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What is Pancuronium
Pancuronium is a parenteral, long-acting, nondepolarizing, neuromuscular blocking agent indicated as an adjunct to general anesthesia to facilitate tracheal intubation and to provide skeletal muscle relaxation during surgery or mechanical ventilation.
Pancuronium is approximately one-third less potent than vecuronium, with a longer duration of action at initially equipotent doses.
Pancuronium has little effect on histamine release at usual doses and is not likely to cause clinically significant bronchospasm compared to agents with histamine-releasing properties such as atracurium and succinylcholine; however, pancuronium may cause significant tachycardia and hypertension due to vagolytic properties.
Indications
- endotracheal intubation
- neuromuscular blockade during mechanical ventilation
- neuromuscular blockade during surgery
- rapid-sequence intubation
- shaking chills
Side Effects
- acute quadriplegic myopathy syndrome
- anaphylactoid reactions
- angioedema
- anxiety
- apnea
- bronchospasm
- conjunctivitis
- dyspnea
- erythema
- flushing
- hypersalivation
- hypertension
- hypotension
- hypoxia
- keratitis
- malignant hyperthermia
- muscle paralysis
- myopathy
- pruritus
- rash
- respiratory depression
- sinus tachycardia
- skin erosion
- skin ulcer
- thrombosis
- tolerance
- urticaria
- weakness
- wheezing
- xerophthalmia
Monitoring Parameters
- peripheral nerve stimulation
Contraindications
- accidental exposure
- acid/base imbalance
- adrenal insufficiency
- asthma
- biliary obstruction
- breast-feeding
- bromide hypersensitivity
- burns
- cardiac disease
- chronic lung disease (CLD)
- chronic obstructive pulmonary disease (COPD)
- dehydration
- edema
- electrolyte imbalance
- geriatric
- hepatic disease
- hypercalcemia
- hypermagnesemia
- hypocalcemia
- hypokalemia
- hypothermia
- labor
- malignant hyperthermia
- metabolic acidosis
- metabolic alkalosis
- myasthenia gravis
- neonates
- neuromuscular blocking agent hypersensitivity
- neuromuscular disease
- obesity
- obstetric delivery
- pregnancy
- premature neonates
- pulmonary disease
- renal disease
- renal failure
- renal impairment
- requires a specialized care setting
- requires an experienced clinician
- respiratory acidosis
- respiratory alkalosis
- tachycardia
Interactions
- Acebutolol
- Acetazolamide
- Aliskiren; Amlodipine
- Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
- Amide local anesthetics
- Aminoglycosides
- Amlodipine
- Amlodipine; Atorvastatin
- Amlodipine; Benazepril
- Amlodipine; Celecoxib
- Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
- Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
- Amlodipine; Olmesartan
- Amlodipine; Telmisartan
- Amlodipine; Valsartan
- Amphotericin B
- Amphotericin B cholesteryl sulfate complex (ABCD)
- Amphotericin B lipid complex (ABLC)
- Amphotericin B liposomal (LAmB)
- Atenolol
- Atenolol; Chlorthalidone
- Bacitracin
- Bendroflumethiazide; Nadolol
- Beta-blockers
- Betaxolol
- Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
- Bismuth Subsalicylate; Metronidazole; Tetracycline
- Bisoprolol
- Bisoprolol; Hydrochlorothiazide, HCTZ
- Botulinum Toxins
- Brimonidine; Timolol
- Calcium
- Calcium Acetate
- Calcium Carbonate
- Calcium Carbonate; Magnesium Hydroxide
- Calcium Carbonate; Risedronate
- Calcium Carbonate; Simethicone
- Calcium Chloride
- Calcium Gluconate
- Calcium-channel blockers
- Calcium; Vitamin D
- Capreomycin
- Carbonic anhydrase inhibitors
- Carteolol
- Carvedilol
- Chromium
- Clevidipine
- Colistimethate, Colistin, Polymyxin E
- Corticosteroids
- Cyclophosphamide
- Cyclosporine
- Demeclocycline
- Desflurane
- Dextromethorphan; Quinidine
- Digoxin
- Diltiazem
- Donepezil
- Donepezil; Memantine
- Dorzolamide; Timolol
- Doxycycline
- Enalapril; Felodipine
- Enflurane
- Entecavir
- Esmolol
- Ester local anesthetics
- Felodipine
- Fosphenytoin
- Galantamine
- Hetastarch; Dextrose; Electrolytes
- Hydrochlorothiazide, HCTZ; Metoprolol
- Hydrochlorothiazide, HCTZ; Propranolol
- Indapamide
- Irinotecan
- Irinotecan Liposomal
- Isoflurane
- Isradipine
- Ketorolac
- Labetalol
- Levobetaxolol
- Levobunolol
- Lincosamides
- Lithium
- Loop diuretics
- Magnesium
- Methazolamide
- Metoprolol
- Minocycline
- Nadolol
- Nebivolol
- Nebivolol; Valsartan
- Neostigmine
- Nicardipine
- Nifedipine
- Nimodipine
- Nisoldipine
- Omadacycline
- Penbutolol
- Perindopril; Amlodipine
- Phenytoin
- Physostigmine
- Pindolol
- Piperacillin
- Piperacillin; Tazobactam
- Polymyxin B
- Polymyxins
- Procainamide
- Propranolol
- Pyridostigmine
- Quinidine
- Quinine
- Ranitidine
- Rivastigmine
- Sarecycline
- Sevoflurane
- Sotalol
- Succinylcholine
- Tetracycline
- Tetracyclines
- Theophylline, Aminophylline
- Thiazide diuretics
- Timolol
- Trandolapril; Verapamil
- Trospium
- Vancomycin
- Verapamil