Pancuronium Vecuronium

Synthetic compounds are pancuronium, vecuronium, atracurium and gallamine. All drugs of this class currently in clinical use have at least one quata-nary amine moiety and are constantly positively charged. This prevents these drugs from crossing the blood-brain barrier and from enteral resorption after oral administration. 

Nondepolarizing Blockers d-Tdbocurarine, Atracurium, Mivacurium, Pancuronium, Vecuronium, Rocuronium, and Rapacuronium... 

Agent Tubocuranine Pancuronium Vecuronium Atracurium Rocuronium Cisatracurium Mivacurium Cis-trans isomer Trans-trans isomer C/s-c/s isomer... 

Muscle relaxants may also contribute to anesthesia. Pancuronium 0.1 mg/kg has been reported to lower the MAC for halothane by 25% (135). It was conjectured that this could be due to a central effect or peripheral effect, through reduction of afferent input from muscle spindles to the reticular activating system. Recently, however, a similar though not identical study (SEDA-15, 124) (136) failed to confirm that pancuronium, vecuronium, or atracurium lowers the MAC for halothane. 

Pancuronium, vecuronium and atracurium are synthetic non-depolarizing neuromuscular... 

B. They may inhibit or reverse the actions of nondepolarizing neuromuscular blocking agents (eg, pancuronium, vecuronium, etc). Neostigmine Is used therapeutically for this purpose. 

Ferres CJ, Mirakhur RK, Pandit SK, Clarke RSI, Gibson FM. Dose-re nse studies with pancuronium, vecuronium anddieir combination. BrJ Clin Pharmacol 9ZA) 18,947-50. 

Brief early attempts to prepare drug-solid phases for the detection of IgE antibodies to the competitive, non-depolarizing, bulky and structurally rigid aminosteroid NMBDs pancuronium, vecuronium and rocuronium, met with only partial success but with the increasing popularity and use of rocuronium in recent years, a Phadia rocuronium ImmunoCap has been prepared by reacting the drug with succinic anhydride to prepare the hemisuccinate followed by activation to the... 

C32H37NO4 76811-98-8) see Fexofenadine hydrochloride 4-[4-[4-(hydroxydiphenylmethyl)-l-piperidinyl]-l-oxo-butyl]-a,a-dimcthylbenzeneacetic acid ethyl ester (C34H4[N04 76812-02-7) see Fexofenadine hydrochloride 3a-hydroxy-2p,16p-dipiperidino-5a-androstan-17-one (C2cjH4jN202 13522-14-0) see Pancuronium bromide Vecuronium bromide 9-hydroxyellipticine... 

CjHgOj 108-22-5) see Desoxycortone acetate Estriol Pancuronium bromide Pipecuronium bromide Vecuronium bromide... 

Vecuronium Rocuronium Pancuronium Atracurium Cis-atracurium Mivacurium Gallamine Tubocurare... 

Pancuronium is a synthetic compound now frequently used and not likely to cause histamine release or ganglionic blockade. It is approx. 5-fold more potent than d-tubocurarine, with a somewhat longer duration of actioa Increased heart rate and blood pressure are attributed to blockade of cardiac M2-cholinoceptors, an effect not shared by newer pancuronium congeners such as vecuronium and pipecuronium. 

Vecuronium is used for the same indications as pancuronium. A synonym of this drug is norcuron. 

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... 

Answer This feature of bradycardia is typical of patients who take (3-blockers, which should be continued so they result ultimately in better anesthetic management. The drugs given could have been modified (i.e., etomidate instead of propofol, which does not raise or may cause a slower heart rate). The potent opioids in the fentanyl family all cause vagal transmitted bradycardia. The muscle relaxant vecuronium (norcuron) has no effect on heart rate and could have been replaced by pancuronium, which has a vagolytic effect and will counter bradycardia in the usual induction bolus doses. 

Vecuronium bromide (Norcuron) is chemically identical to pancuronium except for a tertiary amine in place of a quaternary nitrogen. However, some of the drug will exist as the bisquatemary compound, depending on body pH. Vecuronium has a moderate onset of action (2.4 minutes) and a duration of effect of about 50 minutes. Like pancuronium, it does not block ganglia or vagal neuroeffector junctions, does not release histamine, and is eliminated by urinary excretion. 

Pancuronium is a synthetic steroidal compounds and approximately five times potent than d-tubocurarine. Vecuronium is congener of pancuronium with short duration of action. 

Berg H, Viby-Mogensen J, Roed J, et al. Residual neuromuscular block is a risk factor for postoperative pulmonary complications. A prospective, randomised and blinded study of postoperative pulmonary complications after atracurium, vecuronium and pancuronium. Acta Anaesthesiol Scandinavica 1997 41 1095-103. 

Bowman WC, Rodger IW, Houston J, et al. Structure action relationships among some desacetoxy analogs of pancuronium and vecuronium in the anesthetized cat. Anesthesiol 1988 69 57-62. 

The intermediate-acting steroid muscle relaxants (eg, vecuronium and rocuronium) tend to be more dependent on biliary excretion or hepatic metabolism for their elimination. These muscle relaxants are more commonly used clinically than the long-acting steroid-based drugs (eg, pancuronium, pipecuronium). 

Tubocurarine, metocurine, and succinylcholine have all been shown to elicit histamine release in humans. However, histamine release is less common with pancuronium and alcuronium. Vecuronium does not cause histamine release. 

Rocuronium Zemuron (also Vecuronium, Pancuronium, and Pipecuronium)... 

C.2H27N04 107188-37-4) see Troglitazone 17-acetoxy-5a-androsta-2,16-diene (C2 Hw()2 50588-42-6) see Pancuronium bromide Pipecuronium bromide Vecuronium bromide... 

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