[#title] => [#description] => [#printed] => 1 ) [field_pharmacokinetics] => Array ( [#type_name] => product [#context] => full [#field_name] => field_pharmacokinetics [#post_render] => Array ( [0] => content_field_wrapper_post_render ) [#weight] => 4 [field] => Array ( [#description] => [items] => Array ( [0] => Array ( [#formatter] => default [#node] => stdClass Object *RECURSION* [#type_name] => product [#field_name] => field_pharmacokinetics [#weight] => 0 [#theme] => text_formatter_default [#item] => Array ( [value] => The elimination half-life of Pancuronium has been reported to range between 89–161 minutes. The volume of distribution ranges from 241–280 mL/kg and plasma clearance is approximately 1.1–1.9 mL/minute/kg. Approximately 40% of the total dose of Pancuronium has been recovered in urine as unchanged Pancuronium and its metabolites while approximately 11% has been recovered in bile. As much as 25% of an injected dose may be recovered as 3-hydroxy metabolite, which is half as potent a blocking agent as Pancuronium. Less than 5% of the injected dose is recovered as 17-hydroxy metabolite and 3,17-dihydroxy metabolite, which have been judged to be approximately 50 times less potent than Pancuronium. Pancuronium exhibits strong binding to gamma globulin and moderate binding to albumin. Approximately 13% is unbound to plasma protein. In patients with cirrhosis the volume of distribution is increased by approximately 50%, the plasma clearance is decreased by approximately 22% and the elimination half-life is doubled. Similar results were noted in patients with biliary obstruction, except that plasma clearance was less than half the normal rate. The initial total dose to achieve adequate relaxation may thus be high in patients with hepatic and/or biliary tract dysfunction, while the duration of action is greater than usual. The elimination half-life is doubled and the plasma clearance is reduced by approximately 60% in patients with renal failure. The volume of distribution is variable, and in some cases elevated. The rate of recovery of neuromuscular blockade, as determined by peripheral nerve stimulation is variable and sometimes very much slower than normal. [format] => 1 [safe] =>The elimination half-life of Pancuronium has been reported to range between 89–161 minutes. The volume of distribution ranges from 241–280 mL/kg and plasma clearance is approximately 1.1–1.9 mL/minute/kg. Approximately 40% of the total dose of Pancuronium has been recovered in urine as unchanged Pancuronium and its metabolites while approximately 11% has been recovered in bile. As much as 25% of an injected dose may be recovered as 3-hydroxy metabolite, which is half as potent a blocking agent as Pancuronium. Less than 5% of the injected dose is recovered as 17-hydroxy metabolite and 3,17-dihydroxy metabolite, which have been judged to be approximately 50 times less potent than Pancuronium. Pancuronium exhibits strong binding to gamma globulin and moderate binding to albumin. Approximately 13% is unbound to plasma protein. In patients with cirrhosis the volume of distribution is increased by approximately 50%, the plasma clearance is decreased by approximately 22% and the elimination half-life is doubled. Similar results were noted in patients with biliary obstruction, except that plasma clearance was less than half the normal rate. The initial total dose to achieve adequate relaxation may thus be high in patients with hepatic and/or biliary tract dysfunction, while the duration of action is greater than usual.
The elimination half-life is doubled and the plasma clearance is reduced by approximately 60% in patients with renal failure. The volume of distribution is variable, and in some cases elevated. The rate of recovery of neuromuscular blockade, as determined by peripheral nerve stimulation is variable and sometimes very much slower than normal.
