Pancuronium (Br)

Pancuronium is a competitive neuromuscular blocking agent used during surgical procedures. Chemically Pancuronium (Br) is identified as 1,1-[3,17-bis (acetyloxy) androstane-2,16-diyl] bis (1-methylpiperidinium) dibromide. It has two acetylcholine like molecules in 2-3 and 16-17 positions on the steroid nucleus. Pancuronium (Br) is prepared by chemical synthesis. Pancuronium (Br) is administered parentrally.

Brands
PANCRON PAVULON PANCUR PANCURONIUM PARIUM WAYCRON WAYCRON
Adult Dose
Dose: 0.01 to 0.02 mg/ kg
Single Dose: 0.015 (0.015)
Frequency: As recommended.
Route: IV
Instructions: Incremental Dose. Overdosage should be avoided in obese patient.
Neonatal
Dose: 0.06 ug/kg
Single Dose: 0.06 (0.06)
Frequency: As recommended.
Route: Intra Venous
Instructions: Initially for Once
Paedriatic
Dose: 0.06 ug/kg
Single Dose: 0.06 (0.06)
Frequency: As recommended.
Route: Intra Venous
Instructions: Initially for Once
Characteristics
. It is of Synthetic origin and belongs to Acetylcholine. It belongs to Cholinergic nicotinic antagonist pharmacological group on the basis of mechanism of action and also classified in Muscle Relaxants and Neuromuscular Blocking Agent, Nondepolarizing pharmacological group.The Molecular Weight of Pancuronium (Br) is 732.70.
Contraindications
Pancuronium (Br) is contraindicated in conditions like Anuria.
Effects
The symptomatic adverse reactions produced by Pancuronium (Br) are more or less tolerable and if they become severe, they can be treated symptomatically, these include Tachycardia, Hypertension.
Indications
Pancuronium (Br) is primarily indicated in conditions like Induce neuromuscular blokage, Muscle relaxation (long duration) during intensive care, Muscle relaxation (long duration) for surgery and intubation.
Interactions
Pancuronium (Br) is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementAlbuterolsalbutamol enhace neuromuscular blockade produced by neuromuscular blockers e.g pancuronium and vecuroniumAmikacin (Sulphate)Amikacin possess the neuromuscular blocking activity, which is additive with pancuronium result in severe and prolonged respiratory depression.MajorClosely monitor the vital signs. Adjust dosage regimen accordingly. Ventilatory support should be readily available in case of respiratory arrest.AzathioprineAzathioprine decreases or reverse the effects of pancuronium by inhibiting phosphodiestrase in motor nerve terminals.MinorPatient should monitored for neuromuscular blockade and dose adjustment is necessary.BambuterolBendrofluazideButorphanol (Tartrate)CarbamazepineCarbamazepine reduces the duration effect of pancuronium.ModerateDuring coadministration close observation for decreasing effect of pancuronium is recommended.ClindamycinDesfluraneDigoxinPancuronium may enhance the arrhythmogenic effect of Digoxin. ModerateMonitor for the development of cardiac arrhythmias when Pancuronium is administered to patients who are receiving Digoxin.EnfluraneEnflurane potentiate the effects of pancuronium.ModerateDose of pancuronium should be reduce if necessary.Ethacrynic AcidEtherFrusemide or FurosemideFurosemide may diminish the neuromuscular-blocking effect of Pancuronium. Furosemide may enhance the neuromuscular-blocking effect of Pancuronium. ModerateBe aware that the therapeutic effects of Pancuronium may be altered by coadministration of Furosemide. Low doses of the Furosemide appear to enhance blockade, whereas higher doses may diminish blockade.GentamicinGentamicin by interfering with Calcium influx decrease sensitivity of acetylcholine at postsynaptic membrane thus inhibit release of acetylcholine at neuromuscular junction resulting in severe respiratory depression and paralysis.Death may also reported due to additive effect of both drugs.MajorGentamicin is avoided when pancuronium is given during or immediately after surgery.Adjust dose.HalothaneHalothane potentiate the effect of pancuronium.ModerateDose of pancuronium should be reduced if necessary. Inhalational anesthetics should be administered only by specially trained personnels.HydroflumethiazideIsofluraneKetamine (HCl)LithiumMivacurium (Cl)NeomycinNitrous OxideStreptomycinStreptomycin may increase the actions and side effects of Pancuronium (Br).TerbutalineTetracycline (HCl)TheophyllineTriamcinolone These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interfrence
Risks
Drug should not be given to patients suffering from Liver Malfunction, and Neonates.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
Inj Store in refrigerator. Do not Freeze.
Warnings
Exercise caution in pre-existing pulmonary, liver or kidney diseases. Avoid over dosage of pancuronium bromide.
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