Pancuronium interaction

Crosby E, Robblee JA. Cyclosporine-pancuronium interaction in a patient with a renal allograft. Can J Anaesth 1988 35(3 Pt l) 300-2. 

Adults. 3 g PO q6h x 4 PRN Supl 1-2 g IM or IV repeat PRN Preeclampsia/pre-mature labor 4 g load then g/h IV inf Cardiac arrest 1-2 g IV push (2-4 mL 50% soln) in 10 mL DjW AMI Load 1-2 g in 50-100 mL D5W, over 5-60 min IV then 0.5-1.0 g/h IV up to 24 h (ECC 2005) Feds. 25-50 mg/kg/dose IM or IV q4-6h for 3-4 doses repeat PRN dose w/ low urine output or renal insuff Caution [B, +] Contra Heart block, renal failure Disp Inj 10, 20, 40, 80, 125, 500 mg/mL bulk powder SE CNS depression, D, flushing, heart block Interactions T CNS depression W/ antidepressants, antipsychotics, anxiolytics, barbiturates, hypnotics, narcotics EtOH T neuromuscular blockade Wf aminoglycosides, atracurium, gallamine, pancuronium, tubocurarine, vecuronium EMS Check for absent patellar reflexes this may indicate tox may cause hypokalemia (flattened T waves) and hypocalcemia OD May cause hypotension, resp arrest, T PR, QRS, and QT interval, AV block, and cardiac arrest calcium salts can be given to reverse resp depression... 

Driessen JJ, Vree TB, van Egmond J, Booij LH, Crul JF. In vitro interaction of diazepam and oxazepam with pancuronium and suxamethonium. Br J Anaesth 1984 56(10) 1131-8. 

Gramstad L. Atracurium, vecuronium and pancuronium in end-stage renal failure. Dose-response properties and interactions with azathioprine. Br J Anaesth 1987 59(8) 995-1003. 

Rashkovsky OM, Agoston S, Ket JM. Interaction between pancuronium bromide and vecuronium bromide. Br J Anaesth I985 57(II) I063-6. 

Johnston RR, Miller RD, Way WL. The interaction of ketamine with d-tubocurarine, pancuronium, and succinyl-choline in man. Anesth Analg 1974 53(4) 496-501. 

Belani KG, Anderson WW, Buckley JJ. Adverse drug interaction involving pancuronium and aminophylline. Anesth Analg 1982 61(5) 473. ... 

Clinically important, potentially hazardous interactions with chlorpropamide, diuretics, ethambutol, live vaccines, pancuronium, rifampicin, rifampin... 

Clinically important, potentially hazardous interactions with adefovir, aldesleukin, aminoglycosides, atracurium, bumetanide, carbenicillin, cephalexin, cephalothin, doxacurium, ethacrynic acid, furosemide, methoxyflurane, non-polarizing muscle relaxants, pancuronium, pipecuronium, polypeptide antibiotics, rocuronium, succinylcholine, teicoplanin, torsemide, tubocurarine, vecuronium... 

Clinically important, potentially hazardous interactions with aminophylline, atracurium, cisatracurium, doxacurium, epinephrine, ergometrine, mivacurium, non-depolarizing muscle relaxants, oxprenolol, oxytocin, pancuronium, rapacuronium, rifampin, vecuronium, xanthines... 

Clinically important, potentially hazardous interactions with cisatracurium, demeclocycline, doxacurium, doxycydine, gentamicin, kanamycin, minocycline, neomycin, oxytetracydine, pancuronium, rapacuronium, streptomycin, tetracycline... 

Clinically important, potentially hazardous interactions with acetazolamide, aminoglycosides, anticholinesterases, bambuterol, calcium channel blockers, chloroquine, chlorpromazine, clindamycin, d-pencillamine, ecothiophate iodine, enflurane, furosemide, halothane, hexomethonium, isoflurane, ketamine, lidocaine, lincomycin, lithium salts, magnesium salts, mannitol, MAO inhibitors, organophosphates, pancuronium, phenytoin, polymyxins, procainamide, quinidine, sevoflurane, spectinomycin, tetracyclines... 

Clinically important, potentially hazardous interactions with aluminum, aminophylline, carbamazepine, carbimazole, cyclosporine, daclizumab, diuretics, etoposide, etretinate, grapefruit juice, indomethacin, isoniazid, itraconazole, ketoconazole, licorice, live vaccines, methotrexate, naproxen, oral contraceptives, pancuronium, phenobarbital, phenytoin, rifampicin, troleandomycin... 

The skeletal muscle reiaxants provide muscle relaxation and/or immobility via N-receptor interactions. Most including d-tubocurarine, pancuronium, atracurium, and mivacurium, are competitive and nondepolarizing and can be reversed by AChE inhibitors. Succinylcholine is a depolarizing, noncompetitive agonist. 

Barth L. Paradoxical interaction between halothane and pancuronium. Anaesthesia (1973)... 

Cardiac arrhythmias can develop during the concurrent use of halothane and aminophylline but this seems less likely with isoflu-rane. One report attributes seizures to an interaction between ketamine and aminophylline. Supraventricular tachycardia occurred in a patient taking aminophylline when pancuronium was given. Isolated cases suggest that the effects of pancuronium, but not vecuronium, can be opposed by aminophylline. 

Marked resistance to the effects of pancuronium (but not vecuronium) was seen in one patient receiving an aminophylline infusion. Two other patients are reported to have shown a similar resistance but they had also been given hydrocortisone, which could have had a similar effect (see also Neuromuscular blockers + Corticosteroids , p.l21). These appear to be the only reports of such an interaction. 

Regan AG, Perumbetti PPV. Pancuronium and gentamicin interaction in patients with renal failure.. 4nestfi.4natg (1980) 59, 393. 

Giala MM Paradelis AG. Two cases of prolonged respiratory depression due to interaction of pancuronium with colistin and streptomycin. JAntimicrob Chemother (1979) 5, 234-5. 

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