[#delta] => 0 ) [#title] => [#description] => [#theme_used] => 1 [#printed] => 1 [#type] => [#value] => [#prefix] => [#suffix] => [#children] =>The elimination half-life of Pancuronium has been reported to range between 89–161 minutes. The volume of distribution ranges from 241–280 mL/kg and plasma clearance is approximately 1.1–1.9 mL/minute/kg. Approximately 40% of the total dose of Pancuronium has been recovered in urine as unchanged Pancuronium and its metabolites while approximately 11% has been recovered in bile. As much as 25% of an injected dose may be recovered as 3-hydroxy metabolite, which is half as potent a blocking agent as Pancuronium. Less than 5% of the injected dose is recovered as 17-hydroxy metabolite and 3,17-dihydroxy metabolite, which have been judged to be approximately 50 times less potent than Pancuronium. Pancuronium exhibits strong binding to gamma globulin and moderate binding to albumin. Approximately 13% is unbound to plasma protein. In patients with cirrhosis the volume of distribution is increased by approximately 50%, the plasma clearance is decreased by approximately 22% and the elimination half-life is doubled. Similar results were noted in patients with biliary obstruction, except that plasma clearance was less than half the normal rate. The initial total dose to achieve adequate relaxation may thus be high in patients with hepatic and/or biliary tract dysfunction, while the duration of action is greater than usual.
The elimination half-life is doubled and the plasma clearance is reduced by approximately 60% in patients with renal failure. The volume of distribution is variable, and in some cases elevated. The rate of recovery of neuromuscular blockade, as determined by peripheral nerve stimulation is variable and sometimes very much slower than normal.
) [#title] => [#description] => [#children] =>The elimination half-life of Pancuronium has been reported to range between 89–161 minutes. The volume of distribution ranges from 241–280 mL/kg and plasma clearance is approximately 1.1–1.9 mL/minute/kg. Approximately 40% of the total dose of Pancuronium has been recovered in urine as unchanged Pancuronium and its metabolites while approximately 11% has been recovered in bile. As much as 25% of an injected dose may be recovered as 3-hydroxy metabolite, which is half as potent a blocking agent as Pancuronium. Less than 5% of the injected dose is recovered as 17-hydroxy metabolite and 3,17-dihydroxy metabolite, which have been judged to be approximately 50 times less potent than Pancuronium. Pancuronium exhibits strong binding to gamma globulin and moderate binding to albumin. Approximately 13% is unbound to plasma protein. In patients with cirrhosis the volume of distribution is increased by approximately 50%, the plasma clearance is decreased by approximately 22% and the elimination half-life is doubled. Similar results were noted in patients with biliary obstruction, except that plasma clearance was less than half the normal rate. The initial total dose to achieve adequate relaxation may thus be high in patients with hepatic and/or biliary tract dysfunction, while the duration of action is greater than usual.
The elimination half-life is doubled and the plasma clearance is reduced by approximately 60% in patients with renal failure. The volume of distribution is variable, and in some cases elevated. The rate of recovery of neuromuscular blockade, as determined by peripheral nerve stimulation is variable and sometimes very much slower than normal.
[#printed] => 1 ) [#single] => 1 [#attributes] => Array ( ) [#required] => [#parents] => Array ( ) [#tree] => [#context] => full [#page] => 1 [#field_name] => field_pharmacokinetics [#title] => Pharmacokinetics [#access] => 1 [#label_display] => above [#teaser] => [#node] => stdClass Object *RECURSION* [#type] => content_field [#children] =>The elimination half-life of Pancuronium has been reported to range between 89–161 minutes. The volume of distribution ranges from 241–280 mL/kg and plasma clearance is approximately 1.1–1.9 mL/minute/kg. Approximately 40% of the total dose of Pancuronium has been recovered in urine as unchanged Pancuronium and its metabolites while approximately 11% has been recovered in bile. As much as 25% of an injected dose may be recovered as 3-hydroxy metabolite, which is half as potent a blocking agent as Pancuronium. Less than 5% of the injected dose is recovered as 17-hydroxy metabolite and 3,17-dihydroxy metabolite, which have been judged to be approximately 50 times less potent than Pancuronium. Pancuronium exhibits strong binding to gamma globulin and moderate binding to albumin. Approximately 13% is unbound to plasma protein. In patients with cirrhosis the volume of distribution is increased by approximately 50%, the plasma clearance is decreased by approximately 22% and the elimination half-life is doubled. Similar results were noted in patients with biliary obstruction, except that plasma clearance was less than half the normal rate. The initial total dose to achieve adequate relaxation may thus be high in patients with hepatic and/or biliary tract dysfunction, while the duration of action is greater than usual.
