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Pancuronium bromide
Pancuronium bromide (Pavulon)
Pancuronium bromide
(pan-kyou-ROH-nee-um)
Pregnancy Category: C Pavulon (Rx)

Classification: Neuromuscular blocking agent, nondepolarizing

See Also: See also Neuromuscular Blocking Agents.

Action/Kinetics: Five times as potent as d-tubocurarine. Anticholinesterase agents will reverse effects. Possesses vagolytic activity although it is not likely to cause histamine release. Onset: Within 45 sec. Time to peak effect: 3-4.5 min (depending on the dose). Duration: 35-45 min (increased with multiple doses). t1/2, elimination: 89-161 min. Forty percent is excreted through the urine either unchanged or as metabolites; 10% is excreted through the bile. In clients with renal failure, the t1/2 is doubled. Significantly bound to plasma protein.

Uses: Adjunct to anesthesia to produce relaxation of skeletal muscle. Facilitate ET intubation. Facilitate management of clients undergoing mechanical ventilation.

Special Concerns: Children up to 1 month of age may be more sensitive to the effects of atracurium. Clients with myasthenia gravis or Eaton-Lambert syndrome may have profound effects from small doses.

Additional Side Effects: Respiratory: Apnea, respiratory insufficiency. CV: Increased HR and MAP. Miscellaneous: Salivation, skin rashes, hypersensitivity reactions (e.g., bronchospasm flushing, hypotension, redness, tachycardia).

Additional Drug Interactions: Azathioprine / Reverses effects of pancuronium Bacitracin / Additive muscle relaxation Enflurane / Muscle relaxation Isoflurane / Muscle relaxation Metocurine / Muscle relaxation but duration is not prolonged Quinine / Effect of pancuronium Sodium colistimethate / Muscle relaxation Succinylcholine / Intensity and duration of action of pancuronium Tetracyclines / Additive muscle relaxation Theophyllines / Effects of pancuronium; also, possible cardiac arrhythmias Tricyclic antidepressants with halothane / Administration of pancuronium may cause severe arrhythmias Tubocurarine / Muscle relaxation but duration is not prolonged

How Supplied: Injection: 1 mg/mL, 2 mg/mL

Dosage
•IV Only Muscle relaxation during anesthesia.
Adults and children over 1 month of age, initial: 0.04-0.1 mg/kg. Additional doses of 0.01 mg/kg may be administered as required (usually q 20-60 min). Neonates: Administer a test dose of 0.02 mg/kg first to determine responsiveness.
ET intubation.
0.06-0.1 mg/kg as a bolus dose. Can undertake intubation in 2 to 3 min.