Vecuronium

What is Vecuronium

Vecuronium is a parenteral, intermediate-acting, nondepolarizing, neuromuscular blocking agent indicated as an adjunct to general anesthesia to facilitate endotracheal intubation and to provide skeletal muscle relaxation during surgery or mechanical ventilation.

Vecuronium is approximately one-third more potent than pancuronium, with a shorter duration of action at initially equipotent doses.

Vecuronium causes minimal catecholamine and histamine release and is not likely to cause clinically significant bronchospasm or cardiac adverse effects compared to agents with histamine-releasing properties such as atracurium and succinylcholine.

For this reason, vecuronium is often considered to be a preferred agent in patients with cardiac conditions, hemodynamic instability, asthma, or severe allergic reactions.

Brand Name

Norcuron

Indications

  1. endotracheal intubation
  2. neuromuscular blockade during mechanical ventilation
  3. neuromuscular blockade during surgery
  4. rapid-sequence intubation
  5. shaking chills

Side Effects

  1. acute quadriplegic myopathy syndrome
  2. anaphylactoid reactions
  3. angioedema
  4. anxiety
  5. apnea
  6. bronchospasm
  7. conjunctivitis
  8. dyspnea
  9. erythema
  10. flushing
  11. hypotension
  12. hypoxia
  13. keratitis
  14. malignant hyperthermia
  15. muscle paralysis
  16. myopathy
  17. pruritus
  18. rash
  19. respiratory depression
  20. sinus tachycardia
  21. skin erosion
  22. skin ulcer
  23. thrombosis
  24. tolerance
  25. urticaria
  26. weakness
  27. wheezing
  28. xerophthalmia

Monitoring Parameters

  • peripheral nerve stimulation

Contraindications

  • accidental exposure
  • acid/base imbalance
  • adrenal insufficiency
  • asthma
  • breast-feeding
  • bromide hypersensitivity
  • burns
  • cardiac disease
  • children
  • chronic lung disease (CLD)
  • chronic obstructive pulmonary disease (COPD)
  • dehydration
  • dialysis
  • edema
  • electrolyte imbalance
  • geriatric
  • hepatic disease
  • hypercalcemia
  • hypermagnesemia
  • hypocalcemia
  • hypokalemia
  • hypothermia
  • infants
  • labor
  • malignant hyperthermia
  • metabolic acidosis
  • metabolic alkalosis
  • myasthenia gravis
  • neonates
  • neuromuscular blocking agent hypersensitivity
  • neuromuscular disease
  • obesity
  • obstetric delivery
  • pregnancy
  • pulmonary disease
  • renal failure
  • requires a specialized care setting
  • requires an experienced clinician
  • respiratory acidosis
  • respiratory alkalosis
  • uremia

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
  • Diltiazem
  • Donepezil
  • Donepezil; Memantine
  • Dorzolamide; Timolol
  • Doxycycline
  • Enalapril; Felodipine
  • Enflurane
  • 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
  • Metronidazole
  • 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
  • Vancomycin
  • Verapamil
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