The elimination half-life is doubled and the plasma clearance is reduced by approximately 60% in patients with renal failure. The volume of distribution is variable, and in some cases elevated. The rate of recovery of neuromuscular blockade, as determined by peripheral nerve stimulation is variable and sometimes very much slower than normal.
[#printed] => 1 ) [#title] => [#description] => [#children] =>The elimination half-life of Pancuronium has been reported to range between 89–161 minutes. The volume of distribution ranges from 241–280 mL/kg and plasma clearance is approximately 1.1–1.9 mL/minute/kg. Approximately 40% of the total dose of Pancuronium has been recovered in urine as unchanged Pancuronium and its metabolites while approximately 11% has been recovered in bile. As much as 25% of an injected dose may be recovered as 3-hydroxy metabolite, which is half as potent a blocking agent as Pancuronium. Less than 5% of the injected dose is recovered as 17-hydroxy metabolite and 3,17-dihydroxy metabolite, which have been judged to be approximately 50 times less potent than Pancuronium. Pancuronium exhibits strong binding to gamma globulin and moderate binding to albumin. Approximately 13% is unbound to plasma protein. In patients with cirrhosis the volume of distribution is increased by approximately 50%, the plasma clearance is decreased by approximately 22% and the elimination half-life is doubled. Similar results were noted in patients with biliary obstruction, except that plasma clearance was less than half the normal rate. The initial total dose to achieve adequate relaxation may thus be high in patients with hepatic and/or biliary tract dysfunction, while the duration of action is greater than usual.
The elimination half-life is doubled and the plasma clearance is reduced by approximately 60% in patients with renal failure. The volume of distribution is variable, and in some cases elevated. The rate of recovery of neuromuscular blockade, as determined by peripheral nerve stimulation is variable and sometimes very much slower than normal.
• Production of skeletal muscle relaxation during surgery after general anesthesia.
• Facilitation of endotracheal intubation.
• Treatment to increase pulmonary compliance during assisted or controlled respiration.
• Production of skeletal muscle relaxation during surgery after general anesthesia.
• Facilitation of endotracheal intubation.
• Treatment to increase pulmonary compliance during assisted or controlled respiration.
• Production of skeletal muscle relaxation during surgery after general anesthesia.
• Facilitation of endotracheal intubation.
• Treatment to increase pulmonary compliance during assisted or controlled respiration.
• Production of skeletal muscle relaxation during surgery after general anesthesia.
• Facilitation of endotracheal intubation.
• Treatment to increase pulmonary compliance during assisted or controlled respiration.
• Production of skeletal muscle relaxation during surgery after general anesthesia.
• Facilitation of endotracheal intubation.
• Treatment to increase pulmonary compliance during assisted or controlled respiration.
Known hypersensitivity to pancuronium bromide or any ingredient in the formulation.
[#delta] => 0 ) [#title] => [#description] => [#theme_used] => 1 [#printed] => 1 [#type] => [#value] => [#prefix] => [#suffix] => [#children] =>Known hypersensitivity to pancuronium bromide or any ingredient in the formulation.
) [#title] => [#description] => [#children] =>Known hypersensitivity to pancuronium bromide or any ingredient in the formulation.
[#printed] => 1 ) [#single] => 1 [#attributes] => Array ( ) [#required] => [#parents] => Array ( ) [#tree] => [#context] => full [#page] => 1 [#field_name] => field_contraindications [#title] => Contraindications [#access] => 1 [#label_display] => above [#teaser] => [#node] => stdClass Object *RECURSION* [#type] => content_field [#children] =>Known hypersensitivity to pancuronium bromide or any ingredient in the formulation.
