Pancuronium |
Presentation |
• 4mg in 2ml amp | ||||||||||||
Pharmacology |
• A non-depolarising neuromuscular blocking agent | ||||||||||||
Actions |
• Blocks transmission of impulses at the neuromuscular junction of striated muscles
resulting in skeletal muscle paralysis. • Due to weak vagolytic action, a slight rise in pulse rate and mean arterial pressure may be expected |
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Metabolism |
• By the kidneys • Excreted mainly unchanged in the urine |
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Primary Emergency Indications |
• To maintain skeletal muscle paralysis and allow mechanical ventilation in intubated
Pts following: - Intubation Facilitated Sedation (IFS) Adult Paed, - Rapid Sequence Intubation (RSI) Adult, - or during interhospital transport of ventilated Pts. |
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Contraindications |
• Pancuronium must not be given if continuous monitoring of Pt vital signs including
pulse oximetry and end tidal CO2 monitoring are not available • Status Epilepticus |
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Precautions |
• Ensure patency of IV access • Sedatives must always be administered prior to Pancuronium Bromide • Endotracheal tube placement, adequacy of ventilation, oxygen saturation, end tidal CO2, pulse and blood pressure must be continuously monitored • Pts with myasthenia gravis should be given much smaller doses and monitored carefully due to the potential of increased degree of neuromuscular block • Care should be exercised in Pts with renal impairment |
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Route of Administration |
• IV | ||||||||||||
Side Effects |
• Slight increase in heart rate • Slight increase in mean arterial pressure • Localised reaction at injection site (rare) |
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Special Notes |
• Allergic reactions such as urticaria, laryngeal oedema, bronchospasm and anaphylactic
shock have been reported. • Pancuronium Bromide infusions required during interhospital transfers are to be prescribed and signed by the referring hospital medical offcer. The initial dose is usually 0.1mg/kg. |
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Therapeutic Effect |
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