Pancuronium Bromide

What it is and how it works

Pancuronium competitively antagonises acetylcholine at nicotinic receptors of the motor end-plate, producing skeletal muscle relaxation; it also has vagolytic activity that may increase heart rate.

Indications

Adjunct to general anaesthesia to facilitate tracheal intubation and provide muscle relaxation during surgery; facilitation of mechanical ventilation in intensive care.

Dosage and administration (summary)

Intravenous, dose individualised by the anaesthetist according to body weight and response, typically an initial dose of about 0.05–0.1 mg/kg followed by smaller incremental doses.

Contraindications

Hypersensitivity to pancuronium or bromide ion.

Warnings and precautions

Must be given only by or under the supervision of experienced clinicians with facilities for airway management and ventilation. Effects are prolonged in renal or hepatic impairment, elderly patients and with certain drugs (volatile anaesthetics, aminoglycosides, magnesium); monitor neuromuscular function and reverse appropriately. Tachycardia and hypertension may occur; anaphylaxis to neuromuscular blockers is possible.

Pregnancy

Use only if clearly needed; it crosses the placenta in small amounts.

Storage and supply

Store at 2–8 °C in a refrigerator; protect from light.

Source: reference summary prepared from the EU SmPC/EPAR, BNF and WHO Model Formulary. The approved product information in Iran governs.