[#printed] => 1 ) [#title] => [#description] => [#children] =>Known hypersensitivity to pancuronium bromide or any ingredient in the formulation.
Respiratory Effects:
Potential for severely compromised respiratory function and respiratory paralysis.
Should be used only by individuals experienced in the use of neuromuscular blocking agents and in the maintenance of an adequate airway and respiratory support. Facilities and personnel necessary for intubation, administration of oxygen, and assisted or controlled respiration should be immediately available.
IV cholinesterase inhibitor (e.g., neostigmine, pyridostigmine, edrophonium) should be readily available. (See Reversal of Neuromuscular Blockade under Dosage and Administration.)
Use with caution in patients with pulmonary impairment or respiratory depression.
Neuromuscular Disease:
Possible profound neuromuscular blockade in patients with neuromuscular disease (e.g., myasthenia gravis, Eaton-Lambert syndrome).
Reduce initial dosage; monitor response carefully with a peripheral nerve stimulator.
Hypersensitivity Reactions:
Hypersensitivity reactions (bronchospasm, flushing, redness, hypotension, tachycardia) reported rarely.
Respiratory Effects:
Potential for severely compromised respiratory function and respiratory paralysis.
Should be used only by individuals experienced in the use of neuromuscular blocking agents and in the maintenance of an adequate airway and respiratory support. Facilities and personnel necessary for intubation, administration of oxygen, and assisted or controlled respiration should be immediately available.
IV cholinesterase inhibitor (e.g., neostigmine, pyridostigmine, edrophonium) should be readily available. (See Reversal of Neuromuscular Blockade under Dosage and Administration.)
Use with caution in patients with pulmonary impairment or respiratory depression.
Neuromuscular Disease:
Possible profound neuromuscular blockade in patients with neuromuscular disease (e.g., myasthenia gravis, Eaton-Lambert syndrome).
Reduce initial dosage; monitor response carefully with a peripheral nerve stimulator.
Hypersensitivity Reactions:
Hypersensitivity reactions (bronchospasm, flushing, redness, hypotension, tachycardia) reported rarely.
Respiratory Effects:
Potential for severely compromised respiratory function and respiratory paralysis.
Should be used only by individuals experienced in the use of neuromuscular blocking agents and in the maintenance of an adequate airway and respiratory support. Facilities and personnel necessary for intubation, administration of oxygen, and assisted or controlled respiration should be immediately available.
IV cholinesterase inhibitor (e.g., neostigmine, pyridostigmine, edrophonium) should be readily available. (See Reversal of Neuromuscular Blockade under Dosage and Administration.)
Use with caution in patients with pulmonary impairment or respiratory depression.
Neuromuscular Disease:
Possible profound neuromuscular blockade in patients with neuromuscular disease (e.g., myasthenia gravis, Eaton-Lambert syndrome).
Reduce initial dosage; monitor response carefully with a peripheral nerve stimulator.
Hypersensitivity Reactions:
Hypersensitivity reactions (bronchospasm, flushing, redness, hypotension, tachycardia) reported rarely.
Respiratory Effects:
Potential for severely compromised respiratory function and respiratory paralysis.
Should be used only by individuals experienced in the use of neuromuscular blocking agents and in the maintenance of an adequate airway and respiratory support. Facilities and personnel necessary for intubation, administration of oxygen, and assisted or controlled respiration should be immediately available.
IV cholinesterase inhibitor (e.g., neostigmine, pyridostigmine, edrophonium) should be readily available. (See Reversal of Neuromuscular Blockade under Dosage and Administration.)
Use with caution in patients with pulmonary impairment or respiratory depression.
Neuromuscular Disease:
Possible profound neuromuscular blockade in patients with neuromuscular disease (e.g., myasthenia gravis, Eaton-Lambert syndrome).
Reduce initial dosage; monitor response carefully with a peripheral nerve stimulator.
Hypersensitivity Reactions:
Hypersensitivity reactions (bronchospasm, flushing, redness, hypotension, tachycardia) reported rarely.
Respiratory Effects:
Potential for severely compromised respiratory function and respiratory paralysis.
Should be used only by individuals experienced in the use of neuromuscular blocking agents and in the maintenance of an adequate airway and respiratory support. Facilities and personnel necessary for intubation, administration of oxygen, and assisted or controlled respiration should be immediately available.
IV cholinesterase inhibitor (e.g., neostigmine, pyridostigmine, edrophonium) should be readily available. (See Reversal of Neuromuscular Blockade under Dosage and Administration.)
Use with caution in patients with pulmonary impairment or respiratory depression.
Neuromuscular Disease:
Possible profound neuromuscular blockade in patients with neuromuscular disease (e.g., myasthenia gravis, Eaton-Lambert syndrome).
Reduce initial dosage; monitor response carefully with a peripheral nerve stimulator.
Hypersensitivity Reactions:
Hypersensitivity reactions (bronchospasm, flushing, redness, hypotension, tachycardia) reported rarely.
Anesthetics, general (enflurane, halothane, isoflurane) |
Increased potency of neuromuscular blockade |
Select pancuronium dosage at lower end of recommended initial range |
Antidepressants, tricyclic |
Possible ventricular arrhythmias in patients receiving tricyclic antiderpessants concomitantly with pancuronium and halothane |
Use with caution |
Anti-infective agents (aminoglycosides, bacitracin, polymyxins, tetracyclines) |
Possible prolonged duration of neuromuscular blockade |
|
Magnesium salts |
Possible increased neuromuscular blockade |
Reduce pancuronium dosage if necessary |
Neuromuscular blocking agents, nondepolarizing (e.g., atracurium, vecuronium) |
Increased potency of neuromuscular blockade |
Concomitant use not recommended |
Quinidine |
Possible recurrence of paralysis |
|
Succinylcholine |
Prior administration of succinylcholine may increase potency and prolong duration of neuromuscular blockade |
Allow effects of succinylcholine to subside before administering pancuronium |
[format] => 1 [safe] =>
Anesthetics, general (enflurane, halothane, isoflurane)
Increased potency of neuromuscular blockade
Select pancuronium dosage at lower end of recommended initial range
Antidepressants, tricyclic
Possible ventricular arrhythmias in patients receiving tricyclic antiderpessants concomitantly with pancuronium and halothane
Use with caution
Anti-infective agents (aminoglycosides, bacitracin, polymyxins, tetracyclines)
Possible prolonged duration of neuromuscular blockade
Magnesium salts
Possible increased neuromuscular blockade
Reduce pancuronium dosage if necessary
Neuromuscular blocking agents, nondepolarizing (e.g., atracurium, vecuronium)
Increased potency of neuromuscular blockade
Concomitant use not recommended
Quinidine
Possible recurrence of paralysis
Succinylcholine
Prior administration of succinylcholine may increase potency and prolong duration of neuromuscular blockade
Allow effects of succinylcholine to subside before administering pancuronium
[#delta] => 0 ) [#title] => [#description] => [#theme_used] => 1 [#printed] => 1 [#type] => [#value] => [#prefix] => [#suffix] => [#children] =>
Anesthetics, general (enflurane, halothane, isoflurane)
Increased potency of neuromuscular blockade
Select pancuronium dosage at lower end of recommended initial range
Antidepressants, tricyclic
Possible ventricular arrhythmias in patients receiving tricyclic antiderpessants concomitantly with pancuronium and halothane
Use with caution
Anti-infective agents (aminoglycosides, bacitracin, polymyxins, tetracyclines)
Possible prolonged duration of neuromuscular blockade
Magnesium salts
Possible increased neuromuscular blockade
Reduce pancuronium dosage if necessary
Neuromuscular blocking agents, nondepolarizing (e.g., atracurium, vecuronium)
Increased potency of neuromuscular blockade
Concomitant use not recommended
Quinidine
Possible recurrence of paralysis
Succinylcholine
Prior administration of succinylcholine may increase potency and prolong duration of neuromuscular blockade
Allow effects of succinylcholine to subside before administering pancuronium
) [#title] => [#description] => [#children] =>
Anesthetics, general (enflurane, halothane, isoflurane)
Increased potency of neuromuscular blockade
Select pancuronium dosage at lower end of recommended initial range
Antidepressants, tricyclic
Possible ventricular arrhythmias in patients receiving tricyclic antiderpessants concomitantly with pancuronium and halothane
Use with caution
Anti-infective agents (aminoglycosides, bacitracin, polymyxins, tetracyclines)
Possible prolonged duration of neuromuscular blockade
Magnesium salts
Possible increased neuromuscular blockade
Reduce pancuronium dosage if necessary
Neuromuscular blocking agents, nondepolarizing (e.g., atracurium, vecuronium)
Increased potency of neuromuscular blockade
Concomitant use not recommended
Quinidine
Possible recurrence of paralysis
Succinylcholine
Prior administration of succinylcholine may increase potency and prolong duration of neuromuscular blockade
Allow effects of succinylcholine to subside before administering pancuronium
[#printed] => 1 ) [#single] => 1 [#attributes] => Array ( ) [#required] => [#parents] => Array ( ) [#tree] => [#context] => full [#page] => 1 [#field_name] => field_drug_interactions [#title] => Drug Interactions [#access] => 1 [#label_display] => above [#teaser] => [#node] => stdClass Object *RECURSION* [#type] => content_field [#children] =>
Anesthetics, general (enflurane, halothane, isoflurane)
Increased potency of neuromuscular blockade
Select pancuronium dosage at lower end of recommended initial range
Antidepressants, tricyclic
Possible ventricular arrhythmias in patients receiving tricyclic antiderpessants concomitantly with pancuronium and halothane
Use with caution
Anti-infective agents (aminoglycosides, bacitracin, polymyxins, tetracyclines)
Possible prolonged duration of neuromuscular blockade
Magnesium salts
Possible increased neuromuscular blockade
Reduce pancuronium dosage if necessary
Neuromuscular blocking agents, nondepolarizing (e.g., atracurium, vecuronium)
Increased potency of neuromuscular blockade
Concomitant use not recommended
Quinidine
Possible recurrence of paralysis
Succinylcholine
Prior administration of succinylcholine may increase potency and prolong duration of neuromuscular blockade
Allow effects of succinylcholine to subside before administering pancuronium
[#printed] => 1 ) [#title] => [#description] => [#children] =>
Anesthetics, general (enflurane, halothane, isoflurane)
Increased potency of neuromuscular blockade
Select pancuronium dosage at lower end of recommended initial range
Antidepressants, tricyclic
Possible ventricular arrhythmias in patients receiving tricyclic antiderpessants concomitantly with pancuronium and halothane
Use with caution
Anti-infective agents (aminoglycosides, bacitracin, polymyxins, tetracyclines)
Possible prolonged duration of neuromuscular blockade
Magnesium salts
Possible increased neuromuscular blockade
Reduce pancuronium dosage if necessary
Neuromuscular blocking agents, nondepolarizing (e.g., atracurium, vecuronium)
Increased potency of neuromuscular blockade
Concomitant use not recommended
Quinidine
Possible recurrence of paralysis
Succinylcholine
Prior administration of succinylcholine may increase potency and prolong duration of neuromuscular blockade
Allow effects of succinylcholine to subside before administering pancuronium
Skeletal muscle weakness, slight elevation in pulse rate and excessive salivation.
[#delta] => 0 ) [#title] => [#description] => [#theme_used] => 1 [#printed] => 1 [#type] => [#value] => [#prefix] => [#suffix] => [#children] =>Skeletal muscle weakness, slight elevation in pulse rate and excessive salivation.
) [#title] => [#description] => [#children] =>Skeletal muscle weakness, slight elevation in pulse rate and excessive salivation.
[#printed] => 1 ) [#single] => 1 [#attributes] => Array ( ) [#required] => [#parents] => Array ( ) [#tree] => [#context] => full [#page] => 1 [#field_name] => field_side_effects [#title] => Side Effects [#access] => 1 [#label_display] => above [#teaser] => [#node] => stdClass Object *RECURSION* [#type] => content_field [#children] =>Skeletal muscle weakness, slight elevation in pulse rate and excessive salivation.
[#printed] => 1 ) [#title] => [#description] => [#children] =>Skeletal muscle weakness, slight elevation in pulse rate and excessive salivation.
• Store between 2-8 C°
[#delta] => 0 ) [#title] => [#description] => [#theme_used] => 1 [#printed] => 1 [#type] => [#value] => [#prefix] => [#suffix] => [#children] =>• Store between 2-8 C°
) [#title] => [#description] => [#children] =>• Store between 2-8 C°
[#printed] => 1 ) [#single] => 1 [#attributes] => Array ( ) [#required] => [#parents] => Array ( ) [#tree] => [#context] => full [#page] => 1 [#field_name] => field_storage [#title] => Storage [#access] => 1 [#label_display] => above [#teaser] => [#node] => stdClass Object *RECURSION* [#type] => content_field [#children] =>• Store between 2-8 C°
[#printed] => 1 ) [#title] => [#description] => [#children] =>• Store between 2-8 C°
• Injection 4mg/2ml: Box of 10 Ampoules
[#delta] => 0 ) [#title] => [#description] => [#theme_used] => 1 [#printed] => 1 [#type] => [#value] => [#prefix] => [#suffix] => [#children] =>• Injection 4mg/2ml: Box of 10 Ampoules
) [#title] => [#description] => [#children] =>• Injection 4mg/2ml: Box of 10 Ampoules
[#printed] => 1 ) [#single] => 1 [#attributes] => Array ( ) [#required] => [#parents] => Array ( ) [#tree] => [#context] => full [#page] => 1 [#field_name] => field_packing [#title] => Packing [#access] => 1 [#label_display] => above [#teaser] => [#node] => stdClass Object *RECURSION* [#type] => content_field [#children] =>• Injection 4mg/2ml: Box of 10 Ampoules
[#printed] => 1 ) [#title] => [#description] => [#children] =>• Injection 4mg/2ml: Box of 10 Ampoules
CUROPAN®
Injection 4mg/2ml
Neuromuscular Blocking Agents
Antimyasthenic, Muscle Relaxant
category C
Pancuronium bromide is a nondepolarizing neuromuscular blocking agent possessing all of the characteristic pharmacological actions of this class of drugs (curariform). It acts by competing for cholinergic receptors at the motor end-plate. The antagonism to acetylcholine is inhibited and neuromuscular block is reversed by anticholinesterase agents such as pyridostigmine, neostigmine, and edrophonium. Pancuronium bromide is approximately ⅓ less potent than vecuronium and approximately 5 times as potent as d-tubocurarine; the duration of neuromuscular blockade produced by Pancuronium bromide is longer than that of vecuronium at initially equipotent doses.
The ED95 (dose required to produce 95% suppression of muscle twitch response) is approximately 0.05 mg/kg under balanced anesthesia and 0.03 mg/kg under halothane anesthesia. These doses produce effective skeletal muscle relaxation (as judged by time from maximum effect to 25% recovery of control twitch height) for approximately 22 minutes; the duration from injection to 90% recovery of control twitch height is approximately 65 minutes. The intubating dose of 0.1 mg/kg (balanced anesthesia) will effectively abolish twitch response within approximately 4 minutes; time from injection to 25% recovery from this dose is approximately 100 minutes.
The elimination half-life of Pancuronium has been reported to range between 89–161 minutes. The volume of distribution ranges from 241–280 mL/kg and plasma clearance is approximately 1.1–1.9 mL/minute/kg. Approximately 40% of the total dose of Pancuronium has been recovered in urine as unchanged Pancuronium and its metabolites while approximately 11% has been recovered in bile. As much as 25% of an injected dose may be recovered as 3-hydroxy metabolite, which is half as potent a blocking agent as Pancuronium. Less than 5% of the injected dose is recovered as 17-hydroxy metabolite and 3,17-dihydroxy metabolite, which have been judged to be approximately 50 times less potent than Pancuronium. Pancuronium exhibits strong binding to gamma globulin and moderate binding to albumin. Approximately 13% is unbound to plasma protein. In patients with cirrhosis the volume of distribution is increased by approximately 50%, the plasma clearance is decreased by approximately 22% and the elimination half-life is doubled. Similar results were noted in patients with biliary obstruction, except that plasma clearance was less than half the normal rate. The initial total dose to achieve adequate relaxation may thus be high in patients with hepatic and/or biliary tract dysfunction, while the duration of action is greater than usual.
The elimination half-life is doubled and the plasma clearance is reduced by approximately 60% in patients with renal failure. The volume of distribution is variable, and in some cases elevated. The rate of recovery of neuromuscular blockade, as determined by peripheral nerve stimulation is variable and sometimes very much slower than normal.
• Production of skeletal muscle relaxation during surgery after general anesthesia.
• Facilitation of endotracheal intubation.
• Treatment to increase pulmonary compliance during assisted or controlled respiration.
Known hypersensitivity to pancuronium bromide or any ingredient in the formulation.
Respiratory Effects:
Potential for severely compromised respiratory function and respiratory paralysis.
Should be used only by individuals experienced in the use of neuromuscular blocking agents and in the maintenance of an adequate airway and respiratory support. Facilities and personnel necessary for intubation, administration of oxygen, and assisted or controlled respiration should be immediately available.
IV cholinesterase inhibitor (e.g., neostigmine, pyridostigmine, edrophonium) should be readily available. (See Reversal of Neuromuscular Blockade under Dosage and Administration.)
Use with caution in patients with pulmonary impairment or respiratory depression.
Neuromuscular Disease:
Possible profound neuromuscular blockade in patients with neuromuscular disease (e.g., myasthenia gravis, Eaton-Lambert syndrome).
Reduce initial dosage; monitor response carefully with a peripheral nerve stimulator.
Hypersensitivity Reactions:
Hypersensitivity reactions (bronchospasm, flushing, redness, hypotension, tachycardia) reported rarely.
Anesthetics, general (enflurane, halothane, isoflurane)
Increased potency of neuromuscular blockade
Select pancuronium dosage at lower end of recommended initial range
Antidepressants, tricyclic
Possible ventricular arrhythmias in patients receiving tricyclic antiderpessants concomitantly with pancuronium and halothane
Use with caution
Anti-infective agents (aminoglycosides, bacitracin, polymyxins, tetracyclines)
Possible prolonged duration of neuromuscular blockade
Magnesium salts
Possible increased neuromuscular blockade
Reduce pancuronium dosage if necessary
Neuromuscular blocking agents, nondepolarizing (e.g., atracurium, vecuronium)
Increased potency of neuromuscular blockade
Concomitant use not recommended
Quinidine
Possible recurrence of paralysis
Succinylcholine
Prior administration of succinylcholine may increase potency and prolong duration of neuromuscular blockade
Allow effects of succinylcholine to subside before administering pancuronium
Skeletal muscle weakness, slight elevation in pulse rate and excessive salivation.
• Store between 2-8 C°
• Injection 4mg/2ml: Box of 10 Ampoules
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All Rights Reserved.